Bowel cancer

mbch4kz2's version from 2016-04-16 15:41


Question Answer
What are the 4 main types of small bowel cancer?Adenocarcinoma, sarcoma, neuroendocrine (carcinoid), lymphoma
Name 5 risk factorsCrohn's disease, celiac disease, radiation exposure, hereditary GI cancer syndromes (familial adenomatous polyposis, hereditary nonpolyposis colorectal cancer), males
Name 3 early symptomsAbdominal discomfort associated with nausea, bloating and loss of appetite
Name 5 symptoms that may occur with advanced diseaseFatigue, eight loss, iron deficiency anaemia, malaena, severe nausea and vomiting, jaundice
Name 3 diagnostic testsBarium contrast study of the small intestine, upper GI endoscopy, CT of abdomen, colonoscopy
What is the primary treatment?Surgical removal (chemotherapy or radiotherapy if the cancer is widespread)
Where are colorectal cancers situated?71% in colon, 29% in rectum-- Rectal (40%), Sigmoid (30%), Descending colon (5%), transverse colon (10%), ascending colon and caecum (15%)
What is the most common form of inherited colon cancerHNPCC (also at risk of endometrial cancer)
What are the 2 most common familial conditions associated with single gene defects (account for 5-6% of colorectal cancers)Familial adenomatous polyposis (FAP) and Lynch syndrome
What is the disease process around FAP?Rare autosomal dominant condition that leads to the formation of hundreds of polyps by the age of 30-40. Patients develops carcinoma. Due to a mutation in the APC gene on chromosome 5. Patients generally have a total colectomy with an oleo-anal pouch formation in their twenties. Patients are also at risk from duodenal tumours
What are the 5 stages of colorectal cancerStage 0- Benign polyp in the mucosa, Stage 1- Spread to the muscular is layer, Stage 2- Spread through the colon wall towards the serosa, Stage 3- Spread through nearby lymph nodes, Stage 4- Metastasis
What gene mutation is present in 80% of cancersAPC gene mutation (tumour suppressor gene)
What gene mutation is present in 50-60% of colorectal cancerK-ras oncogene
What gene causes resistance to apoptosisp53 gene (causes massive growth that progresses to carcinoma
How is colorectal cancer screened for?Faecal occult blood test (FOBT)
Name 5 signs and symptomsRectal bleeding, change in bowel habit, rectal mass (DRE), positive family history, abdominal mass, anaemia (90% of right sided colon cancers cause anaemia), >50, abdominal pain, weight loss, abdominal distension (ascites or intestinal obstruction), palpable lymph nodes with advanced disease
Why would a FBC benefit testing?Anaemia
Name 7 diagnostic testsFBC, LFRs, U and Es, colonoscopy, double-contrast barium enema, CT colonoscopy, CT scan of thorax, abdomen and pelvis, tumour antigens (carcinoembryonic antigen- CEA)
Name 5 differential diagnosesIBS, UC, Crohn's, Haemorrhoids, Anal fissure, Diverticular disease
What is the first treatment option for stage 1, low risk cancerLocal excision
What are the treatment options for stage 1, high risk cancersSurgical resection and preoperative radiotherapy
What are the treatment options for Stage 2 and 3Surgical resection, preoperative chemoradiotherapy and postoperative chemotherapy
What are the treatment options for stage 4 cancers?Surgical resection, preoperative chemoradiotherapy, postoperative chemotherapy, Bevacizumag
What are the treatment options for non-surgical candidates?Chemotherapy, monoclonal antibodies, stenting