August 13, 2015 - Colorectal Neoplasia

Question 1

The Beginning of Colorectal Cancer

Answer 1

This begins with polyps along the colon.

The polyps can either be adenomatous (neoplastic or premalignant), or non-adenomatous (not neoplastic and not premalignant). Either way, the polyps are removed and biopsied.

Question 2

Adenomatous Polyps

Answer 2

Resemble glandular structures (form from glands). These are neoplastic or premalignant.

Only 5-10% of polyps are under this category, however these will turn into cancer over a period of 5-10 years.

Question 3

Adenomas and Carcinomas

Answer 3

Adenomas will turn into carcinomas over a period of 5-10 years.

Question 4

Polypectomy

Answer 4

The removal of polyps.

Polyps are snared with a metal wire and an electric current is passed through the wire which burns the skin and cauterizes the wound. The polyps are then removed.

Question 5

Family History and Colorectal Cancer

Answer 5

1st degree relative with CRC before age 65 increases your relative risk by approximately 2.0.

Two or more 1st degree relatives increases your relative risk 3-4 times.

Having a 1st degree relative who got CRC before age 45 increases your risk 5 times.

Question 6

Modes of Spread of CRC

Answer 6

1. Direct continuity
2. Transperitoneal spread

3. Lymphatic spread to regional lymph nodes

4. Hematogenous spread (especially to the liver)

Bold is most common methods for CRC

Question 7

Colorectal Cancer Prognosis

Answer 7

Stage 1 - 95%

Stage 2 - 60-80%

Stage 3 - 20-50%

Stage 4 - 5%

CRC has a fairly good prognosis when detected early.