Colorectal cancer - Week 5

Question 1

A benign tumour of the large bowel is called a…

Answer 1

adenoma

Question 2

A malignant tumour of the large bowel is called a…

Answer 2

adenocarcinoma

Question 3

Give the 4 types of colorectal polyps.

Answer 3

Inflammatory, Hamartomatous, Metaplastic, Neoplastic (adenoma)

Question 4

Which gene changes are associated with the development of cancer?

Answer 4

Activation of oncogenes and disactivation of tumour suppressor genes

Question 5

Which staging systems are used for colorectal cancer?

Answer 5

Duke’s and TNM

Question 6

N1 means that…

Answer 6

3 or fewer nodes are infiltrated

Question 7

N2 means that…

Answer 7

Greater than 3 nodes are affected

Question 8

Metastases from the colon often lodge in…

Answer 8

The liver or lungs

Question 9

Give some lifestyle factors which are protective of colon cancer.

Answer 9

Vegetables
Fibre
Exercise

Question 10

Give some lifestyle factors which are causative of colon cancer.

Answer 10

Red and processed meat
Alcohol
Smoking
Obesity

Question 11

Give 2 bowel cancers which are cause by autosomal dominant inheritance.

Answer 11

FAP and HNPCC

Question 12

FAP is caused by…

Answer 12

Mutation in the APC gene

Question 13

HNPCC is caused by…

Answer 13

Mutation in the mismatch repair gene

Question 14

Give 3 conditions which predispose patients to developing bowel cancer.

Answer 14

Adenomatous polyps, UC, Crohn’s

Question 15

What are the main symptoms of bowel cancer?

Answer 15

Pain, change in bowel habit, anaemia, rectal bleeding, tenesmus

Question 16

How is primary colorectal cancer diagnosed?

Answer 16

Barium enema, CT colography, sigmoidoscopy, colonoscopy

Question 17

What are the main uses of Faecal Occult Blood Testing (FOBT)?

Answer 17

Used for screening

Used in symptomatic patients as rule-out

Question 18

Which test is used in bowel screening?

Answer 18

Faecal Occult Blood Testing (FOBT)

Question 19

Which age group are invited to take part in bowel screening?

Answer 19

aged 50-75 every 2 years

Question 20

Which staging investigations may be carried out if a patient has confirmed bowel cancer?

Answer 20

CT of lungs and liver (abdo)

Question 21

What is the emergency presentation of bowel cancer?

Answer 21

Obstruction/Perforation - Distension, Constipation, Pain , vomiting

Question 22

How can obstruction be treated?

Answer 22

Colostomy +/- resection, Resection + anastamosis, stenting

Question 23

What is surgical treatment of colon cancer?

Answer 23

Varying degrees of colectomy

Question 24

What are the surgical treatments for rectal cancer?

Answer 24

Abdomino-perineal excision
Anterior resection
Local excision