Colon Cancer

Question 1

precursors to colon cancer?

Answer 1

adenomatous polyps

Question 2

treatment of colon cancer?

Answer 2

surgery, radiotherapy, chemotherapy

Question 3

what is Dukes a, b and c?

Answer 3

Dukes A - confined to muscularis propria
Dukes B - throough muscular propria
Dukes C - metastatic to lymph nodes

Question 4

what other staging can be used in colon cancer, other than Dukes?

Answer 4

TNM

Question 5

what is more common? left sided or right sided colon cancer?

Answer 5

left sided (75%)

Question 6

General signs?

Answer 6

anaemia, cachexia, lymphadenopahy, mass hepatomegaly,distension mass, blood

Question 7

what in diet makes colorectal cancer more likely?

Answer 7

diet rich in fat and meat, low in fibre

Question 8

what are the two best predictors for colorectal cancer?

Answer 8

age and family history

Question 9

which IBD is heavily assocaited with colorectal cancer?

Answer 9

UC

Question 10

cancer of the small bowel, common?

Answer 10

very rare, although it has very high cell turnover

Question 11

many of genes associated with colon cancer are found on ?

Answer 11

5q and 18q

Question 12

name of the lymph node at the umbilicus which is a sign on metastatic spread ?

Answer 12

sister mary joseph nodule

Question 13

thinking about anatomy, where is spread of colorectal cancer to?

Answer 13

liver

Question 14

how does colorectal cancer spread?

Answer 14

through bowel wall to local lymph nodes

Question 15

when would you use a barium enema?

Answer 15

where colonoscop cannot be performed

Question 16

Dukes stage D?

Answer 16

widespread metastases

Question 17

how do you check for mets?

Answer 17

CT chest, pelvis and abdo

Question 18

treatment of choice for Dukes A-C

Answer 18

Resection

Question 19

when can radio and chemotherapy be used?

Answer 19

Dukes B and C

Question 20

treatment in Dukes D?

Answer 20

palliative

Question 21

how big a margin do you leave on each side of the tumour

Answer 21

2cm

Question 22

what is usually done surgically after tumour recessed?

Answer 22

anastamoses

Question 23

outcome compared to lung cancer or gastric cancer ?

Answer 23

better

Question 24

how long to live once metastatic disease has been diagnosed?

Answer 24

6 months

Question 25

does an ademona have the potential to become malignant?

Answer 25

yes

Question 26

a rare finding, reflecting something that polyps secrete?

Answer 26

hyperkalaemia secreted by polyps

Question 27

which mutations occur in 75% of carcinomas?

Answer 27

P53- mutations to this occur in more than 75% of carcinomas.

Question 28

you can sometimes get protein in ascites - why would this happen?

Answer 28

local spread into peritoneal cavity

Question 29

where can bowel cancer spread to ?

Answer 29

LIVER, lungs, bone

Question 30

alternating bowel habit - left or right sided cancer?

Answer 30

right

Question 31

iron deficiency anaemia more common on right or left sided colorectal cancer?

Answer 31

right

Question 32

high risk of Recurrence in ?

Answer 32

Rectal cancers

Question 33

what are FOBT used for?

Answer 33

screening

Question 34

downside of barium enema?

Answer 34

misses all the detail that would be picked up on colonoscopy

Question 35

what is used as chemotherapy ?

Answer 35

5 flurouracil

Question 36

what is FAP?

Answer 36

familial adenomatous polyposis

Question 37

what do patients with FAP have?

Answer 37

more than 100 polyps lining the colon

Question 38

less than 100 polyps?

Answer 38

HNPCC