Bowel Cancer

Question 1

What are the red flag symptoms of bowel cancer? (Any 4)

Answer 1

Change in bowel habit 
Weight loss
Rectal bleeding 
Abdominal pain
Iron deficiency anaemia 
Abdominal/rectal palpable mass

Question 2

What are the referral criteria for USCC for bowel cancer?

Over __ years with abdo pain AND ___

Over __ years with unexplained ___

Over ___ years with change in bowel habit

Answer 2

40 unexplained weight loss

50 rectal bleeding

60

Question 3

What screening test is used in bowel cancer and who is it offered to?

Answer 3

Faecal immunochemical test (FIT)

Over 50 with unexplained weight loss

Under 60 with change in bowel habit

Question 4

What risk factors for bowel cancer warrant regular colonoscopies as screening? (3)

Answer 4

FAP

Lynch syndrome (HNPCC)

IBD

Question 5

What investigations can be done for bowel cancer? (4)

Answer 5

Colonoscopy

Sigmoidoscopy

CT colonography

CEA tumour marker in bowel cancer

Question 6

What staging scan can be done after a diagnosis of colorectal cancer to look for mets?

Answer 6

CT TAP

Question 7

What are the operations for colorectal cancer? And what do they involve? (Depends on cancer site) (5)

Answer 7

Right hemicolectomy (removal of caecum, ascending and proximal transverse colon)

Left hemicolectomy (removal of distal transverse colon and descending colon)

High anterior resection/sigmoid colectomy

Low anterior resection (removal of sigmoid and upper rectum, spares the anus and lower rectum)

APR (remove rectum and anus, leaves permanent colostomy)

Question 8

An ileostomy bag is found on the __ hand side of the patient

A colostomy bag is found on the __ side of the patient

Answer 8

Ileostomy Right

Colostomy Left

Question 9

What type of bag is needed after a low anterior resection of the bowel?

Answer 9

Ileostomy

Question 10

What are the 2 follow up investigations for people who have had surgical for bowel cancer?

Answer 10

CEA

CT TAP