Colon cancer Flashcards

(37 cards)

1
Q

Where does colon cancer most commonly affect?

A

2/3rd is colonic
1/3rd is rectal

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2
Q

Where is most commonly affected by colon cancer?

A
  • rectal — 40%
  • sigmoid — 30%
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3
Q

What are the possible risk factors for colon cancer?

A
  • age (>60 years)
  • alcohol, smoking
  • low-fibre diet, red meat
  • IBD
  • neoplastic polyps
  • genetic predisposition
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4
Q

What are the main genetic causes of colon cancer?

A
  • Sporadic ⇒ 95%
  • HNPCC ⇒ 5%
  • FAP ⇒ 1%
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5
Q

What is HNPCC the most common cause of?

A

Inherited colon cancer

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6
Q

What is another term for HNPCC?

A

Lynch syndrome

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7
Q

What type of inheritance does lynch syndrome have?

A

Autosomal dominant condition

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8
Q

Where does HNPCC most commoly affect?

A

Proximal colon

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9
Q

What are the main mismatch repair genes that cause HNPCC?

A

MSH2 (60% of cases)
MLH1 (30% of cases)

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10
Q

What other cancers are associated with HNPCC?

A

Endometrial cancer
Prostate cancer

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11
Q

What does FAP stand for?

A
  • Familial adenomatous polyposis
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12
Q

What type of inheritance does FAP have?

A

A rare autosomal dominant condition

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13
Q

What does FAP cause?

A

The formation of hundreds of polyps by the age of 30-40 years

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14
Q

What are the main symptoms of colon cancer?

A

Abdominal pain
Rectal bleeding
Change in bowel habit
Weight loss
Iron-deficiency anaemia

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15
Q

What can be used to stage colon cancer?

A

Duke’s classification

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16
Q

What is Dukes A?

A

Limited to the bowel wall (i.e. not beyond the muscularis).

17
Q

What is Dukes B?

A

Extends through the bowel wall (i.e. beyond the muscularis).

18
Q

What is Dukes C?

A

Regional lymph node involvement

19
Q

What is Dukes D?

A

Distant metastases

20
Q

What is the current NHS screening for colon cancer?

A

Faecal immunochemical test (FIT) every 2 years for men and women age 60-74

21
Q

If a FIT test is positive, what is the next investigation?

A

Sigmoidoscopy

22
Q

What is the first investigation for colon cancer?

23
Q

What is the function of a FIT test?

A

Used to detect, and can quantify, the amount of human blood in a single stool sample

24
Q

What is the fuction of a colonscopy?

A

Direct visualization of the colon
Biopsies to be taken
Removal of any polyps seen

25
What can be done as an alternative to a colonscopy if it cannot be tolerated?
CT colonoscopy
26
What can be used to stage colon cancer?
CT chest, abdomen and pelvis
27
What is the function of CEA?
To monitor the theraputic response to intervention
28
What staging can be used for colon cancer?
TNM staging
29
What is the management of stage 1-3 disease?
Surgical resection ± post-operative chemotherapy.
30
What is right hemicolectomy surgery for?
Tumours of the caecum and ascending colon
31
What is left hemicolectomy surgery for?
Distal transverse colon and descending colon
32
What is sigmoid colectomy surgery for?
Tumours of the sigmoid colon.
33
What is the surgical management of tumours >8 cm from the anal canal or involving the proximal 2/3 of the rectum?
Anterior resection
34
What is the surgical management of recal tumours <8 cm from the anal canal or involving the distal 1/3 of the rectum.
Abdomino-perineal (AP) resection
35
What symptoms in someone over 40 would require an urgent 2 week wait referal?
Unexplained weight loss AND abdominal pain
36
What symptoms in someone over 50 would require an urgent 2 week wait referal?
Unexplained rectal bleeding
37
What symptoms in someone over 60 would require an urgent 2 week wait referal?
Iron–deficiency anaemia Changes in their bowel habit