Colon Cancer Flashcards

Question

FAP

Answer 1

Rare, 1% of all CRC Autosomal dominant Hundreds - thousands of polyps 100% cancer if untreated ***YEARLY screening for polyps

Answer 2

``` Hereditary NonPolyp Colon Cancer Rare, 1-5% of all CRC Autosomal dominant Less than 100 polyps Lynch Syndrome I -CRC at early stage in particular family Lynch Syndrome II -80-85% chance of CRC over lifetime -Other cancers usually present -Usually diagnosed after cancer -Screening and prophylactic surgery recommended in carriers ```

Answer 3

IBD - UC - Crohns (less than UC)

Answer 4

``` High fiber Low fat High antioxidants Calcium rich diet Vitamin D ```

Answer 5

``` Diet NSAIDs and COX-2 inhibitors -Celecoxib to reduce polyps in FAP Aspirin Postmenopausal hormones Calcium 1000-1200mg if over 50 Vitamin D 400 IU Colectomy ```

Answer 6

Celecoxib | COX-2 inhibitor

Answer 7

Fecal Occult Blood Test

Answer 8

Digital Rectal Exam Annually @ Age 40 Detects ~10% of cancers Only 7-10cm of anus

Answer 9

``` Annual or biannual @ 50 ***Avoid Red Meat 3 types: Guac Dye Heme Porphyrin Immunochemical Assay 70% False Neg for Cancer 90% False Neg for Polyps 1.5% False Pos - Red meat ```

Answer 10

Examines lower third of colon MAY reduce mortality Increases detection rate by 2-3 fold

Answer 11

Age over 50 No history of adenoma, CRC, or IBD No family history

Answer 12

Digital Rectal Exam Fecal Occult Blood Test Flexible Sigmoidoscopy Total Colonic Exam (colonoscopy)

Answer 13

``` Stage III/IV Disease T4 Disease Positive Margins Lymph node involvement Pre-op CEA (antigen) greater than 5 Rectal bleeding Bowel perforation Bowel obstruction Grade 3,4 lesion ```

Answer 14

``` Surgery -colectomy or lymph node resection Radiation -well est for rectal cancer -adjuvant radiation has no role in colon cancer Chemo -Neoadjuvant -before surgery -Adjuvant -after surgery -In metastatic, used for palliation and to prolong survival ```

Answer 15

Useful in rectal cancer | ***NO ROLE in colon cancer

Answer 16

Routine surveillance | +/- surgery to remove polyps

Answer 17

``` Consider adjuvant therapy with Capecitabine or 5-FU/LV Clinical Trial or Observation Consider FOLFOX, CapeOx, or FLOX for pts with: T4 or High risk of recurrence ```

Answer 18

``` Adjuvant therapy Preferred: FOLFOX or CapeOx Category 1: FLOX Other: 5FU/LV or Capecitabine ```

Answer 19

Manage with chemotherapy surgery +/- biologic therapy

Answer 20

Fluorouracil (bolus and IV) Leucovorin Oxaliplatin

Answer 21

Fluorouracil (bolus only) Leucovorin Oxaliplatin

Answer 22

Increases activity of 5-FU | (also increases 5-FU's ADEs - esp GI)

Answer 23

EGFR Inhibitor Must check for EGFR and KRAS mutations Main ADE: acneiform rash

Answer 24

EGFR Inhibitor Must check for EGFR and KRAS mutations Main ADE: acneiform rash

Answer 25

``` Block angiogenesis and inhibit tumor growth Agents: Bevacizumab Ziv-Aflibercept Regorafenib Class related ADEs: HTN Hematologic (bleeding and thrombosis) ```

Answer 26

Vascular Endothelial Growth Factor Targeted Therapy Blocks angiogenesis ADEs: HTN Bleeding Thrombosis

Answer 27

Vascular Endothelial Growth Factor Targeted Therapy Blocks angiogenesis ADEs: HTN Bleeding Thrombosis

Answer 28

Vascular Endothelial Growth Factor Targeted Therapy Blocks angiogenesis ADEs: HTN Bleeding Thrombosis

Answer 29

Myelosuppression - neutropenia - anemia - decreased platelets

Answer 30

``` GI -mucositis -N/V/D Hand-foot syndrome -hands and feet turn red, raw and dry ```

Answer 31

Oral prodrug of 5-FU, so similar to continuous IV 5-FU ADEs -GI N/V/D

Answer 32

Caused by abnormal absorption and secretion of fluids and electrolytes. Prevalence 30-40% Severe 10-20%

Answer 33

Diarrhea caused by acute cholinergic properties - atropine | Delayed - loperamide or lomotil

Colon Cancer Flashcards

(57 cards)