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Pathobiology of Neoplasia > Colon Cancer > Flashcards

Flashcards in Colon Cancer Deck (26):
1

Incidence of CRC

2nd leading cause of deaths
3rd most common cancer in men and women
African American and Ashkanazi Jews

2

Risk factors for CRC

Diet high in fat, processed, fried foods and red meats
Inactivity
Obesity
Smoking
Etoh use
Race
Age
Family hx (1st degree relatives)
FAP and Lynch syndrome

3

What is the number 1 risk factor for CRC

Age >50

4

Characteristics of FAP

Autosomal dominant
Mutation of APC gene
TONS of polyps
Usually occurs in teens and early 20's

5

Characteristics of Lynch syndrome

Autosomal dominant
Many polyps but not as many as FAP
Mutation in MLH1 or MLH2
Proximal location of colon
Most patients

6

Screening recommendations for CRC

Beginning at age 50
OR 10 years earlier than age of family member diagnosed
OR 45 if African American
OR 7yrs after diagnosis of UC

7

Why do screening for CRC?

Most CRC develop from polyps
Reduction in cancer risk by 90%

8

Clinical presentation of CRC

Often ASYMPTOMATIC
-change in bowel habits
-bleeding/occult blood
-unexplained weight loss

9

Gold standard screening modality for CRC

Colonoscopy

10

Most CRC are at what stage when diagnosed?

39% are Localized (stage 1-2)

11

Treatment options for CRC

Surgery
Chemotherapy

12

Advantages of a Laprascopic colon resection

*Faster return of bowel function
Faster recovery
Minimally invasive

13

Treatment for rectal cancer

Surgery (LAR vs APR)
Neoadjuvant XRT and chemo
Possible ileostomy or colostomy

14

Difference between 2 types of Rectal Cancer surgery

LAR
-temporary diverting ileostomy
-no sphincter involvement

APR
-permanent colostomy
-sphincter involvement

15

Differences between Ileostomy and Colostomy

Ileostomy (small bowel).
-high liquid output (diarrhea)
-usually located in RLQ.
-no control of BM

Colostomy (colon)
-lower solid output
-can control BM

16

What is a surgical complication of an ileostomy?

-dehydration

17

Signs and symptoms of Anastomosis

Sepsis
Tachycardia
Leukocytosis
Hypotension
Abd pain
N/v

18

What are some possible Parastomal complications?

Retraction
Bleeding
Necrosis

19

Treatment options for liver mets

Surgery
RFA

20

Common sites of Mets in CRC

*Liver
Lung
Brain
Bone
Soft tissue
Local

21

Cytotoxic chemo used for CRC

FOLFOX

22

What is VEGF Inhibitor?

Used to stop VGEF from forming new blood vessels
-Avastin
-s/e: bleeding, clots, hypertension

23

What is a EGFR Inhibitor?

-attack EGFR
*Used in people who DO NOT have KRAS mutation
-Erbitux & Vectibix
*high incidence of infusion reaction

24

What is a Kinase Inhibitor?

Blocks several kinase proteins to stop cancer growth
*Stivarga

25

Surveillance after treatment

CEA q3 months x2yrs
Colonoscopy one year after surgery
Annual CT C/A/P x3yrs

26

Majority of CRC occur where?

30% occur in right colon