Colorectal Cancer Flashcards Preview

Med/Surg 1 Exam 2 > Colorectal Cancer > Flashcards

Flashcards in Colorectal Cancer Deck (46):
1

Where does colorectal cancer start?

Colon or rectum

2

1 in how many will develop colorectal cancer?

1 : 20

3

What gender is more at risk?

Men

4

Most common over what age?

50
Incidence rises with increasing age

5

Nearly all of colorectal start of as?

Polyps

6

What are polyps?

Small vascular growths on the mucous membrane (in the glandular tissue of intestinal lining)

7

Where do most tumors develop ?

Sigmoid colon or rectum

8

What are hyperplastic polyps?

Generally harmless, small

9

What are adenomatous polyps?

Common: small tumor of epithelial tissue

10

What does most colorectal cancer from from?

Adenomatous --- > Adenocarcinomas

11

What are polypsosis syndromes?

Hereditary conditions which cause polyps
Usually rare, occurs in young people
**High chance of becoming cancerous**

12

What are some risk factors of colorectal cancer?

- Personal or family history of colorectal cancer, polypsosis disorders, inflammatory bowel disease
- Age >50
- Smoking
- Obesity
- Alcohol
- Radiation exposure
- Diets high in calories, fats, and meat proteins
- Presence of anaerobic gut bacteria

13

What is key in prevention of colorectal cancer?

Screening

14

For individuals over 50, what should they do for prevention?

- Yearly fecal occult blood test
- Stool DNA test
- Flexible Sigmoidoscopy every 5 year
- Double contrast barium enema every 5 years
- Colonoscopy every 10 years
- CT colonography every 5 years
- *MAY reduce incidence: exercise, MVI, aspirin, NSAIDS

15

What is the initial manifestation to seek care?

Rectal bleeding

16

Clinical manifestations of colorectal cancer?

Changes in bowel habits
Pain
Anorexia/weight loss
Abdominal mass
Fatigue
Anemia

17

What are some diagnostic tools/tests used for colorectal cancer?

- Endoscopy (Full colonoscopy better than sigmoidoscopy- can detect 50-65%)
- Biopsy of tissue
- Fecal blood tests
- CBC
- Carcinoembryonic Antigen (CEA)

18

What can CEA be used for?

Monitor course of treatment, prognosis
*Detect possible areas of metastasis

19

TNM Staging system: Colorectal Cancer

T is for what?

How far a tumor has grown into the intestinal wall and whether it has grown into nearby areas

20

TNM Staging system: Colorectal Cancer

N is for what?

The extent to nearby (regional) lymph nodes

21

TNM Staging system: Colorectal Cancer

M is for what?

Whether the cancer has spread (metasized) to other organs of the body (most common in colorectal cancer- liver and lungs)

22

What is a "treatment of choice" for colorectal cancer?

Surgical resection (w/ anastomosis) of tumor, adjacent colon and regional lymph node

23

What are some medical treatments for colorectal cancer?

- Surgical resection
- Excision of tumor (sometimes done during endoscopy)
- Laser photocoagulation
- Abdominal resection with permanent colostomy
- Fulguration
- Chemo and EBR (post-op typically)
- Brachytherapy

24

What is laser photocoagulation?

Beam of light to generate heat, destroys small tumors, palliative-obstructions

25

In abdominal resection with permanent colostomy, what wants to be preserved and avoided?

Attempt to preserve anal sphincter and avoid colostomy

26

What is fulguration?

Uses electrical current to kill cancer tissue similar to cauterization

27

In a bowel resection, what is removed?

All or part of large intestine

28

For what type of patients is bowel resection used?

Patients with early stage tumors
High cure rate

29

Bowel resection often leads to what?

Creation of a colostomy (can be either permanent or temporary depending on factors)

30

What are the two types of bowel resection?

Open and laparascopic

31

What chemo drugs are usually used with colorectal cancer?

Fluorouracil (5-FU)
Folonic Acid (Leucovorin)

32

How are the chemo drugs usually given?

IV
sometimes topically

33

What are the side effects of Flurouracil and Folonic Acid?

N/V
Diarrhea
Alopecia
Photosensitivity
Cardiotoxicity
CNS Damage

34

Fluorouracil is usually combined with what other therapy?

Radiation

35

What is a sigmoid colostomy?

Most common: permanent: Cancer of the rectum

36

A double barrel colostomy has what kinds of stomas?
Objective?

- Distal stoma- colon is bypassed expels mucus
- Proximal stoma- functional, diverts feces to abdominal wall

37

Colostomy:
Transverse Loop

Emergency to relieve obstruction or address perforation:
Temporary

38

Colostomy:
Hartman Procedure

Temporary
Distal portion left in place and oversewn for closure
Follow up 3-6 months with reanastamosis
Usually for trauma

39

What should included in the ostomy education?

- Promote quality of life "live your life"
- Monitor medications (changes in bowel habits)
- Well-balanced diet (avoid certain foods)
- Colostomy irrigation (enema through stoma)

40

What should be included in ostomy care?

- Clean with soap and water, pat dry
- Post-op, watch for incision
- Check for leaks
- Cut wafer slightly larger than stoma
- Stoma paste-various products
- Bag "burp" if full of gas

41

What should be emphasized on patient education with colorectal cancer?

Screening

42

What is the survival rate for people with stage 1?

5 year rate of 74-90%

43

How does colon cancer spread throughout?

Direct extension of the entire bowel, circumference, submucosa and outer bowel walls, neighboring structures

44

What is another name of Lynch syndrome?

Hereditary nonpolyposis

45

What is lynch syndrome?

Autosomal dominant disorder
Increase occurrence of all cancers

46

What is the indicator that the bag is working?

Bag "burp" if full of gas