Colorectal cancer Flashcards
1
Q
what is the most common type of colorectal cancer?
A
adenocarcinoma
2
Q
what is the aetiology of adenocarcinoma?
A
- most are sporadic –> most of these are due to pre-existing polyps
- familial –> HNPCC, FAP
- 1% asscoiated with IBD
3
Q
Risk Factors?
A
- MALE
- age
- previous adenoma
- environmental factors ie smoking, alcohol
4
Q
Pathology?
A
- activation of oncogenes –> KRAS
- loss of tumour suppressor genes –> p-53
- microsatellitle instability
5
Q
Symptoms and signs?
A
- rectal bleeding
- altered bowel habit –> diarrhoea
- palpable mass
- weight loss / anorexia
- iron deficiency anaemia
- if stenosing tumour –> colonic obstruction
6
Q
Staging?
A
Duke A- tumour limited to mucosa
Duke B- tumour expands through muscle layer
Duke C- lymphatic spread
Duke D- distant metastatic spread
7
Q
Investigation?
A
Colonoscopy
- allows to take biopsies at the same time
- can be therapeutic as well as diagnostic - if see a polyp, can be resected
8
Q
Treatment?
A
Surgery w/
- radiotherapy as neoadjuvant therapy
- chemotherapy as adjuvant therapy, mops up micro-metastases
