Colorectal cancer and Breast cancer

Question 1

State the ages and frequency for breast cancer screening

Answer 1

50 - 71
Done every 3 years

Question 2

State the ages and frequency for bowel cancer screening

Answer 2

50 - 75
Done every 2 years (home kits - FIT test = faecal immunochemical test)

Question 3

Outline common sites of metastasis for breast cancer

Answer 3

LLBB

Lung
Liver
Brain
Bone

Question 4

Outline common sites of metastasis for bowel cancer

Answer 4

LLLP

Lung
Liver
Lymph nodes
Peritoneum

Question 5

List some risk factors for colorectal cancers (modifiable and non-modifiable)

Answer 5

Non-modifiable:
- Family history
- Increasing age
- Genetic conditions e.g. FAP / HNPCC
- Inflammatory bowel conditions e.g. Crohn’s

Modifiable:
- Red / processed meats
- Obesity
- Alcohol
- Smoking

Question 6

State the top 3 anatomical places where colorectal cancer is most commonly found

Answer 6

Rectum (32%)
Sigmoid colon (23% cases)
Caecum (12%)

Question 7

State presenting factors for colorectal cancer

Answer 7

• PR bleeding
• Change in bowel habit (increased frequency, altered consistency, prolonged constipation or diarrhoea)
• Tenesmus
• Abdominal mass
• Weight loss

Signs:
- Mass on DRE / abdominal mass
- Signs of anaemia

Question 8

State the diagnostic investigations for suspected colorectal cancer

Answer 8

Colonoscopy and biopsy
(CT colonoscopy is 2nd line)

Staging CT scan
If local rectal cancer, MRI can be used to assess local tumour

Question 9

State the management steps for colorectal cancer

Answer 9

• Surgical resection +/- neoadjuvant/adjuvant chemotherapy, targeted therapies or radiotherapy

Question 10

State some hormonal therapies that can be used in the management of breast cancer

Answer 10

Tamoxifen = blocks oestrogen receptors

Aromatase inhibitors e.g. Anastrozole, Letrozole = block aromatase enzyme from converting androgens to oestrogen

LH blockers e.g. Goserelin = stops production of LH, reduces production of oestrogen by the ovaries

Fulvestrant = blocks oestrogen receptors on the cancer cells