Colorectal Carcinoma

Question 1

how common is it

Answer 1

3rd most common cancer

Question 2

what type of cancer is it usually

Answer 2

adenocarcinoma

Question 3

what are some predisposing factors

Answer 3

neoplastic polyps, IBD, genetic predisposition (FAP, HNPCC), diet (low fibre, increased red and processed meat), incr alcohol, smoking, previous cancer

Question 4

prevention

Answer 4

aspirin 75mg a day or above

Question 5

presentation left sided cancer

Answer 5

mass PR, altered bowel habit or obstruction, bleeding/mucus PR, tenesmus

Question 6

presentation right sided cancer

Answer 6

weight loss, decr Hb, abdominal pain, obstruction less likely

Question 7

presentation either side

Answer 7

fistula, haemorrhage, perforation, abdominal mass

Question 8

tests

Answer 8

FBC- microcytic anaemia, Faecal Occult Blood, sigmoidoscopy, barium enema, colonoscopy, LFT, CT/MRI, liver USS, CEA. if Fhx of FAP- DNA test at15

Question 9

what is the classification

Answer 9

dukes- A- limited to muscularis mucosae, B- extended, C- involvement regional lymph nodea, D- distant mets

Question 10

when is radiotherapy used

Answer 10

palliation. post op if high risk local recurrence

Question 11

prognosis

Answer 11

50% 5y. however depends on stage eg A is 93%, D is 6.6%

Question 12

what is a polyp

Answer 12

lump appearing above mucosa