Colorectal Cancer: 1. Routes of Spread 2. Treatment

1. Direct extension, lymphatics, blood, seeding, tends to spread in a radial fashion, rather than longitudinally 2. Surgery (it has not spread, colostomy, radiation, chemo)

Digestive System PPT Flashcards by Nick Calvin

What are the top (3) Cancers in Male estimated new cases

Prostate
Lung & Bronchus
Colon & Rectum

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What are the top (3) Cancers in Women estimated new cases

Breast
Lung & Bronchus
Colon & Rectum

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What are the top (3) Cancers in estimated deaths in Male

Lung & Bronchus
Colon & Rectum
Prostate

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What are the top (3) Cancers in estimated deaths in Women

Lung & Bronchus
Breast
Colon & Rectum

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What is the Digestive System made up of?

Gastrointestinal Tract
Upper Tract- mouth, esophagus & stomach
Lower Tract- Intestines
Accessory Structures- Salivary glands, liver, gallbladder & pancreas

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Colorectal Cancer:

Epidemiology and Incidence

More common in men than woman
More than 90% of cases occur in people older than 50 years of age
Declining in people over 50
Increases in people under 50

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Colorectal Cancer:

Risk Factors

Increase age
Diet high in animal fat and low in fiber
Diet high in processed and red meats and low in fruit and veggies
Obesity, smoking, excessive alcohol consumption, minimal physical activity
family history
chronic ulcerative colitis
polyps (precursor to cancer development)- size type

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Colorectal Cancer:

Signs and Symptoms

Rectal bleeding
blood in stool
change in bowel habits
feeling that the bowel is not empty
symptoms vary depending on part of the colon effected

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Colorectal Cancer:

Screening

Starting at age 50

Colonoscopy

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Colorectal Cancer:

Prognosis

Depends on how far into the bowel wall it is
Nodal involvement 
Metastasis
5-year survival rate 65%
10- year survival rate 58%
5- year survival rate 90% if found early

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Colorectal Cancer:

Routes of Spread
Treatment

Direct extension, lymphatics, blood, seeding, tends to spread in a radial fashion, rather than longitudinally
Surgery (it has not spread, colostomy, radiation, chemo)

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Intestinal tract- What are the (5) continuous layers?

Inner layer: includes mucus producing cells, mucus protects tissue and facilitates passage of contents thru tube.
Epithelial cells: rapid turnover, rate bc of wear and tear
Submucosal Layer: connective tissue, blood vessels, nerves, lymphatics and secretory glands
Muscularis: circular smooth muscle fibers, longitudinal smooth muscle fibers, both muscle fibers responsible for transport of food thru tract
Outer layer- Serosa: connective tissue layer, peritoneum

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Pancreatic Cancer

Epidemiology and Incidence

More common in men then women
accounts for about 2% of cancers diagnosed annually in US
rare in people younger than 45
occurs most often in patients 50-80 years old

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Pancreatic Cancer

Risk Factors

increase in age
cigarette smoking (twice the risk)
family history

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Pancreatic Cancer

Signs and Symptoms

Jaundice
Abdominal pain
Anorexia
Weight loss

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Pancreatic Cancer

Treatment

Surgery, chemo, radiation therapy

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Pancreas- anatomy (Location to other organ or structures)

Gland that extends across the abdomen from its tail
(abutting the spleen) to its head, largest end (encircled by the duodenum)
Retroperitoneal organ
Lies posterior to stomach

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What are the Pancreatic juices made up of?

amylase (digests carbohydrates)

lipase (digest fat)

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Esophageal Cancer

Epidemiology and incidence

Most common in men than women
3 to 4 times
Accounts for 1% of all cancers in the US
Usually diagnosed in patients between 55-85

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Esophageal Cancer

Risk Factors

80 to 90% of cases associated with alcohol and tobacco abuse
increases with the number of packs of cigarettes smoked per day and alcohol consumed

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Esophageal Cancer

Signs and Symptoms

dysphagia, weight loss, food sticking in throat or chest

burning sensation similar to heart burn

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Esophageal Cancer

Other risk factors

Barett’s esophagus- mucosal change in distal esophagus from stratified squamous columnar die to reflex leads to adenocarcinoma

GERD- may lead to adenocarcinoma
Achalasia- may lead to squamous cell carcinoma
Plummer-Vinsion syndrome- may lead to squamous cell carcinoma
Tylosis-mutation in chromosome 17, may lead to squamous cell carcinoma

Liver- anatomy, functions and or structures near by

Located in URQ of abdomen
Largest gland in body
Liver cells regenerate (hepatocytes)
Gluoneogenesis- conversion of protein and fat into glucose
Bile is secreted by liver

Liver Cancer

epidemiology & incidence

More common in men than women (3 times more)

Liver Cancer | Risk Factors

``` Chronic Hep B and C infections heavy alcohol consumption diabetes obesity smoking tobacco genetics ```

Liver Cancer | Signs & Symptoms

weight loss, loss of appetite, feeling very full after a small meal, mass, itching, swelling or fluid buildup in abdomen, jaundice

Cancers of the oral cavity region

1. lip 2. floor of mouth 3. tongue 4. buccal mucosa 5. the hard palate 6. the soft palate 7. the retromolar trigone

Liver Cancer 1. Prognosis 2. Treatment

1. 5 year survival rate for all stages is 18%, localized disease 31% 2. surgery, radiation (used for palliative) target therapies

Upper Gastrointestinal Tract

* mouth, esophagus, stomach, duodenum * digestion of carbohydrates begins in mouth with enzyme amylase from saliva * When stomach is empty stomach wall falls into folds (rugae) * Digestion of proteins begin in the stomach

What are the (3) sections in the small intestine?

1. duodenum- digestion continues here 2. Jejunum 3. Ileum- major site of absorption of nutrients (Ileocecal valve marks the entry point from the ileum into the large intestine)

Lower Gastrointestinal Tract consist of what?

``` Small intestines (section in other flashcard) Large intestine- Cecum-vermiform appendix it attached to it, ascending colon, transverse colon, descending colon, sigmoid colon, rectum and anal canal ```

Inflammation of the liver

Hepatitis A- contaminated water, shellfish Hepatitis B- Transmitted by infected blood Hepatitis C- May be transmitted by blood, transfusion and other fluids- no vaccine Hepatitis D- HBV present, blood transmission Hepatitis E- spreads oral fecal route

Functions of the Gallbladder

* contract releasing bile into duodenum * bile is major vehicle for cholesterol excretion, if crystallizes forms gallstone * blockage of the bile ducts causes jaundice

What are two disorders of the digestive system

Celiac disease- gluten free diet | Chronic inflammatory bowel disease- crohn's disease, ulcerative colitis

Other major disorders of the digestive system

* Intestinal obstruction- mechanical & functional * Appendicitis- inflammation and infection in the vermiform appendix * Peritonitis- inflammation of the peritoneal membrane

Digestive system | Diagnostic Tests

X-ray with barium contrast (oral or enema) ultrasound CT MRI sigmoidoscopy & colonoscopy laboratory analysis (stool and or gastric sample) blood test

Disorder in which liver demonstrates extensive diffuse fibrosis and loss of lobular organization

Cirrhosis- Leads to liver failure | 50% alcohol related

Upper Gastrointestinal Tract Disorders

Dental problems- caries, gingivitis, periodontist, periodontal disease Hyperkeratosis- leukoplakia- whitish plague or epidermal thickening of mucosa that occurs on the buccal mucosa, palate or lower lip

Double layer of peritoneum that supports the intestines and conveys blood vessels and nerves to supply the wall of the intestine

Mesentery

Ball of food

Bolus

Fatty diarrhea

Steatorrhea

Refers to red blood, often on the surface of the stool

Frank blood

Refers to small, hidden amounts of blood that are not visible to the eye but are detectable on test of a stool specimen

Occult blood

Refers to dark colored (tarry) stool that results from significant bleeding that has occurred higher in digestive tract. Dark in color caused by intestinal bacteria

Melena

Pain that is perceived as site distant from its origin

Referred pain

Refers to formation of gallstones

Cholelithiasis

Blood in the vomitus, brown, granular material resulting from the partial digestion in the stomach of protein in the blood.

Hematemesis

Dry Mouth

Xerostomia

Itching

Pruritus

Folds in the stomach

Rugae

Liver cells

Hypatocytes

Gastric content

Chyme

Pancreatic Cancer Prognosis

Tumor at head of pancreas causes early symptoms Tumor in body and tail of pancreas remains asymptomatic until advanced Liver failure is often cause of death Consider one of the deadliest overall survival rate 8%