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Flashcards in Colorectal Cancer Deck (14):
0

How common is colorectal cancer?

2nd most common cancer in the uk

1

What are the risk factors for colorectal carcinoma?

Diet- High in fats and low in fibre
IBD- ulcerative colitis
Genetics- HNPCC, FAP, Gardner's

2

What is the most common histologic type of colorectal carcinoma?

Adenocarcinoma- 90-95%
Mucous/signet ring

Others include:
Squamous cell
Carcinoid
GIST
Primary malignant lymphoma

3

Where are colorectal carcinomas most commonly located?

Rectum- 40%
Sigmoid colon-20%
Caecum - 6%
Remaining colon- 34%

4

How does colorectal cancer spread?

Local invasion
Lymphatic
Venous
Transcoelomic

5

Where does colorectal cancer tend to spread?

Hepatic metastases most common

6

What tests might be used as a screening test for colorectal cancer?

Faecal occult blood

7

What is the occult presentation of colorectal cancer?

Iron deficiency anaemia in colorectal cancer located in the right side of colon and caecum

8

What is the dukes staging system for CRC?

A- invades mucosa and sub mucosa
B- penetrates muscularis mucosa
C- lymph nodes
D- metastases

9

Investigations for CRC?

Rectal exam - detects 75%!
Rigid sigmoidoscopy - up to 25cm
Flexible sigmoidoscopy
Colonoscopy
Double contrast barium enema
CT - staging
Carcinoembryonic antigen - monitoring

10

When is surgery used in CRC?

In early stage - usually curative, standard choice due to unsuspected nodal mets

In advanced disease- resection of liver metastases, resection of local reoccurrence

Palliative - surgery/colonic stunting for obstructive lesions

11

When is radiotherapy used in CRC?

In rectal carcinomas as less risk to other organs

For local recurrence or treatment of metastatic bone disease

12

When is chemotherapy used in CRC

Adjuvant for high risk cases, dukes c+

Oxaliplatin, irinotecan, 5FU

13

What is the prognosis of the different dukes stages of CRC

A- 80% five year survival
B- 50%
C- 15-40%
D- 5%