Colorectal Cancer

Colorectal Cancer

1. Risk factors

   • General
     • Age, History of colorectal cancer or polyps, History of inflammatory bowel disease (IBD), Obesity, Type II diabetes.
   • Genetics
     • Family history, Inherited syndromes, Racial and ethnic background
   • Lifestyle
     • Diet Smoking Alcohol use

2. Epidemiology

   • 2nd most common cancer and the 2nd highest cause of cancer deaths
   • 60% of patients were MEN
   • 85% >40 years old

3. Screening

   • should start at age 50.
   • People with a family history of colorectal cancer or polyps will start screening at age 40

4. Clinical presentation

   • Suspicious signs and symptoms
   • Routine screening
   • Emergency admission

5. S & S

   • hematochezia
   • Melena
   • Abdominal pain
   • Unexplained iron deficiency anemia
   • Change in bowel habits
   • Abdominal distention
   • Nausea and vomiting

6. pathophysiology

7. STAGES

8. management

   • depends on
     • Dukes’ Staging
       • Stage A
         • Surgical resection only
       • Stage B
         • Surgical resection, and adjuvant chemotherapy for high risk patients only
       • Stage C
         • Surgical resection + adjuvant chemotherapy Fluorouracil (FU) + Leucovorin (Folinic acid) for 6 months Follow-up with CEA level measured every 2 - 4 months for 3 years, and then every 6 months for 2 years.

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