Colorectal Cancer
CRC the 2nd leading cause of cancer related deaths
Risk is higher in men & increases with age
Blacks are most likely to develop and die from CRC
CRC may occur at an earlier age in Blacks and Hispanics
Hispanics and Asians are least likely to undergo CRC screening
Assessment:
Develop slowly, symptoms do not appear until the disease is advanced
In early diseaseg fatigue and weight loss
As it progressesg abdominal pain and tenderness with change in bowel habits, palpable
abdominal mass, hepatomegaly, ascites
Right-sided CRCg bleeding, diarrhea
Left-sided CRCg hematochezia (fresh blood in stool), detected later & present w/bowel
obstruction
Complications: obstruction, bleeding, perforation, peritonitis, and fistula formation
Risk Factors:
Hx of IBD, or diabetes
Family hx of CRC in 1st degree relative
Family or personal hx of familiar adenomatous polyposis (FAP)
Family or personal hx of hereditary nonpolyposis colorectal cancer (HNPCC) syndrome
Obesity (BMI > 30)
Red meat >7 servings/wk
Alcohol >4 drinks/wk
Cigarette smoking
Colorectal Cancer Screenings:
Colon Screening (Age 45 to Age 75)
Colonoscopy (every 10 years)-gold std CRC screening
Flexible sigmoidoscopy (every 5 years)
Double-contrast barium enema (every 5 years)
CT colonography (virtual colonoscopy) (every 5 years)
Tests that primarily find cancer:
High sensitivity fecal occult blood test (FOBT) every year
Fecal immunochemical test (FIT) every year
Stool DNA test every 3 years
Once dx’ed with CRCg CBC to check for anemia and liver function test
o CT scan, PET scan, or MRI to detect metastasis
Planning:
Goal of surgical therapy: complete resection of the tumor, thorough exploration of abdomen
to determine the cancerous spread, removing all lymph nodes that drain the area where the
cancer is located, restoring bowel continuity to promote normal bowel function
Overall goal: Normal bowel elimination patterns, quality of life appropriate to the disease
progression, relief of pain, feelings of comfort and well-being
Interventions:
CRC the 2nd leading cause of cancer related deaths
Risk is higher in men & increases with age
Blacks are most likely to develop and die from CRC
CRC may occur at an earlier age in Blacks and Hispanics
Hispanics and Asians are least likely to undergo CRC screening
Assessment:
Develop slowly, symptoms do not appear until the disease is advanced
In early diseaseg fatigue and weight loss
As it progressesg abdominal pain and tenderness with change in bowel habits, palpable
abdominal mass, hepatomegaly, ascites
Right-sided CRCg bleeding, diarrhea
Left-sided CRCg hematochezia (fresh blood in stool), detected later & present w/bowel
obstruction
Complications: obstruction, bleeding, perforation, peritonitis, and fistula formation
Risk Factors:
Hx of IBD, or diabetes
Family hx of CRC in 1st degree relative
Family or personal hx of familiar adenomatous polyposis (FAP)
Family or personal hx of hereditary nonpolyposis colorectal cancer (HNPCC) syndrome
Obesity (BMI > 30)
Red meat >7 servings/wk
Alcohol >4 drinks/wk
Cigarette smoking
Colorectal Cancer Screenings:
Colon Screening (Age 45 to Age 75)
Colonoscopy (every 10 years)-gold std CRC screening
Flexible sigmoidoscopy (every 5 years)
Double-contrast barium enema (every 5 years)
CT colonography (virtual colonoscopy) (every 5 years)
Tests that primarily find cancer:
High sensitivity fecal occult blood test (FOBT) every year
Fecal immunochemical test (FIT) every year
Stool DNA test every 3 years
Once dx’ed with CRCg CBC to check for anemia and liver function test
o CT scan, PET scan, or MRI to detect metastasis
Planning:
Goal of surgical therapy: complete resection of the tumor, thorough exploration of abdomen
to determine the cancerous spread, removing all lymph nodes that drain the area where the
cancer is located, restoring bowel continuity to promote normal bowel function
Overall goal: Normal bowel elimination patterns, quality of life appropriate to the disease
progression, relief of pain, feelings of comfort and well-being
Interventions:
