Transcript Colon Cancer

Colorectal Cancer
Colorectal cancer - statistics
Leading causes of cancer death in the
US
Male
Female
Lung – 31%
Lung – 25%
Prostate – 11%
Breast – 11%
Colorectal –10%
Colorectal –11%
Colorectal cancer - statistics
 Affects 150,000 new patients per
year
 Accounts 60,000 deaths annually
 Peak incidence at 70-80 years
Large Intestine - Colon
Layers of the large intestine
1.
2.
3.
4.
Mucosa
Submucosa
Muscularis externa
Serosa
Changes associated with aging
a) Decreased secretory mechanisms;
b) Decreased motility;
c) Loss of strength and tone of the
muscular tissue;
d) Diminished response to pain and
internal sensations
Colon cancer
Risk factors
1. Diet
2. Alcohol consumption
3. Smoking
4. Hypovitaminosis
5. Genetics
6. Obesity
Colon Cancer
Premalignant conditions and diagnoses:
1. Crohn’s disease
2. Non-specific ulcerative colitis
3. Polyps
4. Polyposis
5. Villous adenomas
Classification of colon cancer
I External grow
II Infiltrative grow
III Mixed grow
Classification of colon cancer
1)
2)
3)
4)
5)
adenocarcinoma
mucous adenocarcinoma
mucocellular carcinoma
non-differentiated cancer
non-classified cancer
Classification of rectal cancer
1)
2)
3)
4)
5)
6)
7)
adenocarcinoma
mucous adenocarcinoma
mucocellular carcinoma
squamous cell carcinoma
glandular-squamous cell carcinoma
non-differentiated cancer
non-classified cancer
Classification of colorectal cancer
TNM – system
T1 - up to mucosa and submucosa
T2 - up to muscular or serous layer
T3 - outside of the bowel
T4 – other organs are involved
Classification of colorectal cancer
TNM-system
N1 – lesions in regional nodules
N4 – lesions in other nodules
M0, M1, MX
G1, G2, G3, GX
Classification of colon cancer
Dukes system:
Dukes A – tumor within the muscularis
propria
Dukes B – tumor invading the
muscularis
Dukes C – tumor with positive lymph
nodes
Dukes D - metastases
Clinical features of colon cancer
1.
2.
3.
4.
Vague abdominal pain
Rectal bleeding
Change in bowel habits
Systemic syndromes
a) weakness
b) malaise
c) fatigue
Colorectal cancer
I. Iron-deficiency anemia in an
elderly male patient is colon cancer
until proven otherwise
II. Large bowel obstruction in all
patients is colon cancer until proven
otherwise
Clinical forms of colon cancer
1.
2.
3.
4.
5.
6.
Asymptomatic
Toxic
Enterocolitis -like
Dyspepsia -like
Pseudo inflammatory
Obstructive
Diagnostics of colon cancer
1.
2.
3.
4.
5.
6.
7.
X-ray
Colonoscopy
Rectoscopy
Sygmoscopy
CEA –carcinoembryonic antigen
CT
MRI
Treatment of colon cancer
Left-sided hemicolectomy
Right-sided hemicolectomy
Excision of the colon
Excision of the sigmoid colon
Colostomy
Treatment of rectal cancer
Depends on the proximity to the anal verge
Abdominoperineal resection (extirpation)
Low anterior resection
Wide local excision
Sygmostomy
Treatment of colorectal cancer
1. Management of colon cancer
depends on lymph node status
2. Colon cancers are resected even if
metastatic
Screening
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


Digital rectum examination
Stool guaiac test
Flexible sigmoidoscopy
Colonoscopy