Colorectal cancer - Chronic
Definition
A malignant neoplasm of the mucosa of the large intestine
Suspected Recurrence
Colorectal cancer
* Carcinoembryonic antigen measurement, serum: Persistently rising carcinoembryonic antigen values suggest disease progression, even in the absence of corroborating radiographs, and require prompt restaging .
Evaluation of recurrent colorectal cancer
* CT of chest, abdomen and pelvis
Medical History
* Family history of Colorectal cancer
* Past medical history of Colorectal cancer
* Past medical history of Neoplasm of endometrium
* Past medical history of Ovarian carcinoma
* Past medical history of Breast cancer
* Past medical history of Polyp of colon
* Past medical history of Inflammatory bowel disease
* Past medical history of Hereditary nonpolyposis colon cancer
* Past medical history of Familial multiple polyposis syndrome
* Past medical history of Hamartomatous disease
* Intestinal polyposis syndrome
* Obesity [Obesity - Chronic]
* Sedentary lifestyle
* Smoking
* Alcohol intake - finding
Findings
* Abdominal pain
* Altered bowel function
* Hematochezia
* Asthenia
* Bowel obstruction
* Rectal mass
* Abdominal mass
* Weight loss
* Tenesmus
* Ulcer of rectal mucosa
* Hepatomegaly
* Ascites
* Umbilical lump
* Lymphadenopathy
Tests
Screening and surveillance for colorectal cancer
* Colonoscopy: Colonoscopy allows for full direct inspection of the entire colon and rectum and allows for concurrent biopsy sampling and polypectomy. It may be used for screening, diagnosis, and therapy of colorectal cancer .
Staging workup for patients presenting with invasive colorectal cancer appropriate for resection
* CT of chest, abdomen and pelvis
Staging workup for patients presenting with invasive colon cancer appropriate for resection
* Complete blood count
* Platelet count
* Basic metabolic panel
Colorectal cancer
* Carcinoembryonic antigen measurement, serum: Persistently rising carcinoembryonic antigen values suggest disease progression, even in the absence of corroborating radiographs, and require prompt restaging .
Rectal cancer
* Endorectal ultrasonography: Endorectal ultrasound, or endorectal or pelvic MRI is recommended as part of the routine preoperative staging workup for patients with resectable rectal cancer .
Differential Diagnosis
* Benign neoplasm of colon
* Hereditary nonpolyposis colon cancer
* Familial multiple polyposis syndrome
* MYH-associated polyposis
* Pseudopolyposis of colon
* Juvenile polyposis syndrome
* Peutz-Jeghers polyps of small bowel
* Cowden syndrome
* Hemangioma
* Pneumatosis cystoides intestinalis
Treatment
Drug Therapy
Chemotherapy agents used as monotherapy or in combination for the treatment of colorectal cancer
FLUOROURACIL
LEUCOVORIN CALCIUM
OXALIPLATIN
IRINOTECAN HYDROCHLORIDE
CAPECITABINE
CETUXIMAB
BEVACIZUMAB
Procedural Therapy
Treatment option for stage 0 colorectal cancer
* Resection of polyp
Colorectal cancer
* Colorectal surgery: Colectomy with en bloc removal of the primary and regional lymph nodes is the standard treatment for resectable colon cancer . Surgical resection of the primary tumor is the treatment of choice for rectal cancer .
Colorectal cancer
* Radiation therapy: Neoadjuvant chemoradiation is the preferred approach for patients with stage II or III rectal cancer .
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