Colon Cancer

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Author:
Anonymous
ID:
10965
Filename:
Colon Cancer
Updated:
2010-03-17 14:21:12
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Colon Cancer
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Colon Cancer
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  1. common genetic susceptability to colorectal cancer
    FAP - familial adenomatous polyposis
  2. Two lifestyle factors that decrease the risk of colorectal cancer
    • exogenous hormone use
    • aspirin and NSAID use
  3. Drugs used in prevention of colorectal cancer
    • Celecoxib - reduces polyps in FAP
    • Aspirin
    • Estrogen
    • Calcium and Vit D
  4. Frequency of:
    fleixble sigmoidoscopy
    colonoscopy
    double contrast barium enema
    CT colonograpy
    • 5 yrs
    • 10 yrs
    • 5 yrs
    • 5 yrs
  5. Tests that detect cancer
    • Fecal occult blood test -- yearly
    • Fecal immunochemical test -- yearly
    • Stool DNA test -- inteval uncertain
  6. what do you do for a family history of familial adenomatous polyposis?
    • begin screening at puberty
    • possible colectomy
    • screening every 1-2 yrs
  7. lab important in workup and diagnosis of colorectal cancer
    CEA - carino embryonic antigen
  8. Stage of cancer that invades the colon wall
    II
  9. Stage that travels to lymph nodes
    III
  10. Chemo agents for colorectal cancer
    • 5-FU - with or without leucovorin
    • Irinotecan
    • Capecitabine
    • Oxaliplatin
    • Mitomycin C
  11. requires wild type K ras
    • Monoclonal antibody therapy
    • cetuximab, panitumumab
  12. synthetic oral antihelminthic drug with immunomodulatory properties
    Lavamisole
  13. direct administration of 5-FU or FUDR
    direct hepatic arterial/portal vein infusions
  14. direct administrations of substances to block liver blood flow to hepatic masses
    hepatic artery chemoembolization
  15. Surgery + adjuvant systemic therapy options for Locally Advanced Colon Cancer Stage (III)
    • 5FU + leucovorin for 6 months
    • FOLFOX
    • Cepecitabine for 6 months
  16. Treatmetn options for localized (stage I-II) colon cancer
    • Surgical resection of primary tumor + regional mesenteric LN
    • Selected patients with Stage II disease may benefit from adjuvant systemic therapy
  17. tx for stage I rectal cancer
    surgical resection
  18. tx for stage II and III rectal cancer
    • surgery followed by radiation therapy with 5FU
    • regimins may include oxaliplatin, LV, or capecitabine

    preoperative fluoropyrimidine based therapy plus XRT also used
  19. First line chemo for tx of metastatic colorectal cancer
    • bevacizumab + 5FU based regimin
    • FOLFOX
    • FOLFIRI (irinotecan + 5FU + Leucovorin)
    • 5FU + leucovorin
    • Capecitabine
    • CapeOx
    • FOLFOXFIRI
  20. 2nd line chemo for tx of metastatic colorectal cancer
    • irinotecan
    • oxaliplatin + 5FU + leucovorin
    • cetuximab + irinotecan
    • panitumumab
  21. what do you do if you get a clot from bevacizumab
    • venous = keep on treating
    • arterial = d/c drug
  22. dose limiting adverse effects of FOLFOX
    • peripheral sensory neuropathy
    • diarrhea
    • myelosuppression
    • hand-foot syndrome
    • pulmonary fibrosis
  23. premedications fro FOLFOX
    • 5HT3 antagonists
    • avoid ice chips

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