Colorectal Cancer Presentation

8/3/2019 Colorectal Cancer Presentation

http://slidepdf.com/reader/full/colorectal-cancer-presentation 1/35

The Ins and OutsThe Ins and Outsof of

ColoRectal Cancer ColoRectal Cancer ByBy

Kelly HannKelly Hann



Anatomy Anatomy

The Body¶s Digestive System

± Esophagus, Stomach, Small Intestine &

Large Intestine1st 6 feet = large bowel or colon

Last 6 inches = rectum & anal canal

The anal canal ends at the anus



American Cancer Society



Signs & SymptomsSigns & Symptoms

Change in bowel habits

Blood in Stool

± Bright red

± Very dark red ± Black/Tarry Stool

Diarrhea

Constipation

Does your bowel feel likeit emptied completely?

General abdominal

discomfort

± Gas pains

± Bloating ± Fullness

± Cramps

Weight loss w/ no

explained reason

Constant tiredness

Vomiting (coffee grounds)



Tests that examine«Tests that examine«

Rectum, Rectal Tissue, & BloodRectum, Rectal Tissue, & Blood

Aids in diagnosing & preventing colon cancer Aids in diagnosing & preventing colon cancer



Physical ExamPhysical Exam

General Medical History

± Includes self health habits

± Past self illnesses

± Various treatments used for previous issues

± Family health history

If patient reports problems with respect to signs

and symptoms related to common bowel change

habits« Are symptoms affecting your everyday life?



Fecal occult blood testFecal occult blood test

Check stool for evidence of blood

Method

± Small samples of stool are placed on specialcards and returned to the Dr. or Lab for

testing under a microscope

Potential harms

± False-positive & false negative results

(uncommon«serious



Digital Rectal ExamDigital Rectal Exam

The doctor or nurse inserts a lubricated,

GLOVED finger into the rectum to feel for

lumps or abnormal areas.



Barium EnemaBarium Enema

Barium is a liquid, that contains a silver-

white compound, inserted into the rectum

The barium coats the lower GI tract and aseries of x-rays are taken of the lower GI

tract

AK A = a lower GI series



What does a Barium Enema do?What does a Barium Enema do?

Detects

± Ulcers

± Narrowed areas (strictures) ± Growth of the lining (polyps)

± Small pouches in the wall of the intestine

Diverticula

± Cancer

± abnormalities



How can one prepare for this test?How can one prepare for this test?

Colon must be completely empty

± Prescribed laxatives or enema (pre-exam)

Special Diet to follow (2 days prior) ± Clear liquids

± Tea or coffee without milk or cream

± Any juice without pulp (NO OJ or Tomato)

± Broth

± Carbonated beverages



Types of Barium EnemasTypes of Barium Enemas

Single Column

± Lie on side on Xray table

± Enema tube inserted into rectum

± Barium bag is delivered into colon

± May feel urge to have a bowel movement«.DON¶T

± Though, a small balloon will keep it inside you

± Take long deep breaths through mouth«helps relax

± May be asked to turn & rotate to evenly coat all colon

± Then the radiologist will take a number of X-ray images

from various angles



Air Contrast (Double contrast) Air Contrast (Double contrast)

Similar to single-column

Big difference« Air is inflated with air in

addition to the barium to expand andimprove the quality of the images

Polyps can be seen easier, among other

abnormalities



Post Barium Enema instructionsPost Barium Enema instructions

You will be able to go to the restroomimmediately following the procedure to expellthe remaining barium

Over next few days your stool will be white, gray,or pink

Might be given a cleansing enema, laxatives,and told to drink a lot of liquids

The remaining barium can cause constipation. Refer back to MD if you don¶t return to normal in

3-4 days



ResultsResults

Negative = no

abnormalities are

found

Positive =abnormalities found,

such as polyps.

If positive you maybe scheduled for

further testing.



Pros of Barium EnemaPros of Barium Enema

Pros

± No sedation, complications are slight

(perforation of colorectal wall)

± If 50+ Medicare covers this every four years

for colorectal cancer screening as an

alternative to colonoscopy

± If you are high risk, covered every two years,though colonoscopy is preferred



Cons of Barium EnemaCons of Barium Enema

miss small polyps or sometimes evensmall cancers

Biopsy and polyp removal cannot be doneduring testing

you may need to follow up with acolonoscopy

Preparing for the procedure (emptying thecolon) and the procedure itself can beunpleasant



SigmoidoscopySigmoidoscopy

Views the rectum andsigmoid colon areas for polyps, abnormalities, or

cancer A sigmoidoscope is a thin

lighted tube is inserted intorectum & up through thesigmoid colon

May remove polyps or tissue samples for biopsy



Procedure DetectionProcedure Detection

The cause of diarrhea, abdominal pain, or constipation

Detect early signs of cancer in descending(sigmoid) colon and rectum

can see bleeding, inflammation, abnormalgrowths, and ulcers

not sufficient to detect polyps or cancer inthe ascending or transverse colon (two-thirds of the colon).



PreparationPreparation ComplicationsComplications

Liquid diet

Most likely given an

enema pre-procedure

Air is pumped into

colon to help expand

and see more surface

area

Duration is 10-20

minutes

Though very

uncommon

It is likely that

bleeding or apuncture of the colon

could result during

procedure



Polyp«««...RemovalPolyp«««...Removal



ColonoscopyColonoscopy

Procedure to look into entire length of

large intestine (colon) to detect

abnormalities

Preparation, procedure, & results same as

sigmoidoscopy

New virtual colonoscopy as alternative

procedure



Virtual or (CT) ColonographyVirtual or (CT) Colonography

a series of x-rays called computed

tomography to make a series of pictures of

the colon

Computer then puts these pictures

together to create a detailed image that

shows polyps, etc.



Prognosis (chances of recovery)Prognosis (chances of recovery)

Depends on

± Stage : in the inner lining of colon only, wholecolon? Spread to other places in body

± Has it blocked or created a hole in the colon? ± Blood levels of carcinoembryonic antigen

(CE A); a substance in the blood that may beincreased when cancer is present, before

treatment begins. ± Has cancer recurred?

± Patient¶s general health?



Treatment OptionsTreatment Options

Surgery (main treatment)

Radiation Therapy

Chemotherapy Newer targeted therapies

± Monoclonal antibodies

Depending on stage of cancer, it is likelythat 2-3 types of treatment may be utilized

at the same time or one after the other



SurgerySurgery

Removal of cancer and normal area of

colon on either side, as well as nearby

lymph nodes

Then sewn back together

Colostomy (bag to catch the waste kept

outside the body)

If cancer is found early, a colonscope can

be used without cutting the abdomen



Surgery for Rectal Cancer Surgery for Rectal Cancer

Surgery is main treatment, along with a combination of radiation therapy

Polypectomy, local excision, and local transanalresection) can be done with instruments placed into the

anus, Stage I, II, & III rectal cancers, other types of surgerymay be done

A low anterior resection is used for cancers near theupper part of the rectum, close to where it connects withthe colon.

Abdominoperineal resection is done for cancers locatedclose near the lower rectum-anal conjunction. After thissurgery, a colostomy is needed



Pelvic Exenteration:

± the surgeon removes the rectum as well asnearby organs such as the bladder, prostate,

or uterus if the cancer has spread to these

organs. A colostomy is needed after this

operation. If the bladder is removed, aurostomy (opening to collect urine) is needed



Radiation TherapyRadiation Therapy high-energy rays (such as x-rays) to kill or shrink

cancer cells

external radiation

internal or implant radiation; placed directly intotumor

Radiation can also be used to ease symptoms of advanced cancer such as intestinal blockage,bleeding, or pain

Main uses is for those where cancer hadattached to an internal organ or the lining of theabdomen

can be aimed through the anus and reaches therectum without passing through the skin of theabdomen



ChemotherapyChemotherapy

use of anticancer drugs injected into a vein or given by mouth

treatment useful for cancers that have spread todistant organs

increase the survival rate for patients with some

stages of colorectal cancer (will kill normal cellsalso)

Side effects depend on amount, length, & type of drugs given (i.e. diarrhea, nausea, vomiting, loss

of appetite & hair, mouth sores, increasedchance of infections, bruising & bleeding after minor cuts or injuries & overall increased fatigue



Risk FactorsRisk Factors

Age 50 or older

Obesity (fat in waist area increases)

30%-40% of smokers diagnosed with cancer will die

A family history of cancer of the colon or rectum.

A personal history of cancer of the colon, rectum, ovary,endometrium, or breast.

A history of polyps or ulcerative colitis (ulcers in thelining of the large intestine) or Crohn¶s disease.

Certain hereditary conditions, such as familial

adenomatous polyposis and hereditary nonpolyposiscolon cancer (HNPCC; Lynch Syndrome)

Heavy use of Alcohol has been linked to this cancer



Dietary Risk FactorsDietary Risk Factors

eat plenty of fruits, vegetables, and whole grainfoods

to limit high-fat foods (especially from animalsources) and limit excessive alcohol

consumption studies suggest that taking a daily multivitamin

containing folic acid or folate can lower risk

Other studies suggest that getting more calcium

with supplements or low-fat dairy products canhelp

Getting enough exercise is important as well 30min of physical activity on 5+ days per week.



Survival RatesSurvival Rates

9 of 10 people whose cancer is found & treated

at early stage (before spreading) will live at least

5 years

Spread to nearby organs/lymph nodes= 5years ± 66% survival rate

Spread to lungs/liver= 5 year ± 9%

(5 yr is based on percentage of patients thatwere alive 5 yrs after diagnosis. Leaving out

those who died of other causes)



Closing PointsClosing Points These numbers provide an overall picture, but keep in

mind that every person¶s situation is unique and thestatistics can¶t predict exactly what will happen in your case.

Don¶t ³strain´ yourself«use more fiber in your diet(supplements work well when you can¶t get it through

your food intake ~ just drink lots of water & not within 1hour of laying down)

Eat healthy food when on the run pack your lunch/snacks

Increase your Healthy lifestyle potential

Parents/Grandparents Increase awareness that it is ok to get screened

Mark it on your to do list in 25-30 years as a birthdaypresent to yourself and family.



Dedicated toDedicated to

FRANCIS HARRY COMPTON CRICK

1962 Nobel Laureate in Medicine f or their discoveries concerning the molecular structure of nuclear acids and its signi f icance f or inf ormation transf er

in living material.

Background

Born: 1916

Died: 7/2 9 /2004 Died Today of Colon Canc er (88 yrs old) R esidence: Great Britain

Aff iliation: Institute of Molecular Biology, Cambridge

Colorectal Cancer Presentation

Documents

Transcript of Colorectal Cancer Presentation