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Flashcards in Chapter 33 WS Deck (89)
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1

two types of polyps found in the colon

Villous adenomas and Tubular adenomas

2

which type is most likely to become malignant? (Villous adenomas or Tubular adenomas)

villous adenomas

3

what is FAP and how is it treated?

The studding of the entire large bowel wall by thousands of polyps.

Treated by completely removing the colon and rectum.

4

what is HNPCC?

Hereditary nonpolyposis colorectal syndrome (Lynch syndrome).

Inherited disorder that greatly increases the risk of colorectal cancers due to repair gene mutations.

5

What are symptoms/clinical presentations of rectal cancer.

- Rectal bleeding
- change in bowel habits
- diarrhea versus constipation
- change in stool caliber

6

Distinguish between symptoms/clinical presentation of cancers of the left side of the colon versus the right

Left Side of Colon: blood in stool, change in stool caliber, obstructive symptoms, and abdominal pain

Right Side of Colon: abdominal pain often accompanied with an abdominal mass, nausea, vomiting, occult blood in stool.

7

an anterior extrarectal mass may be indicative of _______

peritoneal seeding

8

how do colorectal cancers spread to the supraclavicular lymph nodes

As a result of spread from metastatically involved paraaortic nodes via the thoracic duct.

9

What imaging studies are performed in the staging workup for colorectal cancer.

- Chest x-ray to detect mets to lungs,
- CT scan or MRI of pelvis to determine if tumor extends into other pelvic organs or lymph nodes,
- CT scan of abdomen to see if liver involved,
- PET to determine mets.

10

ascending colon: intraperitoneal or retroperitoneal?

retroperitoneal

11

descending colon: intraperitoneal or retroperitoneal?

retroperitoneal

12

cecum: intraperitoneal or retroperitoneal?

intraperitoneal

13

transverse colon: intraperitoneal or retroperitoneal?

intraperitoneal

14

sigmoid colon: intraperitoneal or retroperitoneal?

intraperitoneal

15

hepatic flexure: intraperitoneal or retroperitoneal?

retroperitoneal

16

splenic flexure: intraperitoneal or retroperitoneal?

retroperitoneal

17

define peritoneal seeding

Tumor cells break off and shed into the abdominal cavity then take up residence on another surface.

18

Tumor cells break off and shed into the abdominal cavity then take up residence on another surface.

peritoneal seeding

19

what is the main dose limiting structure when treating colorectal cancer

Small bowel

If treating the ascending or descending colon, then kidney is also a dose-limiting structure.

20

acute side effects of radiation to the colon

- diarrhea
- abdominal cramps and bloating
- proctitis
- bloody or mucus discharge
- dysuria

Also, leukopenia and thrombocytopenia. Chemoradiation increases gastrointestinal and hematologic toxicities. If perineum treated then moist desquamation can occur to this area.

21

chronic side effects of radiation to the colon

- Persistant diarrhea
- increased bowel frequency
- proctitis
- fistula
- urinary incontinence
- bladder atrophy.

Most common is enteritis, adhesions, and obstruction caused by damage to the small bowel.

22

What is the purpose of the surgeon placing clips during surgery for colorectal cancer.

To demarcate the tumor bed so radiation oncologist can more precisely outline the area at risk, thus using smaller treatment volumes

23

how does a full bladder change the location of the small bowel

pushes the small bowel more superiorly

24

What foods should patients avoid eating when being treated with radiation for colon cancer.

- whole grain breads or cereals
- fried or fatty foods
- milk and milk products
- raw vegetables
- fresh fruit.

25

what foods are recommended for patient being treated to the colon

- White bread,
- meat baked, broiled, or roasted until tender,
- macaroni,
- cooked vegetables
- peeled apples and bananas.

26

define dentate line of rectum

Also known as pectinate line. Divides the upper 2/3 and lower 1/3 of the anal canal. Line at which the cells transition from stratified squamous epithelium to columnar epithelium (cuboidal at dentate line)

27

define anal verge

The surface of the ringed opening of the anus. It is the lower edge of the anal canal that marks the junction of the anal canal and the external hair-bearing skin.

28

what are OARs

organs at risk

29

What are the OAR in the treatment for anal cancer.

- Femoral heads and neck,
- genitalia/perineum,
- small bowel,
- bladder.

30

define unresectable

tumor cannot be surgically removed