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Colorectal Cancer

Transcript: Colorectal Cancer By: Mychala Lynch Bio483 Over 50 y.o. History of adenomatous polyps History of inflammatory bowel disease Ulcerative Colitis Crohn's Disease Dysplasia Family history of colorectal cancer Ethinic background African American Jews of Eastern decent Diet Radiation for stomach cancers Pathophysiology Manifestations • change in bowel habits o diarrhea/constipation o change in consistency of stool o rectal bleeding or blood in stool o persistent abdominal discomfort  gas, bloating, pain o feeling of “non-emptied” bowels o weakness or fatigue o unexplained weight loss • symptoms may not be present in early stages Disease Process • Usually start as benign, small clumps (adenomatous polyps) o Stage 0: Very early cancer on the innermost layer of the intestine o Stage I: Cancer is in the inner layers of the colon o Stage II: Cancer has spread through the muscle wall of the colon o Stage III: Cancer has spread to the lymph nodes o Stage IV: Cancer has spread to other organs • TNM method (tumor, lymph nodes, metastasis) • two types of tumors: o tubular and villous • familial adenomatous polyposis (polyps) –FAP o rare genetic disorder that causes development of thousands of polyps in lining of colon and rectum - diet low in fiber and high in fat and calories in conjunction with a sedentary lifestyle leads to the backup of waste which can lead to constipation and release of toxins back into the body or reabsorption back into the colorectal tissues instead of being released as stool Diseases in differential Anemia Diverticulitis Diverticulosis Crohn's Disease Ulcerative Colitis Hemorrhoids Complications o blockage of the colon o cancer returning to the colon o cancer spreading to other organs or tissues (metastasis) o development of second primary colorectal cancer Testing o Flexible sigmoidoscopy o 10-20 minutes, air pushed in by sigmoidscope and expands walls of colon to easier see the wall tissues o pressure on colon or lower abdominal pain o Colonoscopy o About 30 minutes, longer if a polyp is found or removed. Sedation o Starts in cecum, air will be pushed into the colon to better see the walls o Suction used to remove any blood clots or liquid stools o If small polyp found it will be removed and carefully monitored, if large found – biopsy must be done. o Double-contrast Barium enema (air contrast barium enema) o 30-45 minutes, does not require sedation o barium sulfate pumped into colon to partially fill and open up the colon o x-ray pictures taken, different positions for different angles o CT colonography o 10 minutes, drink contrast solution to tag any stool in colon or rectum o Detailed cross sectional images of colon o Fecal occult blood test o Used to find blood that can’t be seen with the naked eye o Detects blood in stool through chemical reactions o If positive, then tests need to be done to determine where blood came from o Stool DNA tests o Look for certain abnormal sections of DNA from cancer or polyp cells o If positive, do a colonoscopy Diagnostics • By using tests such as Sigmoidoscopy, Colonoscopy, Fecal Occult Blood Test to rule out other diseases such as anemias, Crohn’s Disease, which would show loss of iron in blood as well as Hemorrhoids. • Diverticulosis and Diverticulitis would show pockets in the colon and not tumors • Changes in bowel habits and white blood cell count would lead to distinction in blood tests • Colonoscopy would show polyps which would diagnose as cancer Treatments • Systemic chemotherapy o 5-Fluorouracil is main ingredient in colon chemo regiment in metastic as well o Used in conjunction with other medicines like oral medications (Xeloda and Camptosar) o Prolonged treatments include infusion of fluorouracil and capecitabine • Postoperative chemotherapy o Stage II and stage III include treatments of fluorouracil in adjunct with levamisole and leucovorin • Surgery o To remove cancerous polyps for all stages  Local excision: tube inserted into rectum and colon and cuts out tumor  Resection : colectomy -> removing tumor and healthy tissue around it o Chemotherapy (depends on type and stage)  Uses drugs to stop cancerous cell growth • Killing cells or stop dividing  Take pills by mouth, or inject into veins or muscles • Enters blood stream and reach cancer cells • If injected straight into csf, organ, or body cavity -> affects cancers cells instead of other tissues o Radiation  Uses high energy x-rays to kill cancer cells or keep them from growing • External: uses machine outside the body • Internal: uses radioactive materials in tiny delivering objects such as needles to insert directly into or near the cancer. o Targeted therapy  Uses drugs or other substances to identify Colon Cancer Treatment (PDQ®) - National Cancer Institute. (n.d.). Comprehensive Cancer Information - National Cancer Institute. Retrieved April 11, 2011, from http://www.cancer.gov/cancertopics Dragovich,MD, T. (n.d.). Medscape: Medscape Access. Medscape: Medscape Access. Retrieved

Colorectal Cancer

Transcript: Colorectal cancer is also known as "colon cancer"and "bowel cancer" Colorectal cancer is the second leading cancer for men and women over 50. 655,000 people die from it per year in the world. Colorectal cancer affects your colon, rectum and appendix. Colon is part of your digestive system and is where your waste is stored, the rectum is the end of your colon adjacent to the anus and they form the 'large intestine' or 'large bowel.' Tumors are growths formed from the inner wall of your large intestine. There are two types of tumors, benign and cancerous if you do not remove your benign tumor over time it will become cancerous. This picture show's how the cancer grows over time and what the affects are. The symptoms depend if the cancer has metastasised to other parts of the body or is still in the colon wall. There are three types: Local (stays in the same area) Constitutional (spread to the whole body) Metastatic (spread to other organs). Local: Most likely to occur if the tumor is closer to the anus. A change in bowel habit may occur, as well as incomplete bowel procedure, diarreah and possibly bleeding from bowel movements-a sure sign of colon-rectal cancer. If the tumor blocks off bowel movement, then abdominal pain, vomiting and constipation follow. Constitutional: f the colon rectal tumor spreads, pale skin, a loss of appetite and weight and fatigue can occur. Factors that lead to this particular type of cancer is, Overeating (i.e. high calorie intake), diets high in meat and sedentary are likely to increase the risk of colon rectal cancer A person with a healthy body weight, physical fitness and good nutrition decreases the risk in general. Lifestyle changes, accordingly, can decrease the risk of colon rectal cancer by as much as 60-80%. A rich fiber diet does NOT decrease the risk of colon rectal cancer. Cures/surveillance and prevention methods: Surveillance for this disease is taken through colonoscopy, which searches for tumors in the colon wall. This treatment could decrease the chance of death by greater then 80%, provided that this treatment is started before the patient has reached the age of 50 and the procedure is repeated every 5 to 10 years. Cures for this disease are many, but the most common are improved lifestyle and the use of chemotherapy agents through dieting, as well as increased surveillance. Other cures and prevention of colonrectal cancer include chemoprevention, calcium, aspirin taking at slow pace and Vitamin D. All these , especially Vitamin D, help decrease the risk of colon rectal cancer in the body. Survivors story Just two years ago, cancer and colons and calendars were the furthest thing from Smith's mind. She was in good health, with no sign anything was amiss until a night in August 2008.As she prepared for bed, Smith said she went to the bathroom and blood started inexplicably flowing out of her rectum.Smith was terrified, called her mother at 11 p.m. and described what had happened. Her mother, a nurse, suggested it could be a hemorrhoid or abrasion but urged her daughter to visit her personal physician as soon as possible.The next day, Smith's doctor found no immediate reason for the bleeding and more detailed examination by a specialist was recommended. A colonoscopy performed two months later revealed the cause: Smith had Stage 3C colon cancer.According to the National Cancer Institute, Stage 3C cancer is extremely serious, where the cancer has spread to the outermost layer of the colon but has not yet reached nearby organs.Within weeks, Smith had cancerous portions of her colon removed during a surgery at Rush-Copley Medical Center. Seven months of chemotherapy began two weeks later along with follow-up exams and careful monitoring.Her latest colonoscopy and examination last week showed hopeful results."It was totally clear, everything was clear," she said. "I saw my oncologist the same day and he said my blood work looked great, there was nothing going on. He's confident that I'm still in remission." Colorectal Cancer

Colorectal Cancer

Transcript: Chemotherapy usage of strong drugs to... Behavioral Factors Increasing Risk keep cancer from spreading slow cancer growth kill cancer cells can remove polyps colon + rectum = colorectal examines beginning of colon doesn't require sedation easier to recover from done every 5 years Symptoms 3rd most diagnosed cancer 3rd leading cause of cancer death for early stages sometimes used with chemo 1st degree relative had colorectal cancer = 2-3x relative diagnosed at young age or > 1 affected relative = 3-6x be physically active healthy weight healthy diet limit alcohol no smoking take calcium physical inactivity obesity bad dietary choices smoking moderate-high alcohol consumption newer type of chemo that uses drugs to target cancer cell mechanics Invasive and Deadly SEER Summary Staging Genetic Factors Increasing Risk Risks insert thru mouth/veins spreads medication through broader bloodstream more side effect Side Effects family history of colorectal cancer personal history of adenomatous polyps personal history of chronic inflammatory bowel disease inserted through arteries concentrates medication in cancer area few side effects benign adenomatous polyp --> cancer Preventive Efforts! Treatments 1/2 to 1/3 of people develop adenomatous polyps over their lifetime, but chance of it advancing into cancer is only 10% colorectal cancer tends to spread to liver or lungs metastasized = cancer spreading from origin nausea/vomiting hair loss bone marrow change red blood cells - fatigue white blood cells - weakened immunity platelets- impaired clotting uses high energy rays to target and kill cancer focuses in 1 specific area Regional Chemo long flexible tube with camera attached to examine colon The probability of the polyp turning cancerous increases as the size of the polyp increases. Targeted Therapy disrupt cell signaling pathways induces apoptosis inhibits angiogenesis future of treaments colostomy = remove affected segment of colon and reattach healthy ends Surgery symptoms are not present in early stages, so screening is very IMPORTANT bleeding from rectum blood in stools change in stool shape/color cramping/discomfort in lower abdomen unintentional weight loss Overview Staging in situ: cancer not invading walls local: cancer on walls, not through walls regional: cancer spread through wall into lymph nodes or nearby tissues distant: cancer metastasized to other organs Colorectal Cancer Flexible Sigmoidscopy Systemic Chemo Screening examines entire colon requires sedation harder to recover from done every 10 years Regular screening = earlier intervention= saves lives Radiation Colonoscopy

Colorectal Cancer

Transcript: The American Cancer Society's estimates for the number of colorectal cancer cases in the United States for 2013 are: 102,480 new cases of colon cancer, 40,340 new cases of rectal cancer Colorectal Cancer Statistics Signs and symptoms Sources Risk factors Developing colorectal cancer is about 1 in 20 (5%). It is slightly higher that men will get it over women. It is the third leading cancer caused deaths. Estimated that there will be 50,830 deaths during 2013. A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days A feeling that you need to have a bowel movement that is not relieved by doing so Rectal bleeding, dark stools, or blood in the stool (often, though, the stool will look normal) Cramping or abdominal (belly) pain Weakness and fatigue Unintended weight loss Age- over the age of 50 Family History-if any family has it. Personal History- Have a history of inflammatory bowel disease. Inherited Risk Alcohol Cigarette smoking Obesity It is often found after symptoms appear, but most people with early colon or rectal cancer don't have symptoms of the disease. You're doctor will run a series of tests and look up your family history. http://www.cancer.org/cancer/colonandrectumcancer/detailedguide/colorectal-cancer-diagnosed http://www.mayoclinic.com/health/colon-cancer/DS00035/DSECTION=tests-and-diagnosis http://www.cancer.gov/cancertopics/pdq/treatment/colon/patient Diagnosing Colorectal cancer is a disease in which malignant (cancer) cells form in the tissues of the colon or the rectum. Colorectal Cancer What it looks like

Colorectal Cancer

Transcript: Colorectal Cancer A cancerous tumor of the lining of the colon or rectum. Cause Life styles such as high fats and low fiber diets Life styles such as alcohol abuse and obesity Eating many red meats may cause cancer Symptoms This may vary depending on the site of the tumor Abdominal pain Blood in feces Rectal discomfort Loss of appetite Feeling tired frequently Unexplained weight loss Body Systems Affected Stays confined to the bowel and bowel wall May spread to lymph glands within the abdominal cavity Transmission Not contagious May be inherited from family disorders Diagnostic At the age 50, you should be screened regularly Once a year doctors perform tests Blood tests Treatment Changing emotional and physical needs do help You could be treated since 1970( that is when they found a cure) Folic acid, calcuim, vitamin D, Antioxidont vitamins C,E and A is a protection against this cancer Radiation Therapy Outc0me of the Disease the tumor has to be removed no matter what Cure Infection may be removed through surgery 9 in 10 people are treated at an early age Ask about symptoms People at risk People who eat many red meats If you have a low fiber diet Carcinogens are expelled from your body faster If you are obese or have a lack or exercise in your daily life This may be inherited by family disorders Other facts Most common cancer deaths in Canada To get this under the age of 40 is rare Most occur over the age of 60 By Nicole Rare for the age of under 40 Diabetes Genetics may be inherited

Colorectal Cancer

Transcript: What tests are used to determine if you have Colorectal cancer increase in amount of physical activities Limit the intake of red and processed meats Eat more vegetables and fruits Avoid obesity and weight gain around waist Avoid excess alcohol Colorectal Cancer Colorectal cancer also known as colon cancer is formed in the large intestine. The cells divide without control forming a mass called a tumor. The colon and the rectum make up the large intestine, they are responsible to take out nutrients and store solid food until it passes out the body. Flexible sigmoidoscopy- a flexible, lighted tube about the size of a finger with a small video camera on the end. It is inserted through the rectum and into the lower part of the colon. Images from the scope are viewed on a display monitor. yes if you: Change your lifestyle and eating habits Avoiding things known to to cause colorectal cancer You should have a lifestyle that includes daily physical activity Regular screening can find colorectal polyps early and if they are curable then they will be removed before they have a chance to become cancerous What are the signs or symptoms of Colorectal cancer Can diet prevent Colorectal cancer? Causes of Colorectal cancer The treatment depends on many things including the stage of the cancer. If the cancer has just been found then surgery can be done to remove the cancer cells If the cancer has spread then chemotherapy would be done to kill all the cancer cells or radiation therapy could be done to destroy the cancerous tissue References How often does Colorectal cancer occur in males? females? There are two types of causes You can change Lack of excersise being overweight (obese) Smoking Heavy alcohol use Colorectal Cancer Can your lifestyle or environment cause or prevent colorectal cancer? How can colorectal cancer be treated? Keep a good, natural fibre intake. Fibre should be inside your everyday foods - nuts, vegetables, seeds, fruit - not falsely added to it. Can you detect Colorectal cancer early? yes if you do the following : CT colonography- This test is an advanced type of computed tomography (CT or CAT) scan of the colon and rectum. A CT scan is an x-ray test that produces detailed cross-sectional images of your body Colonoscopy- is basically a longer version of a sigmoidoscope. It is inserted through the rectum into the colon. The colonoscope has a video camera on the end that is connected to a display monitor so the doctor can see and closely examine the inside of the colon. Special instruments can be passed through the colonoscope to biopsy (sample) or remove any suspicious-looking areas such as polyps, if needed. https://www.google.ca/imghp?hl=en&tab=wi&ei=vJKYUtGNMa3oiALMmIGICA&ved=0CAQQqi4oAg http://www.webmd.com/colorectal-cancer/guide/colorectal-cancer-diagnosis-tests http://www.cancer.org/cancer/colonandrectumcancer/detailedguide/colorectal-cancer-signs-and-symptoms http://www.nytimes.com/health/guides/disease/colon-cancer/ http://www.cancer.org/cancer/colonandrectumcancer/detailedguide/colorectal-cancer-prevention http://www.cdc.gov/CANCER/colorectal/basic_info/ http://www.cancer.ca/en/?region=on If there is a change in bowel habits- diaherra, constipation, or narrowing of stool Rectal bleeding, dark stools, or blood in stool Cramping or abdominal (belly) pain Weakness and fatigue Other interesting information THE END Colorectal cancer has many names such as Colon Cancer rectal cancer bowel cancer You can't change Age- as you get older your risks get higher Family history of colorectal cancer had colorectal cancer or certain kinds ofpolyps before Colorectal cancer affects both males and females but studies have found that being over weight increases the risk for both but it is stronger in men( having more belly fat, that is a larger waist line) has also been linked to colorectal cancer By: Amir Ingar Colorectal cancer is the third leading cause of dath from cancer in the United States. In men it's third after prostate cancer and lung cancer. In women it's third after breast cancer and lung cancer.

Colorectal Cancer

Transcript: Resources 4th most common cancer in the U.S., behind Skin, Lung, and Prostate Cancer One of the highest cure rates if caught early If cancer spreads throughout the body, it is the second leading cause of cancer deaths in the U.S. 3) Tumor grows into muscle wall Colon Cancer By Rafael Gonzalez-Posada It is imperative that a person gets a colonoscopy around the age of 50 -if the polyp is found early on, the survival rate is high If cancerous polyps is found, patient goes into surgery and receives chemotherapy to reduce the risk of a recurring adenoma If the adenoma has spread to other organs, the cancer is incurable and patient will receive chemotherapy to lengthen their life After the surgery and chemo therapy, patient visits doctor every 3-6 months for check-ups Colonoscopy 1 year after treatment, based on results, doctor sets future date of the next colonoscopy Fiber Fruits & Veggies Exercise Regular Checks-up Colonoscopies Vitamins POSITIVE ATTITUDE Colon cancer usually occurs when men and women of every race reach the age of 50+ Colon cancer is a gradual disease Cells that line the colon are very active, constantly dividing and creating buds known as polyps - Most polyps are benign, however, some of them may turn into cancer - There are different types of polyps, some of the have greater risks than others, one especially dangerous is the adenomatous polyp (adenoma) Adenomas are polyps with uncontrolled growth, they can either start clogging the colon, or spread to other organs such as the lymph nodes After Cancer 4) Cancer invades blood and spreads to the other organs Seattle CCA Overlake Hospital Swedish Hospital Harborview Hospital 1) Polyp Grows Risk Factors Family history of colon cancer Lack of Physical Activity Obesity and overweight Tobacco use Alcohol use Low fiber and high fat diet Lack of fruit and vegetable intake 2) Mutates, becomes cancerous The Facts Symptoms Sudden weight loss Ongoing bloated feeling, cramping, or pain in your abdomens Constant tiredness and weakness Diarrhea, constipation, or feeling your bowel does not completely empty Bright or very dark red blood in your stool Treatment Overview

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