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Colorectal cancer: Difference between revisions
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'''Colorectal carcinoma''' (<abbr>CRC</abbr>) refers to all cancers that can affect the colon and rectum. Carcinomas in the colon are the most common malignancy in the <abbr>GI</abbr>-tract, accounting for 95% of all GI cancers. | <section begin="clinical biochemistry" />'''Colorectal carcinoma''' (<abbr>CRC</abbr>) refers to all cancers that can affect the colon and rectum. Carcinomas in the colon are the most common malignancy in the <abbr>GI</abbr>-tract, accounting for 95% of all GI cancers.<section end="clinical biochemistry" /> | ||
CRC is the third most common type of cancer, but it’s the second most common cause of cancer-related death. It accounts for 10% of the world’s cancers. It’s mostly a disease of elderly, affecting those in their 60s and 70s. >90% of colorectal cancers develop from [[Colonic polyps|adenomatous polyps]] of the colon. | CRC is the third most common type of cancer, but it’s the second most common cause of cancer-related death. It accounts for 10% of the world’s cancers. It’s mostly a disease of elderly, affecting those in their 60s and 70s. >90% of colorectal cancers develop from [[Colonic polyps|adenomatous polyps]] of the colon. | ||
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Once the diagnosis of colon cancer has been made, a CT of the chest, abdomen, and pelvis is required for staging. For rectal cancers, MRI is used. | Once the diagnosis of colon cancer has been made, a CT of the chest, abdomen, and pelvis is required for staging. For rectal cancers, MRI is used. | ||
<section begin="clinical biochemistry" /> | |||
[[CEA]] should be measured upon diagnosis. Elevated CEA is associated with a worse prognosis, and CEA which doesn’t normalise postoperatively is indicative of persistent disease. | [[CEA]] is the tumour marker most specific for CRC and should be measured upon diagnosis. Elevated CEA is associated with a worse prognosis, and CEA which doesn’t normalise postoperatively is indicative of persistent disease. Microcytic or normocytic anaemia (due to chronic GI blood loss) and/or faecal occult blood are typical findings in CRC. | ||
<section end="clinical biochemistry" /> | |||
== Treatment == | == Treatment == | ||
The gold standard treatment for <abbr>CRC</abbr> is radical surgery. Options include left or right hemicolectomy, sigmoid colectomy, or total or subtotal colectomy. This may be performed [[Laparotomy|open]], [[Laparoscopic surgery|laparoscopically]], robot-assisted, etc. At least 12 regional lymph nodes must be removed for proper surgical staging. | The gold standard treatment for <abbr>CRC</abbr> is radical surgery. Options include left or right hemicolectomy, sigmoid colectomy, or total or subtotal colectomy. This may be performed [[Laparotomy|open]], [[Laparoscopic surgery|laparoscopically]], robot-assisted, etc. At least 12 regional lymph nodes must be removed for proper surgical staging. | ||