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Colorectal Tumours

Background Knowledge ๐Ÿง 

Definition

  • Colorectal tumours can be benign (e.g., polyps) or malignant (e.g., colorectal carcinoma).

  • The colon and rectum are common sites for cancer development, often from precursor adenomatous polyps.

Risk Factors

  • Age: Incidence increases over 50.

  • Family history of colorectal cancer or polyps.

  • Hereditary conditions: Familial adenomatous polyposis (FAP), Lynch syndrome.

  • Inflammatory bowel diseases: Ulcerative colitis, Crohn’s disease.

  • Diet: High in red/processed meat, low in fibre.

Classification

  • Adenomas: Precancerous polyps. Can be tubular, tubulovillous, or villous.

  • Colorectal Carcinoma: Most are adenocarcinomas (~95%).

Clinical Features ๐ŸŒก๏ธ

Clinical Presentation

  • Change in bowel habits: Diarrhoea, constipation.

  • Rectal bleeding or melaena.

  • Abdominal pain.

  • Unintended weight loss and fatigue.

  • Iron-deficiency anaemia.

  • Palpable abdominal mass or rectal mass.

Investigations ๐Ÿงช

Investigations

  • Colonoscopy with biopsy: Gold standard.

  • Flexible sigmoidoscopy.

  • Faecal occult blood test (FOBT): Screening.

  • CT colonography.

  • CT, MRI for staging and assessing metastasis.

Management ๐Ÿฅผ

Management

  • Surgery: Primary treatment for localised tumours.

  • Chemotherapy: Adjuvant or for metastatic disease.

  • Radiotherapy: Particularly for rectal tumours.

  • Endoscopic removal for early, small tumours or polyps.

Prognosis

  • Depends on the stage at diagnosis and the presence of metastasis.

  • Regular monitoring and follow-up colonoscopies are essential.

Prevention

  • Regular screening, especially in those over 50 or with risk factors.

  • Dietary modifications: Increase fibre intake, reduce red/processed meat.

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