COLORECTAL CANCER  Barium X-ray-using dual contrast with

air; can locate undetectable lesion. This

COLON CANCER/ RECTAL CANCER test should follow endoscopy because
Ba SO4 interferes with endoscopy
 All are adenocarcinoma
 Carcinoembryonic Antigen(CEA) testing
 Slow to spread; curable with early diagnosis
helps monitor the patient before &
 5 year survival rate for colon cancer-91%
after treatment to detect metastasis or
 5 year survival rate for rectal cancer-83%
recurrence
 Causes: linked to high-fat diet
Treatment
Risk Factors:
Surgery
 Age over 40 y/o, high fat, high protein,
 Depends on tumor location
low fiber diet
 After surgery, chemotherapy or
 Presence of adenomatous polyps
radiation
 History of Ulcerative colitis (average
 Ca of cecum or ascending colon
interval before cancer onset is 11-17
R Hemicolectomy
years)
 Ca of Proximal & middle transverse
 Inherited tendencies toward colon
>colon- R Colectomy
polyps (Familial polyposis)
 Ca of the Sigmoid colon
 Breast and Gynecologic cancer
>limited to sigmoid colon & mesentery
 Ca of upper rectum
Pathophysiology
 >Anterior or low anterior resection
using stapler
 Most lesions of the large bowel are
 Ca of lower rectum
moderately differentiated
>APR or/and permanent sigmoid
adenocarcinoma
colostomy
 Tend to grow slowly
 Remain asymptomatic for long periods
Nursing Management for Colorectal surgery
 Tumors in the sigmoid & descending
colon prow circumferentially and
(to clean the bowel & minimize abdominal &
constrict the intestinal lumen.
perineal cavity contamination)
 At diagnosis, tumor in the ascending
colon are usually large & palpable on
* monitor diet
physical examination
* give laxatives
* enemas
Signs and symptoms:
* antibiotics
 Change in bowel habits (most common)
Chemotherapy
 Blood in stool (2nd most common)
 Unexplained anemia, anorexia, weight
adjuvant therapy for patient with metastasis
loss, & fatigue
 5-fluorouracil with or w/o leucovorin
 Left-sided lesion-bright red blood in
 Lomustine
stool, signs of obstruction or abdominal
 Vincristine
pain, cramping, narrowing of stools
 Mitomycin
(pencil-shaped consistency)
 Cisplatin
 Rectal lesion-tenesmus, rectal pain,
 Methotrexate
alternating constipation & diarrhea,
 Levamisole
bloody stool
 Right-sided lesion-dull abdominal pain,
Radiation Therapy
melena
 used before and after surgery
Diagnostics
 Biotherapy (alone or with
Chemotherapy)- uses the body’s
 Tumor biopsy to verify colorectal Ca
immune system to fight cancer
 DRE detects 15% of colorectal Ca
 FOBT=Fecal Occult Blood Test detects
blood in stools-warning sign of rectal
cancer
 Proctoscopy or Sigmoidoscopy can
detect up to 2/3 of colorectal Ca
 Colonoscopy provides access for
polypectomy & biopsy of suspected
lesions