PREDISPOSING PRECIPITATING

FACTOS FACTORS

1, Advanced age
(age 50 and 1. High-fat Diet
above)
2. Smoking
2. Race
3. Alcoholism
3. Sex/Gender
4. Poor sleep
4. Family history quality & irregular
of colon cancer or sleep habits
polyps

5. Inflammatory
bowel disease
(IBD)

6. Family history
of any type of
cancer

Defective adenomatous
polyposis coli (APC)

Cell line mutations

(uncontrollable cell division in
the colon)

adenomatous polyposis B-Raf proto-oncogene, CIMP-low (CIMP-L) + tumor protein 53 (TP53)

coli (APC) + Kirsten rat serine/threonine kinase predominant KRAS + mutation + loss of
sarcoma viral oncogene (BRAF) mutation + occasional BRAF heterozygosity (LOH) at
homolog (KRAS) mutation CIMP-high (CIMP-H) mutations chromosome 3p (chr 3p)

Tubulovillous adenomas
Tubular Adenoma Villous adenomas " villous adenoma +
" precancerous polyps in " sessile serrated SSA/P + traditional
the colon" adenoma/polyps" serrated adenoma
(TSA)"
 (TSA)"

Adenocarcinoma in situ Adenocarcinoma in situ Adenocarcinoma in situ Adenocarcinoma in situ

(AIS) " cancer stage 0" (AIS) " cancer stage 0" (AIS) " cancer stage 0" (AIS) " cancer stage 0"

bo
bowel out
perforation (ba

precancerous cells in a Presence of polyp that grows Presence of tumor has grown
noninvasive cancer limited area develops over from inner lining of the colon into the muscularis propria -
preinvasive cancer time and become malignant into the submucosa (stage 1) thick layer of muscle (stage 2)

Cancer cells are found only Decreased

in the epithelium or lamina weight loss
appetite
propria

The tumor ha
compressing mass effect local growth of the muscula
dysplasia: entire epithelial stomach tumor into the sub
layer without invasion of
basement membrane into
underlying tissue
pressure from the mass against rectal
Tumor lowers bowel
sphincters compressing the muscles, vessels, The tumor ha
lumen caliber/peristalsis
and nerves surface o
peritoneum a
of the colo
blockage of bowel
contents in the intestines
involuntary rectal bleeding rectal rupture
straining
mechanical bowel The tumor ha
hematochezia rectal pain obstruction has attached t
Tenesmus structures

narrowed passage fecal

ways in the rectum impaction
causes
distention in
ribbon-like stools the abdomen
 hyperthermia
abdominal
abdominal pain
absess
bowel to
bowel contents leak bowel / local melena
out = bacterial infection organ
(bacteremia/ abscess) anal abcess
fistulation rectal pain and swelling

own
a-
e 2)
overt or fatigue pallor dyspnea cold clammy skin
occult GIB

tumor development loss of blood = decrease

umor has grown through + erosion and decrease blood oxygenation in the
muscularis propria and hemorrhage volume blood = ANEMIA
the subserosa (stage 3)

severe increased
blood loss = decrease venous blood pressure
umor has grown into the
urface of the visceral decrease return = SEVERE (lower than 90/60
neum affecting all layers intravascular HYPOTENSION mm Hg)
the colon (stage 4a) volume

Body
compensates tachycardia;
tumor has grown into or to circulate the
tached to other organs or tachypnea
decreased
ructures (stage 4b).
volume faster

reduced renal,
persistent uterine, hepatic HYPOVOLEMIC
dropping of blood and cerebral SHOCK
pressure levels perfusion
 distention in
ribbon-like stools the abdomen

abdominal pain
and cramps

constipation

Surgical
Interventions

Upper GI
endoscopy and
colonoscopy

Colonoscopy, the
gold standard of
colon cancer
screening;
examination of the
location and size o
the tumors

A colectomy is a
bowel resection o
the large bowel;
surgical removal o
any extent of the
colon
 perfusion

If treated If not treated

cancer cells spread through

cal Medical the colon wall
ntions Management

r GI cancer cells break away from

py and Chemotherapy for Radiation therapy the original tumor and spread
copy colon cancer is kills cancer cells or to the bones, liver, brains, Metastasis
treatment with anti- slows their growth and lungs
cancer drugs that by damaging their
may be injected into DNA.
opy, the a vein or taken by
dard of mouth. Impair the function of
ancer essential organs and body Multiple organ
systems which can cause multiple organ dysfunction
ing;
on of the essential body functions failure syndrome
d size of to cease.
mors COMPLIANCE TO THE
THERAPEUTIC REGIMEN
AND MAINTAIN HEALTHY
my is a LIFESTYLE PROGNOSIS:
ection of POOR
bowel;
moval of
t of the PROGNOSIS:
n FAIR DEATH