COLORECTAL CANCER

COLORECTAL CANCER
COLORECTAL CANCER
COLORECTAL CANCER
 DEFINITION
is a disease in which cells in
the colon or rectum grow out
of control. Sometimes it is
called colon cancer, for short.
The colon is the large
intestine or large bowel. The
rectum is the passageway
that connects the colon to the
anus (Center for Disease
Control and Prevention,
2023).
Colorectal cancer starts in
the colon or the rectum.
These cancers can also be
called colon cancer or rectal
cancer, depending on where
they start. Colon cancer and
rectal cancer are often
grouped together because
they have many features in
common.
Facts:
• Malignancy of colon/rectum
• If the disease is detected and
treated at an early stage, the 5
year survival rate is 90%.
• Only 34% of colorectal cancers
are found at an early stage.
• Colon polyps and early cancer
can have no symptoms.
Therefore, regular screening is
important.
PATHOPHYSIOLOGY
• Arise from preexisting benign
adenomatous colon polyps
• Transformation is slow = 1 cm polyp
take 7 years to progress to invasive
carcinoma
• (Adenomastically round and polypoid)
• Lesions penetrate the colon wall and
extend into surrounding tissue
• Lungs and liver metastasize
• Complications: perforation,
abscess formation, peritonitis,
sepsis, and shock.
RISK FACTORS
• Age > 40, increasing age
• Family history of colon CA or polyps
• Previous colon CA
• Personal hx of ulcerative colitis, Crohn’s disease for more than 10
years
• Onset is 63-67 years old
• Whites than African Americans
• Incidence higher in industrialized western world
• High fat diet, high intake of protein(beef), low fiber diet
• Excess alcohol intake
• Genital CA or breast CA
CLINICAL MANIFESTATIONS
• Change in bowel habits, constipation, diarrhea, and bowel
incontinence
• Hematochezia
• Melena
• Unexplained anemia
• Unusual stomach or gas pain
• Unexplained weight loss
• Fatigue
• Vomiting
SCREENING TEST FOR COLORECTAL CANCER

 High-sensitivity fecal occult blood test (FOBT)

 guaiac FOBT –detects heme
 immunochemical FOBT- uses antibodies to detect
hemoglobin protein
 Colonoscopy
MEDICAL MANAGEMENT
Surgery Radiation therapy
• Should be done after
• Polypectomy
surg. healing
• Local
excision
• Resection
• colostomy
NURSING MANAGEMENT
Pre-operative care
• Low residue or liquid diet
• Cathartics to accelerate defection
• Antibiotics
• Enema
• Identify anxiety and provide supportive efforts
NURSING MANAGEMENT
Post-operative care
• Assess return of peristalsis, motility, flatus and bowel sounds
• Absence of ABD pain, distension, bloating, nausea and vomiting
• Check for rectal bleeding
• Promote optimal nutrition
• Promote ventilation
Preventive measurements
• High fiber, low fat diet
• Avoid salt cured or nitrite cured foods
• Avoid obesity
• Annua; occult exam > 50 years old (F/M)
• Sigmoidoscopy every 5-10 years
• Total colon exam every 5-10 years
Nursing diagnosis
• CONSTIPATION RELATED TO OBSTRUCTIVE LESIONS
• ACUTE PAIN RELATED TO TISSUE COMPRESSION
SECONDARY TO OBSTRUCTION
• FATIGUE RELATED TO ANEMIA AND ANOREXIA
• IMBALANCED NUTRITION, LESS THAN BODY
REQUIREMENTS RELATED TO NAUSEA AND ANOREXIA
• RISK FOR FLUID VOLUME DEFICIT RELATED TO VOMITING
AND DEHYDRATION
• ANXIETY RELATED TO IMPENDING SURGERY
• DISTURBED BODY IMAGE RELATED TO COLOSTOMY