Altorjay István dr. Occurance of gastrointestinal malignancies in world HO statistics (2002) incidency males females total place M.S.
|
|
- Kevin Bates
- 5 years ago
- Views:
Transcription
1 Altorjay István dr. Occurance of gastrointestinal malignancies in world HO statistics (2002) incidency males females total place M.S. CRC mo Stomach mo Liver mo Esophagus mo Pancreas mo GI total Total (without skin)
2 Gastrointestinal tumours registered in GLOBOCAN (WHO) 2000 database in Europe Major risk factors of gastrointestinal neoplasms Environmental components Smoking Alcohol-consumption Chewing of Betel-nut Deficiency of oral hygiene Obesity (BMI > 30) Lack of physical activity Hormonal factors Insulin, IGF-1,2 IGFBP1-6 adiponectin Infective agents Human papillomavirus (16, 18) Hepatitis B virus Hepatitis C virus Helicobacter pylori Nutritive factors Meat (red meats: hem, nitrosopeptidek, O6- carboxymetyl guanine etc.) Vegetables, fruits, fibers 2
3 Natural course of carcinoma Detectable preclinic phase A B C D E Biologic origin Detectable by screening Onset of symptoms (patient delay) Diagnosis (doctor s delay) Cancer deaths Death from other cause 1. Carcinoembrionic antigen (CEA): glucoprotein, kd, present in fetal nutritional channel, pancreas. Normal value: 3-5 ng/ml Clinical significance: colorectalis cc, follow-up, breast, lung, pancreas 2. Alfa-foetoprotein (AFP): glucoprotein, kd, produced by fetal liver and graafian follicle, maximum level at 13. Week of pregnancy. Normal value: 8-15 ng/ml. Clinical significance: primary liver cc, non seminoma type of testicular cancer, stomach cancer, biliary tract tumours 3. CA 19-9 (carbohydrate) Normal value: < 35 U/ml, clinical significance: pancreas cancer, biliary tract tumours, liver metastases etc. 4. CA 72-4 (glucoprotein) normal value: < 4 mg/ml, clinical significance: stomach cancer, ovarian cancer. 3
4 1. Size of primary tumour: T in situ - T4 (involving surrounding organs) 2. Regional lymphnodes: N Distant metastases: M0 - Mx - M1 4. Histologic grading: well differentiated -.. undifferentiated 5. Histologic invasivity (lymphatic vessel invasion) CRC is the second most frequently diagnosed tumour in both men and women, in male patients following pulmonary cancer, in women following breast cancer. In Hungary around 8000 new cases are discovered yearly, and the mortality is about One third of the cases is discovered in early stage and one forth with distant metastases. 70 % of the tumours is found in the left colon! 4
5 5 year survival depending on the stage of the disease is between 90% - 9%. 90 % of the patients is older than 50 years % of the cases is considered as sporadic CRC, <1 % is FAP, 3-5 % HNPCC Accumulations in the family is well known, among first line relatives CRC is 3x more frequent. Polyps smaller <1 cm may develop into CRC roughly in 10 years. 5
6 Low (general) risk: age above 50 high intake of fat/low fibers smoking, obesity, alcohol-abusus Medium risk: colorectal adenoma in the own history, CRC and/or colorectal polyps in the family High risk: previous CRC in the history, herediter disease forms (HNPCC, FAP, Gardner sy, P-J sy, krónikus IBD etc. 6
7 Bleeding: - macroscopic - microscopic (FOBT) Rapid new development of hemorrhoids Iron deficiency of unknown origin in elderly Changes in stool-habits palpable abdominal mass, loss of bodyweight, dull pain, loss of appetite (not early signs anymore) A: tumour within the mucosa B1: involving the wall, but not reaching the serosa, no known positive lgl B2: involving the entire wall, reaching the serosa, but no known positive lgl C1: involving the wall, not reaching the serosa, but positive lgl involvement C2: involving the entire wall, including serosa and positive lgl involvement D: distant metastases 7
8 Detection of occult blood in stool (benzidin, human albumin) rectal digital investigation ( ~ 25 % of the tumours can be found) pathologic reflection above the bowel by US colonoscopy, (+) histology, barium enema, abd. CT, CT-colonography, EUS (rectal) tumour markers (CEA) mainly for follow up 8
9 FAP (autosom, dominant) is caused by the inherited mutation and inactivation of APC (adenomatosus polyposis coli) gen (5q21), which is responsible for the degradation of β-catenin. This plays a role - together with E-cadherin - in the cellular adhesion, and connected to TCF-4 (T cell factor) also activates different proliferating gens (c-myc, cyclin D1, PPARδ). The mutation of the oncoprotein K-RAS (12p), that plays a role in the intracellular signal-transduction can be shown in half of the tumours. Following its binding to the membrane-receptor of the epithelial growth factor (EGF) the RAS-GDP turns into RAS-GTP, that will induce proliferating gens. The mutant form of RAS is unable to detach from the GTP, thus the induction goes on. These events are accompanied by the activation of COX-2, then gastrin, DNA-methyltransferase upregulation, and finally the mutation of p53 (17p) and DCC supressor gens occur. The mutation of p53 is characteristic for the later phase of the adenomacarcinoma progression and can be detected in about half of the cases of CRC. 9
10 The HNPCC is caused by the inactivation of the DNA mismatch repair system (MMR). In the process the mutation of about 6 gens (hmsh2, hmsh3, hmsh6-2p21; hmlh1-3p21; hpms1-2q31-33, hpms2-7p22) plays a role. Therefore the so-called microsatellita instability (MSI) can be detected, in about 15 % of the tumours. This process can involve such inportant regulating and supressor gens, like TGF-β II receptor, Insulin-like GF II receptor, TCF-4, BAX etc. The accumulating mutations lead to uncontrolled cell-proliferation. 10
11 Benign tumours of the bowel Sporadic polyps (tubular, tubulovillous, villous, serrated) malignancy on the surface is related to size: <1 cm, 1% >3 cm, 50 % pseudopolyps (hyperplastic, hamartoma, lipoma, haemangioma) Inherited polyps - FAP (autosom, dominant, manifestation between 15-20, malignization 35-40) - Gardner sy: FAP + dermoid tumours, osteomas - Peutz-Jeghers sy: multiplex hamartomas + mucocutan pigmentation Primary treatment: following a correct staging colon cancer needs surgical resection; in case of rectal cancer perioperativ irradiation (5 x 4Gy or 20 x 1,8 Gy) and/or chemoradiotherapy is performed and subsequent surgery. Adjuvant chemotherapy: stage Dukes B/2, C : Mayo protoc. 5-FU 425 mg/m2 (infusion/bolus) + leucovorin or levamisol day 1-5, repeated every 28 days, 6 cycles. (5 year survival 7, 33 % better respectively); 11
12 In stage Dukes D (IV): palliative chemotherapy De Gramont protocol: Leukovorin 200 mg/m2/die, then 5- FU 1000 mg/m2/die continuous infusion for 2 days, repeated by 14 days Irinotecan (Campto) in combination with 5-FU (FOLFIRI) or oral capecitabine (Xeloda) Oxaliplatin (Eloxatin) in combination with 5-FU (FOLFOX) of oral capecitabine (Xeloda) Recently bevacizumab (Avastin) or cetiximab (Erbitux) addition is attempted. Bevacizumab (Avastin) monoclonal antibody against vascular endothelial growth factor (VEGF) in combination with 5FU seems to be more effective, than chemoth. alone. New trials with Avastin + irinotecan Cetuximab (Erbitux) monoclonal antibody against epidermal growth factor (EGF) in combination with chemotherapeutics in trials Dendritic cell vaccination following inoculation with tumour extract or activated against CEA. 12
13 In case of liver metastases: local chemotherapy or chemoembolisation via arteria hepatica, using floxuridine (FUDR) and adriamycin and mitomycin and/or systemic administration of 5FU/leucovorin (neoadjuvant chemotherapy followed by resection of the liver resulted in prolongation of survival) RFA treatment, cryotherapy, ethanol infiltration Diet instructions: more fibers (min. 30 g/die) more Calcium intake more vegetables vitamines C and E more physical activity less animal fat less alcohol 13
14 Mostly accepted strategies of screening CRC FOBT + sigmo/colonoscopy sigmoidoscopy once in 5 years colonoscopia once in lifetime (between years) Comment CRC mortality reduced by 15-33%, 60 % of adenomas and CRC can be detected in case of positive sigmoidoscopy pancolonoscopy is indicated, but so the mortality of CRC is reduced by %! Rationalistic solution. M. Crespi 2001 in half of the above cases total colonoscopy will be indicated, majority of colon adenomas appear by the age of 60! In group of patients with general risk: from the age of 50 annual FOBT, this can reduce CRC mortality by % (Hardcastle et al Lancet 1996). Flexibil sigmoidoscopy once in 5 years, if polyp larger than 1 cm is detected, subsequent total colonoscopy! Double contrast enema once in 5 years may replace endoscopy, as alternative, sensitivity 83 % vs. 95%. Suggestion of ACS: colonoscopy once in 10 years enough. 14
15 Prolonged history of IBD (both CU and MC) (in case of pancolitis after 8 years, in leftg side colitis after 15 years) colonoscopy is indicated in each 1-3 years, together with mapping biopsies. Real polyps should be treated as in non-ibd patients. In familial accumulation of CRC, especially if there were cancer or adenoma cases below the age of 60, close relatives should be screened once in 5 years, starting at minus 10 years of the age of the earliest detected CRC. 15
16 Amsterdam criteria: 3 relatives have tumours, 2 of them must be first grade relatives 2 generations have to be involved, and at least one tumour has to be detected under the age of 50. In HNPCC families from the age of 25 biannual endoscopy should be done, or at least it should be started 5 years earlier, than the onset of the earliest tumour. From the age of 40, annual investigation is indicated. If CRC in the patients own history, increased risk for metachron tumours, therefore total colonoscopy within 6 months following the operation is compulsory. If preoperative total colonoscopy was performed, after curative resection first control after 1 year and subsequently every 3 years. Following successful complete polypectomy with stalk, control colonoscopy once in 3 years. Followiong removal of big, sessile polyps, control endoscopy is indicated after 6 and 12 months. If residuum remained, that cannot be rfemoved by endoscopy, surgery is needed! 16
17 In genetically proven FAP annual endoscopy is indicated from the age of 12, when polyps are detected, total colectomy is indicated and if the rectum was preserved, the residual rectum remnant has to be controlled every 6 months! If no polyps are detected at the age of 40, subsequently endoscopy in every 3 years is enough. FAP (genet. proven) CRC 100% duodenum cc 10% HNPCC CRC: >80% endometrium cc 40-60% ovarium 10% stomach 13-19% bile duct 2-18% urinary bladder 5-10% kidney 3,3% glioblastoma 3,7 % Peutz-Jeghers sy CRC 2-13 % duodenum 2-13% Sertoli cell tumor % SCTAT 20% Juvenilis polyposis CRC upto 50 % rarely stomach Cowden sy CRC rarely, thyroid gland 3-10 % breast cc % 17
Colonic Polyp. Najmeh Aletaha. MD
Colonic Polyp Najmeh Aletaha. MD 1 Polyps & classification 2 Colorectal cancer risk factors 3 Pathogenesis 4 Surveillance polyp of the colon refers to a protuberance into the lumen above the surrounding
More informationColorectal Neoplasia. Dr. Smita Devani MBChB, MRCP. Consultant Physician and Gastroenterologist Aga Khan University Hospital, Nairobi
Colorectal Neoplasia Dr. Smita Devani MBChB, MRCP Consultant Physician and Gastroenterologist Aga Khan University Hospital, Nairobi Case History BT, 69yr male Caucasian History of rectal bleeding No change
More informationColorectal adenocarcinoma leading cancer in developed countries In US, annual deaths due to colorectal adenocarcinoma 57,000.
Colonic Neoplasia Remotti Colorectal adenocarcinoma leading cancer in developed countries In US, annual incidence of colorectal adenocarcinoma 150,000. In US, annual deaths due to colorectal adenocarcinoma
More informationPRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES
PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GASTROINTESTINAL RECTAL CANCER GI Site Group Rectal Cancer Authors: Dr. Jennifer Knox, Dr. Mairead McNamara 1. INTRODUCTION 3 2. SCREENING AND
More informationDavid P. Ryan, M.D. Clinical Director, MGH Cancer Center Chief, Hematology-Oncology, MGH
Colon Cancer 2015 David P. Ryan, M.D. Clinical Director, MGH Cancer Center Chief, Hematology-Oncology, MGH Colon Cancer Case presentation 72yo woman presented 1/03 abd discomfort and nausea Found to have
More informationColonic polyps and colon cancer. Andrew Macpherson Director of Gastroentology University of Bern
Colonic polyps and colon cancer Andrew Macpherson Director of Gastroentology University of Bern Improtance of the problem of colon cancers - Epidemiology Lifetime risk 5% Incidence/10 5 /annum (US Detroit
More informationSurveying the Colon; Polyps and Advances in Polypectomy
Surveying the Colon; Polyps and Advances in Polypectomy Educational Objectives Identify classifications of polyps Describe several types of polyps Verbalize rationale for polypectomy Identify risk factors
More informationClinical Colon Cancer Abby Siegel MD COLON CANCER. 1. Epidemiology 2. Risk factors 3. Manifestations 4. Treatment
Clinical Colon Cancer 2008 Abby Siegel MD COLON CANCER 1. Epidemiology 2. Risk factors 3. Manifestations 4. Treatment 1 1. EPIDEMIOLOGY - Colorectal cancer is the third most common cancer in the United
More informationFamilial Adenomatous Polyposis
Familial Adenomatous Polyposis 1 in 10,000 incidence 100 s to 1000 s of colonic adenomas by teens Cancer risk: colon, gastric, duodenum (periampulla), small bowel, pancreas, papillary thyroid, childhood
More informationPatologia sistematica V Gastroenterologia Prof. Stefano Fiorucci. Colon polyps. Colorectal cancer
Patologia sistematica V Gastroenterologia Prof. Stefano Fiorucci Colon polyps Colorectal cancer Harrison s Principles of Internal Medicine 18 Ed. 2012 Colorectal cancer 70% Colorectal cancer CRC and colon
More informationFamilial and Hereditary Colon Cancer
Familial and Hereditary Colon Cancer Aasma Shaukat, MD, MPH, FACG, FASGE, FACP GI Section Chief, Minneapolis VAMC Associate Professor, Division of Gastroenterology, Department of Medicine, University of
More informationCOME HOME Innovative Oncology Business Solutions, Inc.
COME HOME Rectal Cancer Pathway V8, April 2015 Diagnostic Workup: Bethesda Criteria: Pathology Review All patients H&P All patients Biopsy All patients Colonoscopy All patients CEA All Patients Chest/Abdominal/Pelvic
More informationBy: Tania Cortas, MD Arizona Oncology 03/10/2015
By: Tania Cortas, MD Arizona Oncology 03/10/2015 Epidemiology In the United States, CRC incidence rates have declined about 2 to 3 percent per year over the last 15 years Death rates from CRC have declined
More informationGastric and Colon Cancer. Dr. Andres Wiernik 2017
Gastric and Colon Cancer Dr. Andres Wiernik 2017 GASTRIC CANCER Gastric Cancer Classification Epidemiology General principles of Management 25% GE Junction Gastric Cancer 75% Gastric Cancer Epidemiology
More informationNeoplastic Colon Polyps. Joyce Au SUNY Downstate Grand Rounds, October 18, 2012
Neoplastic Colon Polyps Joyce Au SUNY Downstate Grand Rounds, October 18, 2012 CASE 55M with Hepatitis C, COPD (FEV1=45%), s/p vasectomy, knee surgery Meds: albuterol, flunisolide, mometasone, tiotropium
More informationOPEN ACCESS TEXTBOOK OF GENERAL SURGERY
OPEN ACCESS TEXTBOOK OF GENERAL SURGERY COLORECTAL POLYPS P Goldberg POLYP A polyp is a localised elevated lesion arising from a epithelial surface. If it has a stalk it is called a pedunculated polyp
More informationColon, or Colorectal, Cancer Information
Colon, or Colorectal, Cancer Information Definition Colon, or colorectal, cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Other types of cancer can affect
More informationRisk of Colorectal Cancer (CRC) Hereditary Syndromes in GI Cancer GENETIC MALPRACTICE
Identifying the Patient at Risk for an Inherited Syndrome Sapna Syngal, MD, MPH, FACG Director, Gastroenterology Director, Familial GI Program Dana-Farber/Brigham and Women s Cancer Center Associate Professor
More informationColorectal Cancer. Mark Chapman. MA MS FRCS EBSQ(coloproct) 21 st March 2018 Consultant Coloproctologist
Colorectal Cancer Mark Chapman MA MS FRCS EBSQ(coloproct) 21 st March 2018 Consultant Coloproctologist Overview Epidemiology of colorectal cancer Adenoma carcinoma sequence Tumour diagnosis & staging Treatment
More informationBowel obstruction and tumors
Bowel obstruction and tumors Intestinal Obstruction Obstruction of the GI tract may occur at any level, but the small intestine is most often involved because of its relatively narrow lumen. Causes: Hernias
More informationcolorectal cancer Colorectal cancer hereditary sporadic Familial 1/12/2018
colorectal cancer Adenocarcinoma of the colon and rectum is the third most common site of new cancer cases and deaths in men (following prostate and lung or bronchus cancer) and women (following breast
More informationRazvan I. Arsenescu, MD Assistant Professor of Medicine Division of Digestive Diseases EARLY DETECTION OF COLORECTAL CANCER
Razvan I. Arsenescu, MD Assistant Professor of Medicine Division of Digestive Diseases EARLY DETECTION OF COLORECTAL CANCER Epidemiology of CRC Colorectal cancer (CRC) is a common and lethal disease Environmental
More informationCHEMOTHERAPY FOR COLON CANCER OUTLINE OF TODAY S TALK. Colon Cancer Epidemiology 11/6/2012 GATRA/GCCR FALL CONFERENCE NOVEMBER 14 16, 2012
CHEMOTHERAPY FOR COLON CANCER JONATHAN C. BENDER,MD MEDICAL DIRECTOR OF PIEDMONT FAYETTE CANCER CENTER OUTLINE OF TODAY S TALK 1. Overview of Colon Cancer in the US 2. Colon Cancer staging and risks of
More informationColon Cancer Screening & Surveillance. Amit Patel, MD PGY-4 GI Fellow
Colon Cancer Screening & Surveillance Amit Patel, MD PGY-4 GI Fellow Epidemiology CRC incidence and mortality rates vary markedly around the world. Globally, CRC is the third most commonly diagnosed cancer
More informationFamilial and Hereditary Colon Cancer
Familial and Hereditary Colon Cancer Aasma Shaukat, MD, MPH, FACG, FASGE, FACP GI Section Chief, Minneapolis VAMC Associate Professor, Division of Gastroenterology, Department of Medicine, University of
More informationEARLY DETECTION OF COLORECTAL CANCER. Epidemiology of CRC
Razvan I. Arsenescu, MD Assistant Professor of Medicine Division of Digestive Diseases EARLY DETECTION OF COLORECTAL CANCER Epidemiology of CRC Colorectal cancer (CRC) is a common and lethal disease Environmental
More informationResident Seminar Aug 19 th, 2015 Colon: Neoplastic. Scott Rieder Dr. Colquhoun
Resident Seminar Aug 19 th, 2015 Colon: Neoplastic Scott Rieder Dr. Colquhoun Objectives Medical Expert: 1. The biologic basis of colon neoplasia 2. Colon cancer screening (guidelines and evidence) 3.
More informationClassification of polyposis syndromes two major groups. Adenomatous polyposis syndromes. Hamartomatous polyposis syndromes
Hereditary polyposis syndromes Classification of polyposis syndromes two major groups adenomatous and non-adenomatous polyposis syndromes Adenomatous polyposis syndromes Familial adenomatous polyposis(fap)
More informationPathology reports, related operative reports and consult letters must be provided with a request for assessment.
Page 1 of 6 Polyposis Syndromes Inherited risk for colorectal cancer is associated with a number of polyposis syndromes (genes), some of which are well-defined and others are less common. Identification
More informationThis is the portion of the intestine which lies between the small intestine and the outlet (Anus).
THE COLON This is the portion of the intestine which lies between the small intestine and the outlet (Anus). 3 4 5 This part is responsible for formation of stool. The large intestine (colon- coloured
More informationHereditary Non Polyposis Colorectal Cancer(HNPCC) From clinic to genetics
From clinic to genetics Question 1) Clinical pattern of inheritance of the HNPCC-Syndrome? Question 1) Clinical pattern of inheritance of the HNPCC-Syndrome? Autosomal dominant Question 2) Incidence of
More informationUPDATE IN THE MANAGEMENT AND TREATMENT OF COLORECTAL CANCER. Edwin A. Empaynado, MD Advocare Colon and Rectal Surgical Specialists
UPDATE IN THE MANAGEMENT AND TREATMENT OF COLORECTAL CANCER Edwin A. Empaynado, MD Advocare Colon and Rectal Surgical Specialists WHAT IS COLON CANCER? WHAT CAUSES COLORECTAL CANCER? WHAT ARE THE RISK
More informationChemotherapy of colon cancers
Chemotherapy of colon cancers Stage distribution Stage I : 15% T 1,2 NO Stage IV: 20 25% M+ Stage II : 20 30% T3,4 NO Stage III N+: 30 40% clinical stages I, II, or III colon cancer are at risk for having
More informationDevelopment of Carcinoma Pathways
The Construction of Genetic Pathway to Colorectal Cancer Moriah Wright, MD Clinical Fellow in Colorectal Surgery Creighton University School of Medicine Management of Colon and Diseases February 23, 2019
More informationScreening & Surveillance Guidelines
Chapter 2 Screening & Surveillance Guidelines I. Eligibility Coloradans ages 50 and older (average risk) or under 50 at elevated risk for colon cancer (personal or family history) that meet the following
More informationDisclosures. Colorectal Cancer Update GAFP November Risk Assessment. Colon and Rectal Cancer The Challenge. Issues in Colon and Rectal Cancer
Disclosures Colorectal Cancer Update GAFP November 2006 Robert C. Hermann, MD Georgia Center for Oncology Research and Education Northwest Georgia Oncology Centers, PC WellStar Health System Marietta,
More informationMolecular markers in colorectal cancer. Wolfram Jochum
Molecular markers in colorectal cancer Wolfram Jochum Biomarkers in cancer Patient characteristics Tumor tissue Normal cells Serum Body fluids Predisposition Diagnostic marker Specific diagnosis Prognostic
More informationFor identification, support and follow up related to Familial Gastrointestinal Cancer conditions. South Island Cancer Nurses Network September 2013
For identification, support and follow up related to Familial Gastrointestinal Cancer conditions South Island Cancer Nurses Network September 2013 Who are we? Specialist multidisciplinary team: Nurse coordinators,
More informationLET S TALK ABOUT CANCER
LET S TALK ABOUT CANCER COLORECTAL CANCER AND CROHN S DISEASE & ULCERATIVE COLITIS crohnsandcolitis.ca BACKGROUND Colorectal cancer is the second-leading cause of cancer death in this country. In 2013,
More informationCOLORECTAL CANCER FAISALGHANISIDDIQUI MBBS; FCPS; PGDIP-BIOETHICS; MCPS-HPE
COLORECTAL CANCER FAISALGHANISIDDIQUI MBBS; FCPS; PGDIP-BIOETHICS; MCPS-HPE PROFESSOR OF SURGERY & DIRECTOR, PROFESSIONAL DEVELOPMENT CENTRE J I N N A H S I N D H M E D I C A L U N I V E R S I T Y faisal.siddiqui@jsmu.edu.pk
More informationCaring for a Patient with Colorectal Cancer. Objectives. Poll question. UNC Cancer Network Presented on 10/15/18. For Educational Use Only 1
Caring for a Patient with Colorectal Cancer Tammy Triglianos RN, APRN-BC, AOCNP Nurse Practitioner, GI Oncology 10/15/2018 Objectives Describe common signs and symptoms of colorectal cancer Understand
More informationGENETIC MANAGEMENT OF A FAMILY HISTORY OF FAP or MUTYH ASSOCIATED POLYPOSIS. Family Health Clinical Genetics. Clinical Genetics department
GENETIC MANAGEMENT OF A FAMILY HISTORY OF FAP or MUTYH ASSOCIATED POLYPOSIS Full Title of Guideline: Author (include email and role): Division & Speciality: GUIDELINES FOR THE GENETIC MANAGEMENT OF A FAMILY
More informationCOLON CANCER PROFILE 2012} Cancer Outcomes Analysis Report. The Institute for. Cancer Care
COLON CANCER PROFILE 2012} Cancer Outcomes Analysis Report The Institute for Cancer Care FACT} People with a first-degree relative (parent, sibling, or children) who has colon cancer are between two and
More informationCOLORECTAL CARCINOMA
QUICK REFERENCE FOR HEALTHCARE PROVIDERS MANAGEMENT OF COLORECTAL CARCINOMA Ministry of Health Malaysia Malaysian Society of Colorectal Surgeons Malaysian Society of Gastroenterology & Hepatology Malaysian
More informationMr Chris Wakeman. General Surgeon University of Otago, Christchurch. 12:15-12:40 Management of Colorectal Cancer
Mr Chris Wakeman General Surgeon University of Otago, Christchurch 12:15-12:40 Management of Colorectal Cancer Bowel cancer Chris Wakeman Colorectal Surgeon Christchurch Sam Simon (Simpsons) Elizabeth
More informationColon Cancer Update Christie J. Hilton, DO
POMA Winter Conference Christie Hilton DO Medical Oncology January 2018 None Colon Cancer Numbers Screening (brief update) Practice changing updates in colon cancer MSI Testing Immunotherapy in Colon Cancer
More informationColorectal Cancer Therapy and Associated Toxicity
Colorectal Cancer Therapy and Associated Toxicity Mountain States Cancer Conference November 6, 2010 Colin D. Weekes, M.D., Ph.D Assistant Professor University of Colorado GI Cancers Are Common 2009 Estimated
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abdominal surgery prior as factor in laparoscopic colorectal surgery, 554 555 Abscess(es) CRC presenting as, 539 540 Adenocarcinoma of
More informationGASTROINTESTINAL MALIGNANCIES
Outline GASTROINTESTINAL MALIGNANCIES Bassel F. El-Rayes Winship Cancer Institute Emory University Colorectal Cancer Pancreas Cancer Gastric Cancer Hepatobiliary Cancer Anal Cancer Introduction Epidemiology
More informationCancer Genomics 101. BCCCP 2015 Annual Meeting
Cancer Genomics 101 BCCCP 2015 Annual Meeting Objectives Identify red flags in a person s personal and family medical history that indicate a potential inherited susceptibility to cancer Develop a systematic
More informationAlberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines
Alberta Colorectal Cancer Screening Program (ACRCSP) Post Polypectomy Surveillance Guidelines June 2013 ACRCSP Post Polypectomy Surveillance Guidelines - 2 TABLE OF CONTENTS Background... 3 Terms, Definitions
More informationCOLON CANCER CARE GUIDELINES NON-METASTATIC DISEASE
COLON CANCER CARE GUIDELINES NON-METASTATIC DISEASE Guideline Authors: Todd S. Crocenzi, M.D.; Mark Whiteford, M.D.; Matthew Solhjem, M.D.; Carlo Bifulco, M.D.; Melissa Li, M.D.; Christopher Cai, M.D.;
More informationIndex. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Abdominal drainage, after hepatic resection, 159 160 Ablation, radiofrequency, for hepatocellular carcinoma, 160 161 Adenocarcinoma, pancreatic.
More informationHereditary GI tumor syndromes ACG guidelines of genetic testing and management. Dr. med. Henrik Csaba Horváth PhD
Hereditary GI tumor syndromes ACG guidelines of genetic testing and management Dr. med. Henrik Csaba Horváth PhD Genetic testing and management of hereditary GI tumor syndromes June 29, 2016 2 Clinical
More informationFACT SHEET 49. What is meant by a family history of bowel cancer? What is bowel cancer? What causes bowel cancer?
Important points The most important factors that can influence an individual s chance of developing bowel cancer are getting older and having a family history of bowel cancer A family history of bowel
More informationA Trip Through the GI Tract: Common GI Diseases and Complaints. Jennifer Curtis, MD
A Trip Through the GI Tract: Common GI Diseases and Complaints Jennifer Curtis, MD Colon Cancer How does it develop? Most cancers arise from polyps Over time these can turn into cancer Combination of genetic
More informationSerrated Polyps and a Classification of Colorectal Cancer
Serrated Polyps and a Classification of Colorectal Cancer Ian Chandler June 2011 Structure Serrated polyps and cancer Molecular biology The Jass classification The familiar but oversimplified Vogelsteingram
More informationColon Screening in 2014 Offering Patients a Choice. Clark A Harrison MD The Nevada Colon Cancer Partnership
Colon Screening in 2014 Offering Patients a Choice Clark A Harrison MD The Nevada Colon Cancer Partnership Objectives 1. Understand the incidence and mortality rates for CRC in the US. 2. Understand risk
More informationGuidelines for Breast, Cervical and Colorectal Cancer Screening
Guidelines for Breast, Cervical and Colorectal Cancer Screening Your recommendation counts. Talk to your patients about screening for cancer. CancerCare Manitoba provides organized, population-based screening
More informationremoval of adenomatous polyps detects important effectively as follow-up colonoscopy after both constitute a low-risk Patients with 1 or 2
Supplementary Table 1. Study Characteristics Author, yr Design Winawer et al., 6 1993 National Polyp Study Jorgensen et al., 9 1995 Funen Adenoma Follow-up Study USA Multi-center, RCT for timing of surveillance
More informationPolypectomy and Local Resections of the Colorectum Structured Pathology Reporting Proforma
Polypectomy and Local Resections of the Colorectum Structured Pathology Reporting Proforma Mandatory questions (i.e. protocol standards) are in bold (e.g. S1.03). Family name Given name(s) Date of birth
More informationHereditary Gastric Cancer
Hereditary Gastric Cancer Dr Bastiaan de Boer Consultant Pathologist Department of Anatomical Pathology PathWest Laboratory Medicine, QE II Medical Centre Clinical Associate Professor School of Pathology
More informationTHE CROSSROADS: Drug Development, Biomarkers, and Colorectal Cancer
THE CROSSROADS: Drug Development, Biomarkers, and Colorectal Cancer SANJAY GOEL, M.D., M.S. PROFESSOR OF MEDICINE ALBERT EINSTEIN COLLEGE OF MEDICINE MONTEFIORE MEDICAL CENTER DEPT. OF ONCOLOGY JUN 22,
More informationNatural History and Epidemiology of Colorectal Cancer
Natural History and Epidemiology of Colorectal Cancer Prevent Cancer Foundation 2017 Dialogue for Action April 19, 2017 Roy J. Duhé, Ph.D. Associate Director for Cancer Education; Professor of Pharmacology;
More informationLocally Advanced Colon Cancer. Feiran Lou MD. MS. Richmond University Medical Center Department of Surgery
Locally Advanced Colon Cancer Feiran Lou MD. MS. Richmond University Medical Center Department of Surgery Case 34 yo man presented with severe RLQ abdominal pain X 24 hrs. No nausea/vomiting/fever. + flatus.
More informationHereditary Colorectal Cancer Syndromes Miguel A. Rodriguez-Bigas, MD
Hereditary Colorectal Cancer Syndromes Miguel A. Rodriguez-Bigas, MD Living Beyond Cancer A-Z January 12,2019 Hereditary CRC Syndromes Objectives are to discuss the : Most common Hereditary CRC syndromes
More informationColorectal Cancer Screening
Scan for mobile link. Colorectal Cancer Screening What is colorectal cancer screening? Screening examinations are tests performed to identify disease in individuals who lack any signs or symptoms. The
More informationADVANCES IN COLORECTAL CANCERS IS THERE HOPE? Dr Lim Hwee Yong Medical Oncologist
ADVANCES IN COLORECTAL CANCERS IS THERE HOPE? Dr Lim Hwee Yong Medical Oncologist limhweeyong@live.com CRC: Epidemiology in 2012 Third most common cancer diagnosis in US [1] Estimated 143,460 new cases
More informationA superficial radiotherapy B single pass curettage C excision with 2 mm margins D excision with 5 mm margins E Mohs micrographic surgery.
1- A 63-year-old woman presents with a non-healing lesion on her right temple that has been present for over two years. On examination there is a 6 mm well defined lesion with central ulceration, telangiectasia
More informationBowelGene. How do I know if I am at risk? Families with hereditary bowel cancer generally show one or more of the following clues:
BowelGene BowelGene What is hereditary bowel cancer? Bowel cancer (also known as colorectal cancer) is the fourth most common cancer in the UK. Unfortunately 1 in 19 women and 1 in 14 men will develop
More informationCLINICAL PRACTICE GUIDELINE FOR COLORECTAL CANCER SCREENING
CLINICAL PRACTICE GUIDELINE FOR COLORECTAL CANCER SCREENING This guideline is designed to assist practitioners by providing the framework for colorectal cancer (CRC) screening, and is not intended to replace
More informationContent. Diagnostic approach and clinical management of Lynch Syndrome: guidelines. Terminology. Identification of Lynch Syndrome
of Lynch Syndrome: guidelines 17/03/2009 Content Terminology Lynch Syndrome Presumed Lynch Syndrome Familial Colorectal Cancer Identification of Lynch Syndrome Amsterdam II criteria Revised Bethesda Guidelines
More informationCOLORECTAL CANCER 44
COLORECTAL CANCER 44 Colorectal Cancer Highlights from the 2009 Annual Meeting of the American Society of Clinical Oncology Edited by Stuart M. Lichtman, MD Memorial Sloan-Kettering Cancer Center Commack,
More informationMichele Bettinelli RN Maria Scholz RN Sandra Scolaro RN
Michele Bettinelli RN Maria Scholz RN Sandra Scolaro RN Objectives Define Peutz-Jeghers Syndrome (PJS) Describe the management and treatment of PJS Discuss the patient experience associated with the diagnosis
More informationBowel cancer screening and prevention
Bowel cancer screening and prevention Cancer Incidence and Mortality Victoria 2012 Number 6000 5000 4000 3000 2000 Incidences = 29,387 Mortality = 10,780 Incidence Mortality 1000 0 Prostate Breast Bowel
More informationGHUK BowelGene_2017.qxp_Layout 1 22/02/ :22 Page 3 BowelGene
GHUK BowelGene_2017.qxp_Layout 1 22/02/2017 10:22 Page 3 BowelGene BowelGene What is hereditary bowel cancer? Bowel cancer (also known as colorectal cancer) is the fourth most common cancer in the UK.
More information11/21/13 CEA: 1.7 WNL
Case Scenario 1 A 70 year-old white male presented to his primary care physician with a recent history of rectal bleeding. He was referred for imaging and a colonoscopy and was found to have adenocarcinoma.
More informationLIST OF ABBREVIATIONS
Gastroenter oenterology 2005 Royal College of Physicians of Edinburgh Screening and surveillance for upper and lower gastrointestinal cancer JN Plevris Consultant Gastroenterologist and Honorary Senior
More informationGeneral Surgery Grand Grounds
General Surgery Grand Grounds University of Colorado Health Sciences Center Case Presentation December 24, 2009 Adam Lackey, PGY-5 J.L. - 2111609 27 YO female with chief complaint of abdominal pain. PMHx:
More informationCOLON CANCER GENETICS (FOR SURGEONS) Mark W. Arnold MD Chief, Division of Colon and Rectal Surgery Professor of Surgery The Ohio State University
COLON CANCER GENETICS (FOR SURGEONS) Mark W. Arnold MD Chief, Division of Colon and Rectal Surgery Professor of Surgery The Ohio State University 1. I am a surgeon; of course I have nothing to disclose.
More informationCANCER = Malignant Tumor = Malignant Neoplasm
CANCER = Malignant Tumor = Malignant Neoplasm A tissue growth: Not necessary for body s development or repair Invading healthy tissues Spreading to other sites of the body (metastasizing) Lethal because
More informationTest Bank for Robbins and Cotran Pathologic Basis of Disease 9th Edition by Kumar
Link full download:https://getbooksolutions.com/download/test-bank-for-robbinsand-cotran-pathologic-basis-of-disease-9th-edition-by-kumar Test Bank for Robbins and Cotran Pathologic Basis of Disease 9th
More informationTerm: FIMS Week: CBL SESSION Surgery
Term: FIMS Week: CBL SESSION Surgery CBL Title: Colo-Rectal Cancer CBL Session Coordinators: Coordinators email/phone: Key issues that may be addressed in CBL sessions: SUGGESTED LIKELY CASES FOR DISCUSSION
More informationIs it possible to cure patients with liver metastases? Taghizadeh Ali MD Oncologist, MUMS
Is it possible to cure patients with liver metastases? Taghizadeh Ali MD Oncologist, MUMS Survival Rates of by Stage of Adenocarcinoma of the Colon Liver Resection New Perspective Colorectal cancer liver
More informationObjectives. Definitions. Colorectal Cancer Screening 5/8/2018. Payam Afshar, MS, MD Kaiser Permanente, San Diego. Colorectal cancer background
Colorectal Cancer Screening Payam Afshar, MS, MD Kaiser Permanente, San Diego Objectives Colorectal cancer background Colorectal cancer screening populations Colorectal cancer screening modalities Colonoscopy
More informationGastric Polyps. Bible class
Gastric Polyps Bible class 29.08.2018 Starting my training in gastroenterology, some decades ago, my first chief always told me that colonoscopy may seem technically more challenging but gastroscopy has
More informationCOLON CANCER & GENETICS VERMONT COLORECTAL CANCER SUMMIT NOVEMBER 15, 2014
COLON CANCER & GENETICS VERMONT COLORECTAL CANCER SUMMIT NOVEMBER 15, 2014 WENDY MCKINNON, MS, CGC CERTIFIED GENETIC COUNSELOR FAMILIAL CANCER PROGRAM UNIVERSIT Y OF VERMONT MEDICAL CENTER 1 CHARACTERISTICS
More informationGI CANCER SCREENING- Is It Worth It? Sylvia M. Oats, MSN, APRN, ANP-BC Susan H. Miedecke, MSN, APRN, FNP-BC Gastroenterology Clinic of Acadiana
GI CANCER SCREENING- Is It Worth It? Sylvia M. Oats, MSN, APRN, ANP-BC Susan H. Miedecke, MSN, APRN, FNP-BC Gastroenterology Clinic of Acadiana Life is a sexually transmitted disease, and the mortality
More informationPreoperative Data Colorectal Cancer Database
Preoperative Data Please place patient label here Patient Information Patient s Last Name First Middle Initial UR MH MP Birth Date Sex Post Code / / M F ECOG (see codes below) Date of Diagnosis Consultant
More informationNavigators Lead the Way
RN Navigators Their Role in patients with Cancers of the GI tract Navigators Lead the Way Nurse Navigator Defined Nurse Navigator A clinically trained individual responsible for the identification and
More information2. Describe pros/cons of screening interventions (including colonoscopy, CT colography, fecal tests)
Learning Objectives 1. Review principles of colon adenoma/cancer biology that permit successful prevention regimes 2. Describe pros/cons of screening interventions (including colonoscopy, CT colography,
More informationNeoplasia part I. Dr. Mohsen Dashti. Clinical Medicine & Pathology nd Lecture
Neoplasia part I By Dr. Mohsen Dashti Clinical Medicine & Pathology 316 2 nd Lecture Lecture outline Review of structure & function. Basic definitions. Classification of neoplasms. Morphologic features.
More informationTest Bank for Robbins and Cotran Pathologic Basis of Disease 9th Edition by Kumar
Link full download: http://testbankair.com/download/test-bank-for-robbins-cotran-pathologic-basis-of-disease-9th-edition-bykumar-abbas-and-aster Test Bank for Robbins and Cotran Pathologic Basis of Disease
More informationPathology perspective of colonic polyposis syndromes
Pathology perspective of colonic polyposis syndromes When are too many polyps too many? David Schaeffer Head and Consultant Pathologist, Department of Pathology and Laboratory Medicine, Vancouver General
More informationWhat is Colorectal Cancer?
COLORECTAL CANCER (CRC) What is Colorectal Cancer? Colorectal cancer (also known as colon cancer) is cancer of the colon and/or rectum and occurs when a growth in the lining of the colon or rectum becomes
More informationColorectal Cancer - Working in Partnership. David Baty Genetics, Ninewells Hospital
Colorectal Cancer - Working in Partnership David Baty Genetics, Ninewells Hospital Genetics and Pathology National initiatives Colorectal cancer Inherited CRC Sporadic CRC The Liquid Biopsy The future?
More informationnumber Done by Corrected by Doctor مها شوماف
number 15 Done by Ali Yaghi Corrected by Waseem Alhaj Doctor مها شوماف 1 P a g e Epidemiology Epidemiology is the study of the incidence of a disease. It can give us information about the possible causes
More informationBowel obstruction and tumors
Bowel obstruction and tumors Intestinal Obstruction Obstruction of the GI tract may occur at any level, but the small intestine is most often involved because of its relatively narrow lumen. Causes: Hernias
More informationColon Cancer and Hereditary Cancer Syndromes
Colon Cancer and Hereditary Cancer Syndromes Gisela Keller Institute of Pathology Technische Universität München gisela.keller@lrz.tum.de Colon Cancer and Hereditary Cancer Syndromes epidemiology models
More informationWhen is a programmed follow-up meaningful and how should it be done? Professor Alastair Watson University of Liverpool
When is a programmed follow-up meaningful and how should it be done? Professor Alastair Watson University of Liverpool Adenomas/Carcinoma Sequence Providing Time for Screening Normal 5-20 yrs 5-15 yrs
More information