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Colon Cancer
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common genetic susceptability to colorectal cancer
FAP - familial adenomatous polyposis
Two lifestyle factors that decrease the risk of colorectal cancer
exogenous hormone use
aspirin and NSAID use
Drugs used in prevention of colorectal cancer
Celecoxib - reduces polyps in FAP
Aspirin
Estrogen
Calcium and Vit D
Frequency of:
fleixble sigmoidoscopy
colonoscopy
double contrast barium enema
CT colonograpy
5 yrs
10 yrs
5 yrs
5 yrs
Tests that detect cancer
Fecal occult blood test -- yearly
Fecal immunochemical test -- yearly
Stool DNA test -- inteval uncertain
what do you do for a family history of familial adenomatous polyposis?
begin screening at puberty
possible colectomy
screening every 1-2 yrs
lab important in workup and diagnosis of colorectal cancer
CEA - carino embryonic antigen
Stage of cancer that invades the colon wall
II
Stage that travels to lymph nodes
III
Chemo agents for colorectal cancer
5-FU - with or without leucovorin
Irinotecan
Capecitabine
Oxaliplatin
Mitomycin C
requires wild type K ras
Monoclonal antibody therapy
cetuximab, panitumumab
synthetic oral antihelminthic drug with immunomodulatory properties
Lavamisole
direct administration of 5-FU or FUDR
direct hepatic arterial/portal vein infusions
direct administrations of substances to block liver blood flow to hepatic masses
hepatic artery chemoembolization
Surgery + adjuvant systemic therapy options for Locally Advanced Colon Cancer Stage (III)
5FU + leucovorin for 6 months
FOLFOX
Cepecitabine for 6 months
Treatmetn options for localized (stage I-II) colon cancer
Surgical resection of primary tumor + regional mesenteric LN
Selected patients with Stage II disease may benefit from adjuvant systemic therapy
tx for stage I rectal cancer
surgical resection
tx for stage II and III rectal cancer
surgery followed by radiation therapy with 5FU
regimins may include oxaliplatin, LV, or capecitabine
preoperative fluoropyrimidine based therapy plus XRT also used
First line chemo for tx of metastatic colorectal cancer
bevacizumab + 5FU based regimin
FOLFOX
FOLFIRI (irinotecan + 5FU + Leucovorin)
5FU + leucovorin
Capecitabine
CapeOx
FOLFOXFIRI
2nd line chemo for tx of metastatic colorectal cancer
irinotecan
oxaliplatin + 5FU + leucovorin
cetuximab + irinotecan
panitumumab
what do you do if you get a clot from bevacizumab
venous = keep on treating
arterial = d/c drug
dose limiting adverse effects of FOLFOX
peripheral sensory neuropathy
diarrhea
myelosuppression
hand-foot syndrome
pulmonary fibrosis
premedications fro FOLFOX
5HT3 antagonists
avoid ice chips
Author
Anonymous
ID
10965
Card Set
Colon Cancer
Description
Colon Cancer
Updated
2010-03-17T18:21:12Z
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