Pathogenesis
Risk Factors for Colorectal Cancer
- Familial syndromes - Lynch syndrome, familial adenomatous polyposis
- Family history of colorectal cancer
- Past polyps / colorectal cancer
- Inflammatory bowel disease
- Dietary factors - red meats, processed meats; lack of fruit and vegetables
- Physical inactivity
- Obesity
- Smoking
- Alcohol
Manifestations
Complications of Colorectal Cancer
Disease-Related
- Lower GI bleeding
- Bowel obstruction
- Perforation
Management-Related
- Surgical complications - bleeding, wound infection, anastomotic leak, intra-abdominal collection, ileus
- Adverse effects of chemotherapy - fatigue, nausea / vomiting / diarrhoea, myelosuppression
- Adverse effects of VEGF inhibitors - hypertension, arterial / venous thromboembolism, myelosupression
- Adverse effects of EGFR inhibitors - acneiform rash, nausea / vomiting / diarrhoea, hypomagnesaemia
Management
Management Strategy
- Depends on stage and the patient's functional status.
Non-Metastatic
- Surgical resection with or without adjuvant chemotherapy
- Surveillance - CEA level, CT, colonoscopy
Metastatic
- Surgical resection (solitary metastasis) with adjuvant chemotherapy
- VEGF inhibitors - bevacizumab
- EGFR inhibitors - cetuximab, panitumumab
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