Familial adenomatous polyposis (FAP) syndrome.
Falimial Adenomatous Polyposis is Affecting 1:10,000 people and accounts for approximately 0.5% of colorectal cancer. The classic form of FAP is characterized by the developments of hundreds to thousands of colonic adenomatous polyps. and a variety of extracolonic symptoms.
Colorectum cancer is the second leading cause of death due to malignancy in the EU. Colorectal cancer will develop in approximately 65% of Americans and 40% of those will die of the disease.
Between 1996 and 2010, mortality has decreased by 46%. During this same period, the percentage of patients 50 years older who were screened for colorectal cancer has increased to 66.1%.
The high suspicious about more of colorectal cancer originates from familial adenomatous polyposis in the colon.
These cells grow like fungus and are usually benign, once in a while they turn cancerous with time. In more of the cases, the diagnosis from cancer localized is for colonoscopy.
R I S K F A C T O R S.
The population in the USA has the risk to contract cancer colon is about 7%. Such kind of factor that helps to develop this disease.
#1. Age. The risk to develop colorectal cancer increases with age. Most of the cases present between 60 to 70 years. It is less common before 50 hears except with the presence of colorectal cancer.
Particularly adenomatous polyps. The elimination of polyps from the colon around the colonoscopy dismiss the subsequent risk from colon cancer.
#2. History of cancer or Familiar Adenomatous Polyposis. The individuals that previously was diagnosed and treated with cancer has one high risk from the population to get colorectal cancer.
The woman with a history of ovary cancer, wound or breast has a risk in the apparition of colon cancer.
#3. Inherence. It is the second important cause of colorectal cancer the cause of death around the world every year and their most common form of cancer. The history of colorectal cancer in the family, especially from one closer member less the 55 years.
#4. Familial adenomatous polyposis in 100 % develops to colorectal cancer for the 40 years.
#5. Lynch Syndrome or heritage colorectal cancer is associated with polyposis.
#6. Chronic ulcers colitis of Crohn disease, approximate 30% from 25 years if the whole colon is compromised.
Is probably that one smoker death from colorectal cancer than nonsmoker person. The American society against cancer made a study and found the 40% is more probable than smoker woman’s death from colorectal cancer compared with women who never smoke. The male smoker has a risk of 30% high to die than those who do not smoke.
The studies show up the diet with meat and in fruit, vegetable bird and fish increase the risk of colorectal cancer.
One prospective Europe Study by Cancer and Nutrition suggests that diets high in red meat, the same as the low fiber are associated with colorectal cancer, such people eat fish show up low risk.
However other studies put in dude, to confirm a diet rich in fiber decrease the risk of colorectal cancer. The less fiber diet is associated with colorectal cancer. The less fiber diet is associated with colorectal cancer is controversial.
#9. Physical activity.
Persons with activity has a less risk to develop colorectal cancer.
The lack of selenium corporal is a factor.
Plays an important role in the risk of colorectal cancer.
Other epidemiologic studies show an association with the alcohol and cancer of the colon is not determinate.
A study found those who drink more than 30-45 have more risk to develop colorectal cancer. Other studies show that consumption of one alcoholic drink every day is associated with a high incidence in 70% high to the half of colon cancer.
While we found a duplication of colon cancer. With the consumption of alcohol, including beer and other beverages. The studies show for minimizing the risk of colorectal cancer is better minimized the consume.
SY M P T O M S.
Colorectal cancer cannot give symptoms in the advanced stage and for the mayor of patients present tumors and invade all the intestine wall or are affected the regional ganglions. When appear the symptoms and signs of colorectal carcinoma are variable and specific. The age the development of cancer colorectal is between 60-80 years of age.
When there is hereditary the diagnostic is before 50 years ago. The frequent symptoms include low digestive hemorrhages and rectorrhagia, changes in the defecations and abdominal pain. The present of distinguishes systems o the form of manifestation depends on the site from the tumor and the extension from the disease.
P A T H O L O G Y.
The pathology report after the resection of tissue through the operation. The pathologic description of the cells type and the degree of advance. The common type is cancerogenic cells is Adenocarcinoma, in 95% of the cases. Other less frequent are lymphomas and the squamous cells carcinoma.
Cancer from the right size (ascendent colon and sigmoid), with an exophytic pattern, it means the tumor grows into the intestinal space. This type cause obstruction from the feces and present symptoms like anemia. Cancer from the left side can be circumferential and produce obstructive symptoms.
Frequent Types of Cancer.
Right Colon Cancer. The principal symptoms are anemic syndrome and occasional, palpitation from the abdominal tumor. In this portion the tumors can be a bigger size, producing stenosis without obstructive symptoms. The abdominal pain presence in more the 60% of patients in the right half from the abdomen.
The anemic syndrome is present in 60% for the continued loose, that not modifies the feces aspect, from the ulcers superficies from the tumor.
Presence of fatigue, palpitations angor pectoris with anemia hypochromia and macrocytic with the iron deficit. Is necessary to do Endoscopy and Radiology from the whole colon.
Cancer left colon. The pain in abdomen inferior can relief with the defecations in case some patients can develop anemia for lack of iron in case of colon cancer right.
Recommendations for Colorectal Cancer Screening.
Average risk individuals >59 years old.
Annual fecal occult blood testing using higher sensitivity ties (Hemoccult SENSA)
Annual fecal Immunochemical test (FIT)
Fetal DNA test (interval uncertain)
Flexible sigmoidoscopy every 5 years
Colonoscopy every 10 years
CT Colonography every 5 years.
Individuals with a family history of a first-degree member with colorectal neoplasia.
Single first degree relative with colorectal cancer diagnosed at age >60 years. Begin screening at age 40.
Screening guidelines same as average risk individual; the however preferred method is colonoscopy every 10 years.
A single first degree relative with colorectal cancer or advanced adenoma diagnosed at age <60 years, or two first-degree relatives: being screening at age 40 or at age 10 years younger than the age at diagnosis of the youngest affected relative, whichever is first in time.
Recommended screening colonoscopy every 5 years.
Colonoscopy Test for Early Detection of Familial Adenomatous Polyposis.
The colonoscopy allows evaluation of the entire colon and is the way of detection and removing adenomatous and serrated polyps.
It should be performed in all patients who have positive FOBT, FIT, fecal or DNA test or iron deficiency anemia (see Occult Gastrointestinal bleeding and obscure gastrointestinal bleeding) as the prevalence of colonic neoplasm is increased in this patients.
The Stages from Colon Cancer.
The TNM system is used classification to stage colorectal cancer. Staging is important not only because it correlates with the patient long term survival but also because it is used to determine which patient should receive therapy.
State I. Has a 90-100% survival 5 years rate, no therapy required.
Stage II. The 5 years survival year drops to 80% and who are at higher risk for recurrence (perforations, obstruction, T4 tumor or fewer than 12 lymph nodes) get to benefit from adjuvant chemotherapy.
Stage III. (node-positive disease) The surgical resection alone, the expected 5-year survival rate is 30-50%. Postoperative adjuvant chemotherapy significantly increases disease-free survival as well as overall survival up to 30% and is recommended tor all fit patients.
Large designated studies of adjuvant therapy for stage III colon cancer reported a higher rate of disease-free survival at 5 years for patients treated for 6 months postoperatively in combination with chemotherapy.
Stage IV. (metastatic disease) Approximately 20% of patients have metastatic disease at the time of initial diagnosis and additional 30% eventually develop metastasis. A subset of these patients has a limited disease that is potentially curable with surgical resection.
The majority of patients with metastatic disease do not have a respectable (curable) disease. In the absence of other treatment, the median survival is less than 12 months. However, with current therapies, median survival approaches 24 months.
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