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40 Cards in this Set
- Front
- Back
- 3rd side (hint)
Colonoscopy |
Facilitates examination of entire bowel to cecum in most patients, simultaneous removal of premalignant lesions, gold standard for colorectal screening |
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Flexible sigmoidoscopy |
Uses 40-60cm flexible to examine lower of half of the bowel to the splenic flexure for most patients |
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Computed Tomography Colonography (CTC) |
Virtual colonoscopy: imaging procedure creates 2D or 3D images of colon |
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Double Contrast Barium Enema (DCBE) |
Coating interior bowel with Barium and distending it with air to produce an image of entire colon |
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Fecal Occult Blood Tests |
Used to detect occult blood stool that may be associated with bleeding adenomas or cancer |
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STOOL DNA SCREENING TESTS |
Molecular screening strategies analyze stool samples for presence of potential markers of malignancy in cells |
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EsophagoGastroDuodenoColonoscopy |
Examination of esophagus, stomach, upper small bowel and large intestine |
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Regional lymphadenectomy |
Complete surgical resection of primary tumor, curative approach for patients with operable CRC |
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Total Excision of mesorectum |
Preferred surgical procedure for rectal cancer which includes perirectal fat and draining lymph nodes |
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Adjuvant Therapy for CRC |
Administered after complete tumor resection to eliminate residual micrometastatic disease, not indicated for stage 1 CRC |
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Adjuvant radiation therapy |
Limited role in colon cancer, most recurrences are extrapelvic and abdomen |
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Adjuvant Chemotherapy |
Standard for stage 3 Colon cancer |
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Fluorouracil (fluoropyrimidine) |
Administered by IV bolus injection (leukopenia) & continuous IV infusion (palmar plantar erythrodysesthesias, hand foot syndrome and stomatitis) |
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Fluorouracil/ leucovorin |
Acceptable options in patients who cannot receive oxiplatin and unable to tolerate oral capecitabine |
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Oxiplatin based regimens |
Recommended therapy by national guidelines as 1st line option for stage 3 colon cancer can tolerate combination therapy |
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Adjuvant Radiation plus chemotherapy (rectal cance) |
Standard for stage 2 and 3 rectal cancer, RT reduces risk of local tumor recurrence , given prior to surgery to decrease tumor size |
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Preoperative (neoadjuvant) chemoradiation |
Shrinks rectal tumors proor to surgical resection improving sphincter preservation (fluorouracil based regimens or oral capecitabine) |
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Resectable potentially resectable unresectable |
Patients with MRC are considered that are: |
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Multimodality therapy |
Indicated for resectable or potentially resectable metastasis |
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Chemotherapy |
For disseminated disease and the primary treatment modality for unresectable MCRC |
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Surgical resection of Metastases |
Primary goal with curative intent |
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NEOADJUVANT or Conversional chemotherapy |
Administered to complete resection rates with resectable & potentially resectable liver or lung lesions |
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Hepatic directed therapy |
In addition or alternative to surgical resection in patients with liver only or predominant MCRC |
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Hepatic Artery Infusion |
Delivers chemotherapy (floxuridine and fluorouracil) thru hepatic artery directly into the liver |
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Tumor ablation |
Uses radio-frequency ablation or microwave ablation to generate heat to destroy tumor cells |
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Cryoablation |
Placement of cryoprobe into tumor, either percutaneously, lowering 20-40 degrees causes tumor destruction |
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Oxiplatin FOLFOX, CapOx (Fluorouracil, Leucovorin, Oxiplatin) |
Higher response rates improved PFS and OS Approved first line and salvage therapy unresectable MCRC |
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Irinotecan (FOLFIRI) -Topoisomerase I |
initial therapy improves tumor response rates, time to progression, and OS, dose limiting toxicities late onset diarrhea, neutropenia |
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Infusional Fluorouracil, leucovorin, oxiplatin, irinotecan (FOLFOXIRI) |
Improved PGS and OS compared to FOLFIRI, causes more neutropenia, neurotoxicity, diarrhea and alopecia |
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Capecitabine monotherapt (Xeloda) |
Suitable for first line in patients not likely to tolerate IV chemotherapy , available in oral administration, converted to fluorouracil, suitable replacement for infusional fluouracil with oxiplatin |
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Bevacizumab |
Directed against VEGF, associated with HTN, other safety concerns: bleeding, thrombocytopenia, and proteinuria , should be used as second line if not used as initial tx |
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Cetuximab |
Patients with wild type KRAS, tumors in combination with FOLFIRI, side effects acne skin like reactions, asthenia, lethargy, malaise, and fatigue |
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Panitumumab (EGFR inhibitor) |
Can be combined with either FOLFOX or FOLFIRI in patients with wild type KRAS tumors |
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Cetuximab, Panitumumab, Ziv aflebercept, Regorafenib |
Treatment for metastatic disease, second line therapy |
General treatment: administer EFGR inhibitors in combination with irinotecan or as single agents except bevacizumab and ziv aflibercept |
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Cetuximab |
Alone or combi with irinotecan, patients with disease progression on irinotecan, response rates are greater combination therapy |
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Panitumumab |
Monotherapy or in combination with chemotherapy regimens, shoule be limited to wild type KRAS tumors |
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Ziv Aflibercept |
Soluble recombination fusion protein, designed to block angiogenic process |
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Regorafenib (oral angiogenesis inhibitors) |
Approved for 3rd/4th line treatment of MCRC, no conclusive survival advantage has been demonstrated for palliative HAI |
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•Irinotecan-Induced diarrhea •Bevacizumab -GI perforation, HTN, proteinuria •Oxiplatin -induces neuropathy •cetuximab and panitumumab-skin rash |
•Irinotecan•Bevacizumab•Oxiplatin •cetuximab and panitumumab |
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•Cure stages 1,2,3 - Eradicate Micromestatic disease •IV (incurable) -Palliative treatment -control growth, reduce symptoms, improve QOL, extend survival |
Goals of treatment for Colorectal Cancer |
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