Colon Cancer

genetics
family history
polyps
race
IBD
T2DM
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Terms in this set (21)
genetics
family history
polyps
race
IBD
T2DM
What are some non-modifiable risk factors?
Diet, BMI, activity, lifestyle
What are some modifiable risk factors?
Average risk: everyone age 45-75
-colonoscopy q10 years

Average risk: age 76-85
- selectively screen
Who should get screened for colon cancer?
history of:
- cancer
- polyps
- family history of CRC
- genetic condition
- IBD
Who is not average risk?
KRAS or BRAF mutation
What genetic factors lead to Colon cancer?
Local:
- BM changes
- gas or bloating
- abdominal discomfort
- N/V

Systemic
- fatigue
- loss of appetite
- weight loss
What are some local and systemic symptoms of colon cancer?
Tissue Biopsy for evaluation by a pathologist
What has to be done for diagnosis?
EGFR
KRAS
BRAF
What are some colon tumor mutations?
DPYD
UGT1A1
What are some patient genetic polymorphisms?
Cetuximab, Panitumumab

It causes increased signaling even though EGFR is being inhibited
What are the anti-EGFR drugs?

What does mutated KRAS do?
BRAF signalingWhat does Encorafenib inhibit?used to MONITOR response and progression of disease NOT DIAGNOSISWhat is Carcinoembryonic antigen (CEA) used for?Cure = Stage I-III Prolong survival and reduce symptoms = Stage IVWhat stages of colon cancer can we cure and not cure?Surgery (Resection)what is the primary treatment for stages I-III?RadiationWhat therapy is not commonly used for colon cancer?Stage I - not recommended just remove it Stage II - only if they have high risk features Stage III - adjuvant chemo therapy is standard of care FOLFOX or CapeOxWhen is Adjuvant treatment recommended? What stages?I - surgery II - surgery and consider chemo for high risk (wont have to know high risk on exam) III - surgery and chemo combo (FOLFOX or CapeOx)Summary of Treatments: I - II - III -MOA: VEGF inhibitor / angiogenesis inhibitor ADE: HTN, hemorrhagic issues, GI bleed, do not give within 28 days of surgeryWhat are the MOA's and ADE's of Bevacizumab?MOA: EGFR inhibitor ADE: Acneiform RashWhat is cetuximab MOA? ADE:helps to inactivated 5-FU - it is the rate limiting enzyme (if we don't have it then could lead to serious toxicities)What does DPYD do?inactivate irinotecan.... Have to have UGT1A1 testing if irinotecan dose ≥ 180mgWhat does UGT1A1 do?