Hereditary nonpolyposis colorectal cancer history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
The hallmark of hereditary nonpolyposis colorectal cancer is a first-degree relative of those with known MMR/EPCAM gene mutation. A positive history of colorectal cancer and meeting Amsterdam I or II criteria or revised Bethesda guidelines is highly suggestive of HNPCC. Some symptoms that are associated with colorectal cancer are change in bowel habits, hematochezia, and rectal pain.[1]
History and symptoms
Colon cancer often causes no symptoms until it has reached a relatively advanced stage. When symptoms do occur, they depend on the site of the lesion. Generally speaking, the nearer the lesion is to the anus, the more bowel symptoms there will be, such as:
- Change in bowel habits
- Change in frequency (constipation and/or diarrhea)
- Change in the quality of stools
- Change in consistency of stools
- Hematochezia or bleeding per rectum
- Mucus in stools
- Abdominal cramps or discomfort
- Melena (usually associated with upper gastrointestinal disease)
- Tenesmus (usually associated with rectal cancer)
- Diminished caliber of stools (usually associated with rectal cancer)
- Rectal pain (usually associated with rectal cancer)
- Past medical history of longstanding inflammatory bowel disease, diabetes, another primary cancer, or renal transplantation
- Family history of polyps or colorectal cancer
- Smoking and/or alcohol
- Low fiber/high fat diet and/or red meat diet
- Sedentary lifestyle
Constitutional symptoms
- Nausea/vomiting
- Unexplained weight loss
- Unexplained loss of appetite
- Weakness
- Fatigue
- Dizziness
- Palpitations
Metastatic symptoms
There may be symptoms attributed to distant metastasis:
Endometrial (most common):
- Abnormal vaginal bleeding, abnormal menstrual periods
- Metrorrhagia in premenopausal women
- Postmenopausal vaginal bleeding [2]
- Postcoital bleeding
References
- ↑ Kladny J, Lubinski J. Lynch syndrome (HNPCC). Hered Cancer Clin Pract. 2008;6(2):99-102.
- ↑ Kong A, Johnson N, Kitchener HC, Lawrie TA (2012). "Adjuvant radiotherapy for stage I endometrial cancer". Cochrane Database Syst Rev. 4: CD003916. doi:10.1002/14651858.CD003916.pub4. PMC 4164955. PMID 22513918.