Colorectal cancer history and symptoms: Difference between revisions

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{{Colon cancer}}
{{Colon cancer}}
 
To view the history and symptoms of familial adenomatous polyposis (FAP), click [[Familial adenomatous polyposis history and symptoms|'''here''']]<br>
'''Editor(s)-in-Chief:''' [[C. Michael Gibson]], M.S.,M.D. [mailto:charlesmichaelgibson@gmail.com]  Phone:617-632-7753; Elliot B. Tapper, M.D., Beth Israel Deaconess Medical Center; {{RT}}
To view the history and symptoms of hereditary nonpolyposis colorectal cancer (HNPCC), click [[Hereditary nonpolyposis colorectal cancer history and symptoms|'''here''']]<br><br>
{{CMG}} {{AE}} Saarah T. Alkhairy, M.D.; Elliot B. Tapper, M.D.


==Overview==
==Overview==
The history of a patient with colorectal cancer may include a family history of polyps/colorectal cancer or a history of inflammatory bowel disease. Some symptoms that are associated with colorectal cancer are change in bowel habits, hematochezia, and rectal pain. Metastatic symptoms include dyspnea, abdominal pain, fractures, and confusion.


==History==
==Colorectal Cancer History and Symptoms==
A directed history is to be obtained to asertain:
* Any change in bowel habits
* Any [[bleeding per rectum]]
* Excessive [[fatigue ]]
* Unexplained [[weight loss]]
* [[Abdominal pain]]
 
===Past Medical History===
* Any history of long standing [[inflammatory bowel disease]]
* Any history of [[Diabetes]]
 
===Family History===
* Any family history of colorectal cancer
 
====Alcohol====
* History of long standing history of alcohol intake should be inquired.


====Smoking====
===History===
* Any history of long standing tobacco use/[[smoking]]
The following may be in the history for a patient with colorectal cancer:
*Past medical history of longstanding inflammatory bowel disease or diabetes
*Past medical history of another primary cancer or renal transplantation
*Family history of polyps or colorectal cancer
*Use of cigarettes and/or alcohol
*Low fiber/high fat diet and/or red meat diet
*Sedentary lifestyle


==Symptoms==
===Symptoms===
Colon cancer often causes no symptoms until it has reached a relatively advanced stage.  Thus, many organizations recommend periodic screening (see below). 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:
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 bowel habits
** change in frequency ([[constipation]] and/or [[diarrhea]]),
:*Change in frequency ([[constipation]] and/or [[diarrhea]])
** change in the quality of stools
:*Change in the quality of stools
** change in consistency of stools
:*Change in consistency of stools
* [[hematochezia|Bloody stools]] or rectal bleeding
*[[Hematochezia]] or bleeding per rectum
* Stools with [[mucus]]
*[[Mucus]] in stools
* Tarry stools ([[melena]]) (more likely related to upper gastrointestinal eg stomach or duodenal disease)
*Abdominal cramps discomfort
* Feeling of incomplete defecation ([[tenesmus]]) (usually associated with rectal cancer)
*([[Melena]]) (more likely related to upper gastrointestinal disease)
* Reduction in diameter of feces
*[[Tenesmus]] (usually associated with rectal cancer)
* [[Bowel obstruction]] (rare)
*Diminished caliber of stools (usually associated with rectal cancer)
*Rectal pain (usually associated with rectal cancer)


===Constitutional symptoms===
===Constitutional symptoms===
Especially in the cases of cancer in the [[ascending colon]], sometimes only the less specific constitutional symptoms will be found:
*Nausea/vomiting
* [[Anemia]], with symptoms such as [[dizziness]], [[malaise]] and [[palpitation]]s.  Clinically there will be [[pallor]] and a complete blood picture will confirm the low [[hemoglobin]] level, often with low mean corpuscular volume.
*Unexplained [[weight loss]]
* [[Anorexia (symptom)|Anorexia]]
*Unexplained loss of appetite
* [[Asthenia]], [[weakness]]
*Weakness
* Unexplained [[weight loss]].
*[[Fatigue]]
[[Image:Colon cancer.jpg|thumb|200px|left|[[Gross examination|Gross]] appearance of a [[colectomy]] specimen containing two [[Colorectal polyp|adenomatous polyps]] (the brownish oval tumors above the labels, attached to the normal beige lining by a stalk) and one '''invasive colorectal carcinoma''' (the crater-like, reddish, irregularly-shaped tumor located above the label).]]
*[[Dizziness]]
<br clear="left"/>
*[[Palpitations]]


===Metastatic symptoms===
===Metastatic symptoms===
There may also be symptoms attributed to distant [[metastasis]]:
There may be symptoms attributed to distant [[metastasis]]:
* [[Shortness of breath]] as in [[lung]] [[metastasis]]
*Lungs - dyspnea, cough, chest wall pain
* [[Epigastric pain|Epigastric]] or [[right upper quadrant pain]], as in [[liver]] [[metastasis]].  Rarely there can be [[jaundice]] if the outflow of [[bile]] is blocked.  Clinically there might be [[hepatomegaly|liver enlargement]].
*Liver - abdominal pain, swelling in hands/feet, itchiness, jaundice
*Bones - pain, fractures
*Brain/spinal cord - pain, confusion, memory loss, headache, blurred or double vision, difficulty with speech, difficulty with movement or seizures


==References==
==References==

Revision as of 19:05, 14 July 2015

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To view the history and symptoms of familial adenomatous polyposis (FAP), click here
To view the history and symptoms of hereditary nonpolyposis colorectal cancer (HNPCC), click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.; Elliot B. Tapper, M.D.

Overview

The history of a patient with colorectal cancer may include a family history of polyps/colorectal cancer or a history of inflammatory bowel disease. Some symptoms that are associated with colorectal cancer are change in bowel habits, hematochezia, and rectal pain. Metastatic symptoms include dyspnea, abdominal pain, fractures, and confusion.

Colorectal Cancer History and Symptoms

History

The following may be in the history for a patient with colorectal cancer:

  • Past medical history of longstanding inflammatory bowel disease or diabetes
  • Past medical history of another primary cancer or renal transplantation
  • Family history of polyps or colorectal cancer
  • Use of cigarettes and/or alcohol
  • Low fiber/high fat diet and/or red meat diet
  • Sedentary lifestyle

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 discomfort
  • (Melena) (more likely related to 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)

Constitutional symptoms

Metastatic symptoms

There may be symptoms attributed to distant metastasis:

  • Lungs - dyspnea, cough, chest wall pain
  • Liver - abdominal pain, swelling in hands/feet, itchiness, jaundice
  • Bones - pain, fractures
  • Brain/spinal cord - pain, confusion, memory loss, headache, blurred or double vision, difficulty with speech, difficulty with movement or seizures

References


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