1. COLORECTAL
CANCER
PRESENTED BY
MR SUDIP DAS
M.SC NURSING 2ND SEMESTER
DEPARTMENT OF MEDICAL SURGICAL NURSING
INS.

2. DEFINITION :-
 Colorectal cancer (CRC), also known as bowel
cancer and colon cancer, is the development
of cancer from the colon or rectum (parts of the large
intestine). A cancer is the abnormal growth of cells that
have the ability to invade or spread to other parts of the
body.

3. ANATOMY AND PHYSIOLOGY :-

4. INCIDENCE :-
 The colorectal cancer is the third most common
cancer case in India. Incidence increases with age
and is higher in people with family history of colon
cancer. Men are having high risk then women.

5. RISK FACTOR / CAUSES :-
 Increasing age.
 Family history of colon cancer.
 Previous colon cancer or adenomatous polyps.
 High consumption of alcohol.
 Smoking.
 Obesity.
 History of gastrectomy.
 History of inflammatory bowel disease.

6. STAGES OF COLORECTAL CANCER:-

7. TNM CLASSIFICATION OF
COLORECTAL CANCER:-

8. PATHOPHYSIOLOGY :-
Due to etiology
Begins as adenomatous polyp that arise from the mucosa lining
of the colon and rectum
Progress down from the tip of polyp through the body and stalk
Invasive and penetrates the muscularis mucosa
Tumor cell generation occurs to the regional lymphnodes and
vascular system
Metastates ( liver, lung, peritoneum )

10. CLINICAL FEATURES :-
 A change in bowel habits, such as diarrhea,
constipation, or narrowing of the stool, that lasts for
more than a few days
 A feeling of incomplete evacuation after a bowel
movement.
 Rectal bleeding with bright red blood
 Blood in the stool, which may make the stool look dark
 Cramping or abdominal (belly) pain
 Weakness and fatigue
 Unintended weight loss
 Abdominal pain.
 Rectal lesions and tenesmus.

11. DIAGNOSTIC EVALUATION :-
 Abdominal and rectal examination.
 High-sensitivity fecal occult blood tests (FOBT)
 Sigmoidoscopy.
 Standard colonoscopy.
 Virtual colonoscopy.
 Double contrast barium enema.

12. TREATMENT :-
 Adjuvent therapy :
 Radiation therapy.
 Chemotherapy {5-flurouracil, capecitabine
(Xeloda), irinotecan (Camptosar), oxaliplatin
(Eloxatin).}
 Biologic and targeted therapy (Two drugs target
epithelial growth receptor factor that is cetuximab,
panitumumab and other drug targets vascular
endothelial growth factor that is bevacizumab)
 Surgery.(Abdominoperineal Resection , Total
Mesorectal Excision , Radiofrequency Ablation )

13. PRE-OPERATIVE NURSING
MANAGEMENT :-
 Assessment.
 Nursing diagnosis :-
 Acute pain related to damage of mucosa layer of
the colon and rectum
 Fluid volume deficit related to increased intestinal
movement.
 Immbalance nutrition less than body requirement
related to disease process.
 Sleeping pattern disturbance related to pain.
 Anxiety related to hospitalization.
 Knowledge deficit related to treatment process.
o Intervention.

14. POST-OPERATIVE NURSING
MANAGEMENT :-
 Assessment.
 Nursing diagnosis :-
 Acute pain related to surgical incision.
 Fluid volume deficit related to blood loss during
surgery.
 Immbalance nutrition less than body requirement
related to surgical intervention.
 Sleeping pattern disturbance related to pain.
 Anxiety related to hospitalization.
 Knowledge deficit related to treatment process.
o Intervention.

15. PREVENTION OF COLORECTAL CANCER :-
 Take an occasional aspirin
 Don’t smoke
 Avoid red meat
 Get enough calcium and vitamin D
 Exercise.
 Genetic counselling.

16. BIBLIOGRAPHY :-
 Brunner & Suddarth, “Textbook of Medical Surgical
Nursing”, 12th edition,2014, vol-I, Wloters
kluwer,New delhi, Page no-1098-1107.
 Lewis, “ Medical Surgical Nursing”, 2014 edition,
New delhi, South asian publication, Page no –
1075-1088.
 Lippincott, “Manual of Nursing Practice”, 10th
edition, 2014, Wloter kluwer, New delhi Page no-
705-708.

17. THANK YOU