Get the PDF version of this article FAMILIAL ADENOMATOUS POLYPOSIS: ONE GENE. MANY MANIFESTATIONS. ALPHABET SOUP: FROM HERE TO THERE AND BACK AGAIN…AGAIN Part III of this series looked at Familial Adenomatous Polyposis (FAP) and the genetics underlying the disease. Part IV will examine the ways in which this knowledge can be used to diagnose
Get the PDF version of this article FAMILIAL ADENOMATOUS POLYPOSIS: ONE GENE. MANY MANIFESTATIONS. MAKING SENSE OF THE ALPHABET SOUP THAT IS THE GENETIC CODE. Parts I and II of this series looked at the genetics, diagnosis and treatment of hereditary nonpolyposis colorectal cancer. Part III will examine familial adenomatous polyposis and the damage caused
Get the PDF version of this article Hereditary Nonpolyposis Colorectal Cancer: From Diagnosis to Treatment In this four-part series, Part 1 reviewed the basic pathologic and genetic concepts underlying hereditary nonpolyposis colorectal cancer. This second part defines the clinical challenges facing the clinician who is at the forefront of diagnostic and treatment efforts. Parts 3
Get the PDF version of this article HEREDITARY NONPOLYPOSIS COLORECTAL CANCER: GENETICS AND DIAGNOSIS THE ALPHABET SOUP OF GENETICS AND DIAGNOSIS EXPLAINED With a myriad of vexing abbreviations and obscure terminology, the genetics controlling the formation of colonic polyps and malignancies may be difficult to appreciate. Paradoxically, the physician, positioned at the beginning of the
Squamous cell cancer of the anal canal is rare and adenocarcinoma is rarer still, accounting for 10% of all anal cancers. , The three types of anal adenocarcinoma are those arising in the anorectum, those arising in anal glands, and those arising in an anorectal fistula.
Part I of this series covered anal anatomy and anal intraepithelial neoplasia. Part II covered perianal cancers and their treatment. Part III will examine squamous cancers of the anal canal. Part IV will look at unusual cancers of the anal canal.
The anal canal and perianal region are subject to a diverse group of diseases. The anatomy of this region was covered in part I of this series and malignant precursors were discussed. Part II will examine perianal cancers. Part III will examine squamous cancers of the anal canal. Part IV will look at unusual cancers of the anal canal.
Anal neoplasms are a rare, diverse group of lesions. Each manifests a different behavior. With the recent publicity surrounding anal cancer, attention has focused on screening, early diagnosis and treatment.
Get the PDF version of this article The Good News? These are Rare Lesions. PERIANAL TUMORS: “Most of these rare anal tumors are aggressive tumors and are difficult to treat. The best that can be said of them is that they are rare.” pdf only Paget’s Disease Perianal Paget’s disease is thought to be a
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Minimally invasive surgical techniques have gained popularity in approaching benign diseases such as cholecystitis, appendicitis, gastric fundoplications, benign colorectal polyps, and recurrent diverticulitis. Initial concerns for the laparoscopic approach to colorectal cancer have centered around the oncologic principles of adequate tumor excision, lymph node and mesentery excision, early reports of port-site (incisional) recurrence, and lack of long-term follow-up in well conducted studies. A significant number of recent well conducted prospective studies have shed new light on these topics, effectively reshaping the approach to colorectal cancer.
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Get the PDF version of this article Celebrating Their Health: Colonoscopies Make For A Most Unusual Birthday Party By Valerie Kuklenski, Staff Writer; U-Entertainment Jack Merrick was drawing on the straw in his jumbo Scorpion cocktail with such gusto, it seemed the drink’s floating gardenia would be vacuumed up. Surrounded by old friends, good food,
Surgery is the most effective treatment for colorectal cancer. Even when all visible cancer has been removed, it is possible for cancer cells to be present in other areas of the body. These cancer deposits, when very small, are undetectable at the time of surgery, but they can begin to grow at a later time.
Colon and rectal cancer remains the second leading cause of cancer mortality in the United States. In 1999, an estimated 130,000 new cases and 50,000 deaths will occur.(1) Curing patients with colorectal cancer depends on early diagnosis, successful operation and the appropriate use of adjuvant therapy. Currently, the most important aspect of therapy is appropriate and successful operation. In the past decade, though, adjuvant therapy has begun to play an increasingly important role.
Cancer of the colon and rectum is the second leading cause of cancer-related death in the United States in both men and women. Approximately 131,000 Americans will be diagnosed every year with colorectal cancer, and approximately 55,000 people will die from their disease. Detection and removal of pre-cancerous lesions is the key to the prevention of colorectal cancer.
Minimally invasive surgical techniques have gained popularity in the treatment of many benign diseases. However, there have been concerns surrounding the laparoscopic approach in the removal of colorectal carcinomas.Recently, these questions have been addressed in well-controlled, prospective, randomized studies.
Approximately 150,000 new cases of colorectal cancer are diagnosed each year in the United States. It is the second leading cause of cancer mortality, resulting in almost 60,000 deaths every year.1 Cancer of the colon and rectum most commonly develop from precursor adenomatous polyps that increase in size over time.2,3 Early detection and removal of these premalignant polyps usually prevents them from developing into invasive cancer.4,5 This is the rationale behind the colorectal cancer screening recommendations from the American Cancer Society and the American College of Gastroenterology.
The rectum is a specialized reservoir which provides vital sensory and storage functions for the gastrointestinal system. When diseases such as inflammatory bowel disease, cancer, polyposis or congenital anomalies require the surgical removal of the rectum, an important part of the body is lost. Quite often, these disease processes occur in young patients between the ages of 30 and 45. Physical and emotional adjustments must be made to compensate for this loss. Research has been directed toward finding a suitable replacement for the surgically removed rectum. The major focus of investigation has been on the creation of a neorectum, or rectal pouch.
At any given time in the United States, twenty million men and women have an active Human papillomavirus (HPV) infection. Five million new cases are diagnosed each year. These represent one third of all cases of newly diagnosed sexually transmitted infections. In addition to the morbidity of the disease itself, HPV is strongly associated with the development of squamous cell carcinoma of the anus. Hence, this ubiquitous virus has taken on a more menacing significance than simply that of an inconvenient sexually transmitted disease.
It appears that early detection and removal of pre-malignant polyps, or frank malignancies, has resulted in an overall decreased death rate from cancers of the colon and rectum. From 1990 to 2003, the endpoint of the study period, the death rate attributable to colon and rectal cancer in men decreased 2.1% annually.
Approximately 150,000 new cases of colorectal cancer are diagnosed each year in the United States. It is the second leading cause of cancer mortality, resulting in almost 60,000 deaths every year.1 Cancers of the colon and rectum most commonly develop from precursor adenomatous polyps that increase in size over time.2,3 Early detection and removal of these premalignant polyps usually prevents them from developing into invasive cancer.4,5 This is the rationale behind the colorectal cancer screening recommendations from the American Cancer Society.
It is now accepted that most colon cancers originate from benign colon polyps. The cancer-to-polyp sequence is the driving force behind colon screening to find and remove polyps before they transform into a malignancy. There is a unified set of screening guidelines that address the age of first screening, the frequency of screening and the method of screening. This screening has been effective in achieving the stated goal of reducing the number of new colon malignancies detected per year.
The term Anal Intraepithelial Neoplasia (AIN) describes the microscopic finding of dysplastic, non-malignant cells in the anal canal. AIN has been subdivided into AIN I, II, and III, representing low, moderate, and high-grade dysplasia. This dysplasia has been thought to arise as a result of local infection with the Human papillomavirus. The Human papillomavirus is a small double-stranded DNA virus with a diameter of 55 nm. and is encased in a protein capsid. The term AIN has gradually replaced other descriptive terminology such as atypical squamous cells of indeterminate significance (ASCUS), low-grade squamous intraepithelial lesions (LSIL), or high-grade squamous intraepithelial lesions (HSIL).
Alert to the genetics and findings in patients with hereditary colorectal cancer syndromes, physicians may be better able to diagnose and recommend treatment for the colonic manifestations of each disease.
With a myriad of vexing abbreviations and obscure terminology, the genetics controlling the formation of colonic polyps and malignancies may be difficult to appreciate. A review of these colonic disorders will aid in an understanding of the underlying genetics.
Approximately five per cent of patients with colorectal cancer have an inherited or hereditary mutation in the APC gene, a gene known to be associated with cancer development. Many of the high-risk mutations which lead to colorectal cancer can be located on individual genes using genetic sequence testing. At present however, clinical genetic manipulation cannot reduce the risk of disease development in individual patents.
Hereditary nonpolyposis colorectal cancer (HNPCC) or Lynch syndrome accounts for four percent of all colorectal cancers. HNPCC is usually the result of an inherited mutation in one of the group of genes known as mismatch repair genes (MMR). This mutation has also been known to arise spontaneously. MMR genes correct errors that result from faulty DNA replication. Colorectal cancer occurring in the absence of polyps or polyposis is the final phenotypic expression of this DNA mutation, although an occult polyp remains the precursor lesion of the cancer.
Squamous cell carcinoma of the anus is the most well known member of an uncommon group of GI neoplasms. The incidence of this tumor has been increasing slowly, with 3,500 cases reported in the United States in 2001, and 5,260 cases reported in 2009.