Compare conditions

Put any two — or three — conditions side by side, adult or pediatric, to spot the look-alike differences fast, row by row.

Colorectal Cancer

—

In one line

·Cells in the colon or rectum pick up broken genes over many years until they ignore all stop signals and grow out of control.

—

Normal physiology

·The colon and rectum are a five-foot tube that takes the leftover liquid from your small intestine, pulls out the last bit of water and salt, and turns it into solid stool to leave your body.

—

What goes wrong

·Cells in the colon lining pick up broken genes one at a time over ten to twenty years, and each broken gene takes away one more safety brake until the cell ignores all the body's stop signals and grows into a tumor.

—

Hallmark signs

·Blood in the stool (bright red or very dark, tar-like)
·Change in bowel habit lasting more than a few weeks (new diarrhea, new constipation, or feeling like you can't empty your bowel completely)
·Belly pain or cramping that doesn't go away
·Unexplained weight loss
·Feeling very tired or weak (fatigue)
·Anemia (low red blood cell count) with no clear reason
·Narrow or ribbon-like stools
·A lump or mass you can feel in your belly or rectum

—

Red flags · escalate now

·Blood in the stool (visible or found on testing)
·Unexplained weight loss of more than 10 pounds without trying
·New constipation or diarrhea lasting more than a few weeks
·Severe belly pain or a hard lump you can feel in your abdomen
·Anemia (low red blood cells or low iron) that doctors cannot explain by diet or other causes

—

Workup

·Complete blood count (CBC)
·Fecal immunochemical test (FIT) or fecal occult blood test (FOBT)
·Colonoscopy with biopsy
·Carcinoembryonic antigen (CEA) blood test
·CT scan of chest, abdomen, and pelvis with IV contrast
·Microsatellite instability (MSI) or mismatch repair (MMR) testing on tumor tissue
·RAS (KRAS and NRAS) and BRAF mutation testing on tumor tissue
·Comprehensive metabolic panel (CMP)

—

Treatment

·Colonoscopy with biopsy to confirm cancer and measure how deep it has grown
·Surgery (partial colectomy or low anterior resection) to cut out the tumor and nearby lymph nodes
·Adjuvant chemotherapy (FOLFOX or CAPOX) after surgery for stage III or high-risk stage II
·Targeted therapy (bevacizumab, cetuximab, or panitumumab) added to chemotherapy for metastatic cancer (stage IV)
·Immunotherapy (pembrolizumab or nivolumab) for MSI-high or dMMR tumors
·Radiation therapy (neoadjuvant or adjuvant) for rectal cancer, especially if the tumor is close to the anus or has grown through the rectal wall
·Genetic counseling and testing for Lynch syndrome or familial adenomatous polyposis (FAP) in patients diagnosed before age 50 or with strong family history

—

NCLEX trap

·Constipation in colorectal cancer means the tumor is narrowing the colon like a clogged pipe. The colon might be blocked or close to tearing (perforation). You need a CT scan or colonoscopy right away to see how bad the blockage is—not just send them home with softeners.
·Bright red blood can come from hemorrhoids OR from colorectal cancer. Anyone 45 or older with new rectal bleeding needs a colonoscopy to rule out cancer, even if hemorrhoids are present. Never assume it's only hemorrhoids.
·Anemia (low blood count) in an older adult with no clear cause is colorectal cancer until you prove it's not. Iron pills hide the problem by raising the count, but the tumor keeps bleeding. Do a colonoscopy first to find the source.
·Colorectal cancer is painless early on. Weight loss, tiredness, and anemia in someone over 45 mean you need a colonoscopy now—not later. Pain means the cancer is already advanced.
·Even stage I colorectal cancer needs surveillance. Guidelines say do a colonoscopy 1 year after surgery, then every 3 to 5 years. New cancers or polyps can grow silently in the rest of the colon.
·CEA (a blood marker for colorectal cancer) is just one clue. Ten percent of colorectal cancers never raise CEA. You must use imaging (CT or MRI) and colonoscopy to check for spread—not just rely on CEA.

—

Install Maldek by Hill as an app — studies work even offline