This webinar discusses rectal cancer. It begins with introducing the speaker and providing objectives for the webinar. It then covers topics such as prevalence and risk factors of rectal cancer, methods of diagnosis, determining the cancer stage, standard treatment options including surgery, radiation, chemotherapy and targeted therapy. Treatment is discussed in relation to cancer stage. The webinar also touches on survivorship issues and future research regarding rectal cancer.
In this webinar our Medical Advisory Board member Dr. Dennis Ahnen will cover the basics of colorectal cancer – the hows, whats, and whys.
This August 2015 webinar is brought to you by Fight CRC’s Research Advocacy Training and Support (RATS) program. http://fightcolorectalcancer.org/do-something/support-research/research-advocacy-training-and-support-rats/
In this webinar our Medical Advisory Board member Dr. Dennis Ahnen will cover the basics of colorectal cancer – the hows, whats, and whys.
This August 2015 webinar is brought to you by Fight CRC’s Research Advocacy Training and Support (RATS) program. http://fightcolorectalcancer.org/do-something/support-research/research-advocacy-training-and-support-rats/
colorectal cancer, epidemiology, risk factors, sign and symptom,
pathophysiology, complications, assessment and diagnostic findings, medical and nursing interventions
Have you or someone you love recently been diagnosed with stage III or stage IV colorectal cancer? Feeling overwhelmed? Learn where to go from here.
We’ll talk about every leg of the journey from understanding your diagnosis to tips on building your treatment team.
Join Dr. Edward Crane to better understand your options for treatment and know that you are not alone in your diagnosis.
Colorectal Cancer Detection: Fact vs FictionJarrod Lee
Colorectal cancer is the most common cancer in Singapore. It can be prevented by timely screening. Yet there are many misconceptions about colorectal cancer screening. This talk addresses some of the common perceptions about colorectal cancer screening. This talk was first presented to the public at Feel Fab Fest 2018.
RESEARCH & TREATMENT NEWS: Highlights from the 2014 GI Cancer SymposiumFight Colorectal Cancer
Each January, the brightest minds in colorectal cancer research meet at the Gastrointestinal Cancer Symposium.
Fight Colorectal Cancer and The Colon Cancer Alliance are partnering to bring you the big news in colorectal cancer from the symposium. Dr. Allyson Ocean will be presenting.
Get insights about new types of treatments on the horizon, diagnostic tests available, research for upcoming drugs/biomarkers and the way colorectal cancer is treated. We’ll take a look back and a look forward. You’re not going to want to miss it.
Each January, the best and brightest minds in colorectal cancer research meet at the Gastrointestinal Cancers Symposium. Fight Colorectal Cancer and the Colon Cancer Alliance are partnering to bring you the big news in colorectal cancer from the 2013 symposium.
Join us to learn more about these topics:
- Can aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) keep cancer from returning?
- The relationship of body mass index (BMI) and exercise in colorectal cancer
- What scientists are learning about how your immune system can fight cancer
- The latest on what biomarkers can tell us about your cancer
- Rectal cancer treatment that is based on your biological make-up
The webinar will be led by Dr. Richard Goldberg, an internationally renowned gastrointestinal oncologist who specializes in colorectal cancer. He is a tenured professor in the Department of Internal Medicine at The Ohio State University and serves as physician-in-chief at Ohio State’s Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).
Information about Colorectal cancer by Dr Dhaval Mangukiya.
Details of Colorectal cancer, Epidemiology, Risk Factors, Protective Factors, Pathology, Prognostic Determinants, Clinical Presentation, Rectal Cancer, Dignosis, Differential Diagnosis, Staging and Management etc.
https://drdhavalmangukiya.com/
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
Has cancer science got you stumped and overwhelmed? Leading gynecologic oncologist, Dr. Don Dizon, takes us to cancer college in this webinar. He explains the science behind ovarian cancer, how it develops, how it's diagnosed, and how ovarian cancer treatments work.
I and 4 other classmates researched Colorectal Cancer, commonly called Colon Cancer, and presented before our class about what we learned. Our presentation covered the pathophysiology, epidemiology, risk factors, screenings, signs and symptoms, assessments and diagnostic tests, diagnostic criteria, treatments, and article on evidence based practices.
Fight Colorectal Cancer’s Medical Advisory Board Member, Axel Grothey, MD, focused this webinar to stage III colon cancer patients. Dr. Grothey, medical oncologist at Mayo Clinic, will spend the hour discussing current treatment options and exciting new research that pertains to stage III colon cancer patients.
colorectal cancer, epidemiology, risk factors, sign and symptom,
pathophysiology, complications, assessment and diagnostic findings, medical and nursing interventions
Have you or someone you love recently been diagnosed with stage III or stage IV colorectal cancer? Feeling overwhelmed? Learn where to go from here.
We’ll talk about every leg of the journey from understanding your diagnosis to tips on building your treatment team.
Join Dr. Edward Crane to better understand your options for treatment and know that you are not alone in your diagnosis.
Colorectal Cancer Detection: Fact vs FictionJarrod Lee
Colorectal cancer is the most common cancer in Singapore. It can be prevented by timely screening. Yet there are many misconceptions about colorectal cancer screening. This talk addresses some of the common perceptions about colorectal cancer screening. This talk was first presented to the public at Feel Fab Fest 2018.
RESEARCH & TREATMENT NEWS: Highlights from the 2014 GI Cancer SymposiumFight Colorectal Cancer
Each January, the brightest minds in colorectal cancer research meet at the Gastrointestinal Cancer Symposium.
Fight Colorectal Cancer and The Colon Cancer Alliance are partnering to bring you the big news in colorectal cancer from the symposium. Dr. Allyson Ocean will be presenting.
Get insights about new types of treatments on the horizon, diagnostic tests available, research for upcoming drugs/biomarkers and the way colorectal cancer is treated. We’ll take a look back and a look forward. You’re not going to want to miss it.
Each January, the best and brightest minds in colorectal cancer research meet at the Gastrointestinal Cancers Symposium. Fight Colorectal Cancer and the Colon Cancer Alliance are partnering to bring you the big news in colorectal cancer from the 2013 symposium.
Join us to learn more about these topics:
- Can aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) keep cancer from returning?
- The relationship of body mass index (BMI) and exercise in colorectal cancer
- What scientists are learning about how your immune system can fight cancer
- The latest on what biomarkers can tell us about your cancer
- Rectal cancer treatment that is based on your biological make-up
The webinar will be led by Dr. Richard Goldberg, an internationally renowned gastrointestinal oncologist who specializes in colorectal cancer. He is a tenured professor in the Department of Internal Medicine at The Ohio State University and serves as physician-in-chief at Ohio State’s Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).
Information about Colorectal cancer by Dr Dhaval Mangukiya.
Details of Colorectal cancer, Epidemiology, Risk Factors, Protective Factors, Pathology, Prognostic Determinants, Clinical Presentation, Rectal Cancer, Dignosis, Differential Diagnosis, Staging and Management etc.
https://drdhavalmangukiya.com/
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
Has cancer science got you stumped and overwhelmed? Leading gynecologic oncologist, Dr. Don Dizon, takes us to cancer college in this webinar. He explains the science behind ovarian cancer, how it develops, how it's diagnosed, and how ovarian cancer treatments work.
I and 4 other classmates researched Colorectal Cancer, commonly called Colon Cancer, and presented before our class about what we learned. Our presentation covered the pathophysiology, epidemiology, risk factors, screenings, signs and symptoms, assessments and diagnostic tests, diagnostic criteria, treatments, and article on evidence based practices.
Fight Colorectal Cancer’s Medical Advisory Board Member, Axel Grothey, MD, focused this webinar to stage III colon cancer patients. Dr. Grothey, medical oncologist at Mayo Clinic, will spend the hour discussing current treatment options and exciting new research that pertains to stage III colon cancer patients.
This class covers what all physicians need to know about colorectal cancer (except prevention and screening, dealt with elsewhere). It is exceedingly simple, but accurate to the best of my knowledge. It is based on Harrison's 19th, Edition.
Each month, join us as we highlight and discuss hot topics ranging from the future of higher education to wearable technology, best productivity hacks and secrets to hiring top talent. Upload your SlideShares, and share your expertise with the world!
Not sure what to share on SlideShare?
SlideShares that inform, inspire and educate attract the most views. Beyond that, ideas for what you can upload are limitless. We’ve selected a few popular examples to get your creative juices flowing.
Rectal cancer grows in the rectum cells which are placed beneath the sigmoid colon and over the anus in our body. The rectal and colon that are present in the body come together, that is colorectal cancer. The reason behind these circumstances is that they both are part of the digestive system.
Oncology Nursing:-An oncology nurse is a specialized nurse who cares for cancer patients. These nurses require advanced certifications and clinical experiences in oncology further than the typical baccalaureate nursing program provides. Oncology nursing care can be defined as meeting the various needs of oncology patients during the time of their disease including appropriate screenings and other preventive practices, symptom management, care to retain as much normal functioning as possible, and supportive measures upon the end of life.
What is oncology?
Oncology is the branch of medicine that researches, identifies, and treats cancer. A physician who works in the field of oncology is an oncologist.
Oncologists must first diagnose cancer, which is usually carried out via biopsy, endoscopy, X-ray, CT scanning, MRI, PET scanning, ultrasound, or other radiological methods. Nuclear medicine can also be used to diagnose cancer, as can blood tests or tumor markers. Oncology is often linked with hematology, which is the branch of medicine that deals with blood and blood-related disorders.
Treatment
Once a diagnosis is made, the oncologist discusses the disease stage with the patient. Staging will dictate the treatment of cancer. Chemotherapy — which is defined as the destruction of cancer cells — may be used, as well as radiation therapy. Surgery is used to remove tumors. Hormone therapy is used to treat certain types of cancers, and monoclonal antibody treatments are gaining popularity. Research into cancer vaccines and immunotherapies is ongoing. Palliative care in oncology treats pain and other symptoms of cancer.
Treatment team
Cancer is often treated in a team effort, with at least two or three types of oncologists, including medical, surgical, or radiation. The oncology treatment team may also include a pathologist, a diagnostic radiologist, or an oncology nurse. In the event of a new or a difficult-to-treat case of cancer, the oncology care team may consult a tumor board, made up of various medical experts from all relevant disciplines. The tumor board reviews the case and recommends the best course of cancer treatment for the patient.
Oncology nurse
The oncology nurse has many roles, from helping with cancer screening, detection, and prevention, to the intensive care focus of bone marrow transplantation. Work settings for oncology nurses also vary and include acute care hospitals, ambulatory care clinics, private offices, radiation therapy facilities, and home care agencies. Oncology nurses work with adult and pediatric patients with cancer.
Pediatric Oncology
Pediatric oncology is a medical specialty that focuses on cancer care for children.
The National Cancer Institute estimates that 10,270 new cases of cancer will be diagnosed in children in 2017. Of these, 1,190 children will die from the disease.
Pediatric oncology is an important medical field that treats all pediatric cancer types, including acute lymphocytic leukemia,
In this presentation, Dr. Deborah Schrag, Medical Oncologist from Dana Farber Cancer Institute covers therapy options, surgery options, and radiation options, that are specific to rectal cancer patients. She also touches on the importance of clinical trials for this population, and highlights a few trials in research that she finds most interesting.
More information related to our Webinar Series can be found at http://fightcolorectalcancer.org/about/webinars
breast cancer
cancer
epidemiology
community medicine
awareness of breast cancer
سرطان الثدي
وبائيات سرطان الثدي
epidemiology of breast cancer
prevention of breast cancer
risk factors of breast cancer
epidemiology of breast cancer in iraq
sign and symptoms of breast cancer
location of breast cancer
Please share this video with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● Understanding colorectal and anal cancer, including symptoms, risk factors
● Treatment options, including chemotherapy, radiation and biologics
● Preventing colorectal and anal cancer
View the video: https://youtu.be/q0z8N1_L-JQ
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
Dr. Murphy presents slides discussing general screening trends in the US, including how the US compares to other countries, different screening modalities, and differences in screening by:
-Age
-Gender
-Geography
-Race/Ethnicity
Looking to kick start your physical activity? Hoping to learn about how body movement can be a huge benefit for CRC patients and survivors? Curious about Climb for a Cure? Join this interactive webinar featuring Karia Coleman, MSK, personal trainer and athletic strength coach, and Fight CRC advocates as they discuss the importance, challenges, and joys of physical activity.
From bowel frequency, pain, and more, many colorectal cancer treatments lead to digestive side effects. Join this webinar with Dr. Cathy Eng to learn all about the digestive system, the side effects that are common due to CRC treatment, and how to manage those side effects.
Maine recently passed major colorectal cancer (CRC) policy at the state level. Join us to listen to their story and learn what worked well for CRC state advocacy!
Indiana just passed major colorectal cancer (CRC) policy this year. Join us to listen to their story and learn what worked well for CRC advocacy in Indiana!
Kentucky was one of the first states in the US to pass major colorectal cancer (CRC) policy. Join us to listen to their story and learn what worked well for CRC state advocacy!
Join Fight CRC in a webinar about biomarkers. In this session, Dr. Chris Lieu will focus the discussion on the NTRK biomarker, in addition to ctDNA, and Next-Generation Sequencing.
Join us as Eden Stotsky-Himelfarb, BSN, RN from Johns Hopkins Medicine discusses how to manage after a colorectal cancer diagnosis. In this session, she will cover understanding diagnoses, shared decision making, managing mental health, talking to family and colleagues, and more.
Some colorectal cancer treatments lead to side effects of the skin. In this webinar, Dr. Nicole LeBoeuf will discuss these specific side effects. She will talk about why they occur, how to prepare for them, and how to manage them.
Hear about the latest breaking colorectal cancer research! Fight CRC will be joined by Dr. Axel Grothey who will spend the hour detailing the research presented at the 2020 Gastrointestinal (GI) Cancers Symposium hosted by the American Society of Clinical Oncology.
Anticipating the end of life and making decisions about medical care at this time can be difficult and distressing for people with cancer and their loved ones. However, it is incredibly important to plan for the transition to end-of-life care.
In this webinar, we will discuss questions to ask when considering an end to curative treatment, what to expect with hospice and end-of-life care, a new medical care team, advance directives and healthcare proxies, options for pain, the role of caregivers and loved ones, and more.
In this webinar, Dr. Angela Nicholas, Dr. Chris Heery, and Wenora Johnson discuss all things clinical trials. Dr. Nicholas, a family practitioner and caregiver to her late husband, John MacCleod will dive into her experience searching for clinical trials along with advice to those currently searching, or planning on searching in the future. Dr. Heery, Chief Medical Officer for Precision Biosciences will spend time dispelling myths around clinical trials and challenges to enrollment, and Wenora Johnson, a stage III colon cancer survivor will describe the process and her point of view curating trials in the Fight CRC trial finder.
In this webinar, Dr. Popp will discuss everything you need to know about palliative care! This is an important webinar for colorectal cancer patients and their loved ones.
eeling worn out and exhausted all the time? You may be experiencing cancer-related fatigue. Tune in to this webinar to learn what cancer-related fatigue is, how to spot it, and how to manage it.
In this webinar, Dr. Azad discusses colorectal cancer recurrence. She addresses things to do to help reduce the risk of recurrence, in addition to what steps should be taken if colon or rectal cancer returns.
Join Fight CRC and Dr. Scott Kopetz to learn about the latest breaking colorectal cancer research from the American Society of Clinical Oncology 2019 Annual Conference.
May 2019 – What You Need to Know About Chemotherapy Induced Neuropathy WebinarFight Colorectal Cancer
Neuropathy is a common side effect for colorectal cancer patients. It is a side effect that can be incredibly challenging to manage, and can affect daily living. Join this informative webinar to learn all about neuropathy—why it happens, how to prepare for it, and methods to try and reduce its effects. This is an important webinar for all survivors and patients! Dana will speak from both the medical professional and patient angle, as she is a colon cancer survivor herself!
A cancer diagnosis and cancer treatment can be traumatic. An experience with cancer can lead to serious psychological distress that should be addressed. In this webinar, Schuyler Cunningham, Clinical Social Worker, talks about what trauma is, how to identify it, and what steps to take next.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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2. • Speaker(s): Mary Mulkerin, RN, OCN
• Archived Webinars: FightColorectalCancer.org/Webinars
• AFTER THE WEBINAR: Expect an email with links to the
material & a survey. If you fill it out, we’ll send you an “I
booty” bracelet.
• Ask a question in the panel on the RIGHT SIDE of your
screen
• Follow along via Twitter – use the hashtag #CRCWebinar
Today’s Webinar:
4. Disclaimer
:
The information and services provided by Fight Colorectal
Cancer are for general informational purposes only. The
information and services are not intended to be substitutes
for professional medical advice, diagnoses or treatment.
If you are ill, or suspect that you are ill, see a doctor
immediately. In an emergency, call 911 or go to the nearest
emergency room.
Fight Colorectal Cancer never recommends or endorses any
specific physicians, products or treatments for any condition.
5. Speaker:
Mary Mulkerin, RN, OCN is the Gastrointestinal
Oncology Nurse Coordinator at University of
Wisconsin Carbone Cancer Center, coordinating multi-
disciplinary patient care and leading a Gilda’s Club
support group. She obtained her BSN from the
University of Wisconsin-Madison and has practiced in
Oncology for the last 31years. She is currently
completing her MS in Nursing Education at Edgewood
College to pursue her research interests in
survivorship and patient and staff education, in
addition to developing a patient education app that
would make patient’s management of their care more
accessible and user-friendly.
6. MARY MULKERIN, RN, BSN, OCN
UNIVERSITY OF WISCONSIN
CARBONE CANCER CENTER
MAY 25, 2016
Rectal Cancer 101
7. Objectives
Discuss:
Prevalence, risk factors and diagnosis of rectal
cancer
Staging of rectal cancer
Types of treatment and treatment by stage
Survivorship
Future research
8. Rectal Cancer
Malignant (cancer cells) form in the tissues of the
rectum
The rectum is about 6 inches – temporary
storehouse for feces
Coccyx
Tumor
Rectum
Bladder
Image retrieved from: aibolita.com
9. Prevalence
Colorectal Cancer (CRC) – 3rd most common
diagnosed cancer
39,220 new cases per year – slightly more prevalent
in men than women
About 5% or 1 in 20 people of the general population
90% of cases are diagnosed over age 50
Rates are decreasing over time
There are more than 1 million CRC survivors!
American Cancer Society, 2016
10. Increased Prevalence in Younger Adults
Incidence increasing in people under age 40
Between 1984-2005, rate increased by 3.8% - doubled
Approximately 18% rectal cancer cases are in people
<50, 11% for colon cancer
Of these, 20% are caused by familial syndromes
Cause unknown, but possibly related to lifestyle
behaviors and environmental factors
Malik, M., 2016
11. Who’s at risk?
Age 40 or older
Certain hereditary conditions
Having a parent, sibling, or child with a history of
colorectal cancer
Behavioral risk factors
Personal history of:
Colorectal cancer
Polyps
Cancer of the ovary, endometrium or breast
Cleveland Clinic, 2016
12. Symptoms
Change in bowel habits
Diarrhea/Constipation
Narrow stools
Feeling like the bowel does not empty completely
Blood in the stool
Abdominal discomfort
Change in appetite
Unintentional weight loss
Fatigue
Anemia
Cleveland Clinic, 2016
13. Detection
Physical exam and history
Digital rectal exam
Proctoscopy
Colonoscopy
Biopsy
Carcinoembryonic antigen (CEA) – tumor marker
Cleveland Clinic, 2016
14. Factors Affecting Prognosis and Treatment
Stage of the cancer
Whether the tumor has spread into or through the
bowel wall
Where the cancer is located in the rectum
Whether the bowel is blocked or has a hole in it
Whether all of the tumor can be removed by surgery
General health of the person
New diagnosis vs. recurrence
Cleveland Clinic, 2016
16. How Does Cancer Spread?
Through tissue – cancer invades the surrounding
normal tissue
Through the lymph system – cancer invades the
lymph nodes then travels
Through the blood – Capillaries and veins are
invaded by cancer
Metastasis – cancer cells spread from the primary
tumor and form another tumor in another site
Cleveland Clinic, 2016
18. Standard Treatment of Rectal Cancer
Surgery
Radiation Therapy
Chemotherapy
Targeted Therapy
Cleveland Clinic, 2016
19. Surgery
Surgery is the most common treatment for all stages
Radiation therapy or chemotherapy may be given
before surgery – neoadjuvant therapy
After surgery, chemotherapy or radiation may be
given – adjuvant therapy
Cleveland Clinic, 2016
20. Types of Surgery
Type of surgery depends on the stage and overall
health of the person
Types
Polypectomy
Cryosurgery
Local excision - TAMIS
Resection
Radiofrequency ablation
Pelvic exenteration
Cleveland Clinic, 2016
21. Surgical Resection
Low Anterior Resection (LAR) – Tumor is in
the upper part of the rectum. May have a temporary
ostomy.
Proctectomy with colo-anal anastomosis –
Tumor is in the mid to lower third. Entire rectum
removed and colon is attached to the anus
Abdominoperineal resection (APR) – Tumor is
in the lower rectum. Permanent ostomy
American Cancer Society, 2016
22. Radiation Therapy
High-energy x-rays or other types of radiation is
used to kill cancer cells
2 types of radiation:
External beam
Internal radiation – uses needles seeds, wires or catheters
Type of treatment chosen and length of treatment
depends on stage
Cleveland Clinic, 2016
23. Chemotherapy – Anti-Cancer Drugs
Chemotherapy is give at different times during
treatment – before or after surgery and for stage IV
cancer
Chemotherapy is given is different ways:
Systemic chemotherapy – IV or orally
Regional chemotherapy – given directly into an
artery that leads to a part of the body with a
tumor. Examples: Hepatic artery infusion,
Chemoembolization
American Cancer Society, 2016
24. Embolization
Substances are injected into the hepatic artery to try
and block or reduce the blood flow to cancer cells in
the liver
3 main types of embolization:
Arterial embolization
Chemoembolization (TACE)
Radioembolization
American Cancer Society, 2016
25. Targeted Therapy
Drugs that attack specific genes or proteins in a
cancer
Often have different and less severe side effects
May be given alone or with chemotherapy
Examples:
Drugs that target blood vessel formation
Drugs that target Epidermal Growth Factor Receptor –
Test tumor for KRAS Mutation/Molecular Profiling
Kinase inhibitors – block signals to the cancer cell’s
control center
American Cancer Society, 2016
26. Treatment of Rectal Cancer by Stage
Stage 0 – Removal of the polyp only
Stage I
Local excision
Resection
Resection with radiation therapy and chemotherapy
usually before surgery but may be after
Stage II
Resection plus chemotherapy and radiation
Resection with or without chemotherapy after surgery
Cleveland Clinic, 2016
27. Treatment of Rectal Cancer by Stage
Stage III
Resection plus chemotherapy and radiation usually
before surgery
Resection with or without chemotherapy after surgery
Stage IV and Recurrent Rectal Cancer
Resection with or without chemoradiation before surgery
Resection or pelvic exenteration as palliation
Palliative radiation and/or chemotherapy
Chemotherapy with or without targeted therapy
Placement of a rectal stent/diverting ostomy
Tumor Molecular Profiling
Cleveland Clinic, 2016
28. Treatment of Rectal Cancer by Stage
Treatment of liver metastasis
Cryosurgery of Radiofrequency Ablation
Chemoembolization or systemic chemotherapy
Internal radiation therapy
Surgery to remove the tumor
Treatment of lung metastasis
Cryosurgery or Radiofrequency Ablation
Surgery
Cleveland Clinic, 2016
29. Living as a Rectal Cancer Survivor
A cancer survivor is anyone who has been diagnosed
with cancer – from the time of diagnosis and for the
balance of his or her life
Survivorship Care Plan
Treatment summary
Suggested schedule for follow-up exams and tests
Long-term effects from treatment – management and
when to call the doctor
Surveillance for recurrence and secondary cancers
Healthy lifestyle suggestions
American Cancer Society, 2016
30. Survivorship
Follow-up
Doctor visits
Colonoscopy
CT Scans or other imaging
CEA
Some side effects linger after treatment or may
develop months or years later
American Cancer Society, 2016
31. Long-Term Treatment Effects
Fatigue
Keep a diary for 1 week and use the diary to plan your
schedule
Make a daily schedule with rest breaks
Keep naps to < 30 minutes
Be active
3 Ps: Prioritize, Plan and Pace
Neuropathy
Take practical steps to make your environment safer
May take months or years to improve
Full recovery sometimes is not possible
32. Long Term Treatment Effects
Changes in bowel function
Imodium, Stool bulking agents
Pelvic floor exercises
Diet
Phantom rectal sensation/pain – common, resolves
spontaneously in most cases
Ice packs/warm baths
Anti-depressant medications
Pelvic floor exercises, yoga
Relaxation techniques
33. Emotional Challenges
Sense of relief
Sadness, sense of loss
Worry, irritability and
anxiety
Fear of recurrence
Unexpected emotions
Losing the “safety net”
Role changes
Changes in social
support
Changes in relationships
with family, friends &
coworkers
Unmet expectations
about returning to
normal, “new normal”
34. Additional Concerns
Changes in sexual function
Infertility
Returning to work
Financial issues
Genetic counseling
35. Lowering Risk of Recurrence
Healthy weight
Being active
Eating a healthy diet
Aspirin
Alcohol
Quitting smoking
American Cancer Society, 2016
36. What’s New in Rectal Cancer Research
Prospect Clinical Trial – awaiting data analysis. 4
months of IV chemotherapy is given prior to surgery
instead of chemotherapy and radiation
TNT – Total neoadjuvant therapy. IV chemotherapy
followed by chemotherapy and radiation, then
surgery. No further treatment after surgery.
Traditionally, only 68% of patients complete all of
their adjuvant therapy
37. References
American Cancer Society. (2016). Retrieved from
http://www.cancer.org/cancer/colonandrectumcanc
er/detailed guide
Cleveland Clinic. (2016). Retrieved from
http://my.clevelandclinic.org/health/diseases_condi
tions/hic-colorectal-cancer
Malik, M., (2015). Rising rates of sporadic colorectal
cancer in young adults: a possible environmental
link. Retrieved from http://am.asco.org/rising-rates-
sporadic-colorectal-cancer-young adults-possible-
environmental-link
38. Question & Answer:
SNAP A
#STRONGARMSELFIE
Bayer HealthCare will donate $1 for every
photo posted (up to $25,000).
Flex a “strong arm” & post it to Twitter or
Instagram! (Use the hashtag!)
Biopsy – may check for gene mutations, Lynch syndrome, special immunohistochemical stains
Stage 0 – Carcinoma in situ – abnormal cell are found in the innermost (mucosa) lining of the rectum
Stage I – cancer formed in the mucosa of the rectal wall and has spread to the submucosa and possibly to the muscle layer
Stage II – Cancer has spread through the muscle layer and possibly through the serosa, and possibly nearby organs. No lymph nodes involved.
Stage III – Cancer has spread to the mucosa and possibly through the submucosa, serosa and muscle wall. Cancer has spread to nearby lymph nodes.
Stage IV – Cancer has spread through the muscle wall and may have spread to nearby organs and lymph nodes. Cancer has spread to one or more organs not near the rectum, such as liver or lung.
Neoadjuvant therapy – makes it easier to remove the tumor with clean margins, lessens problems with bowel control after surgery
Cryosurgery – Instrument is used to freeze and destroy abnormal tissue. Carcinoma in situ or stage 0
Local excision – Cancer has not spread to the wall of the rectum Trans Anal Minimally Invasive Surgery
Resection – Cancer has spread to the wall. Portion or all of the rectum is removed. Lymph nodes removed. Will cover more later.
RFA – High – energy radio waves. Probe through the skin, uses and electric current. Used on liver/lung
Pelvic Exenteration – Cancer has spread to nearby organs. Lower colon, bladder, and lymph nodes are removed. In women, the cervix , vagina and ovaries are removed. In men, the prostate is removed.
Needs to be done in a high volume center with a dedicated colorectal surgeon – better outcomes
LAR – part of the rectum is removed and the reattached to the remaining part of the rectum wither right away or later
Chemo – Capecitabine, FOLFOX
Arterial embolization – catheter is inserted in the femoral artery to the hepatic artery and small particles are injected to block up the artery
Radioembolization – small beads (microspheres) coated with radioactive ytrium-90 in the hepatic artery
4 in 10 patients are KRAS mutations
Stage I – 5 year survival rate 87%
Stage IIA 80%, IIB 49%
Stage IIIA 84%, IIIB 71%, IIIC 58%
Stage IV 12%
Take care of emotions, express thoughts and feelings, time to heal, communicate, find ways to relax, use min-body approaches, focus on solutions