Summary of Clase Dr. Sergio Buenaventura Cisneros - Cáncer colonorectal

Summary of Scientific Concepts and Discoveries on Colorectal Cancer

Definition and Prevalence: Colorectal Cancer is a malignant neoplasm originating from the mucosa of the colon or rectum. It is one of the most common malignancies globally, ranking third in incidence and mortality for both genders.

Epidemiology

• Increasing incidence attributed to factors like increased life expectancy, poor diet, smoking, obesity, and sedentary lifestyle.
• Majority of cases are sporadic, with a small percentage linked to genetic syndromes such as Lynch Syndrome and Familial Adenomatous Polyposis.

Risk Factors

• Non-modifiable Factors:
  • Age (most common between 65-67 years)
  • Gender (more common in males)
  • Family history of Colorectal Cancer or adenomatous polyps
  • Chronic inflammatory disorders (e.g., ulcerative colitis)
• Modifiable Factors:
  • Alcohol consumption
  • Smoking
  • Diet high in red and processed meats
  • Obesity

Pathology

The adenocarcinoma model explains the progression from normal mucosa to adenomatous polyps and invasive carcinoma, involving genetic changes (e.g., APC gene activation, alterations in p53).

Protective Factors

• Regular physical activity
• High intake of fruits and vegetables (over 200 grams/day)
• Adequate dietary fiber (10 grams/day)
• Calcium (400-800 mg/day)
• Certain medications (e.g., Aspirin, statins)

Genetic Syndromes

• Lynch Syndrome: Diagnosed using Amsterdam and Bethesda criteria, associated with a high risk of Colorectal Cancer.
• Familial Adenomatous Polyposis: Autosomal dominant disorder with mutations in the APC gene, characterized by numerous adenomas.

Diagnosis and Staging

• Gold standard for diagnosis: Colonoscopy (high sensitivity and specificity).
• Staging based on the TNM system (tumor size, lymph node involvement, metastasis).
• Imaging studies (CT, MRI) are used for staging and assessing metastasis.

Treatment

• Non-metastatic Stages (1-3): Surgical intervention is the cornerstone, often followed by adjuvant chemotherapy.
• Metastatic Stage (4): Systemic treatment with chemotherapy, targeted therapies, and immunotherapy; surgery may play a role in select cases.

Screening Recommendations

• Regular screening for individuals aged 50 and older, with options including fecal tests and Colonoscopy.
• Consideration of patient preferences and health status for screening decisions in older adults.

Featured Researchers/Sources

• Dr. Sergio Buenaventura Cisneros
• American Cancer Society guidelines (2018)

Notable Quotes

— 28:15 — « Colorectal cancer is one of the most common malignancies. We already mentioned that in incidence and mortality it represents the third cause in both the female gender and the male gender. »

— 28:31 — « Regarding the related genetic syndromes, these represent less than 5 percent and the most important are Lynch syndrome and familial adenomatous polyposis. »

— 28:46 — « Something very important is that new therapies such as anti-FR, anti-angiogenic drugs and more recently immunotherapy have had an impact on overall survival in these patients. »

Category

Science and Nature

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