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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute thrombotic thrombocytopenic purpura (TTP) occurred in three patients following abdominal surgeries. One patient underwent extensive lysis for intestinal adhesions with bowel resection, another cholecystectomy for acute cholecystitis, and the third right colectomy and partial intestinal resection for colon cancer. The diagnosis of acute TTP was established on the basis of absent hematologic features of TTP prior to surgery and development of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and unexplained mental changes after surgery. Hematologic evidence of TTP developed 3 to 9 days after surgery. Other clinical features were acute respiratory distress syndrome (ARDS) in two patients and peripheral digit ischemic syndrome (PDIS) also in two patients. In all three patients, establishing the diagnosis of TTP was delayed. Exchange plasmapheresis in one patient was ineffective due to associated ARDS and two others died soon after the diagnosis was established. In view of our experience, postoperative TTP should be considered in the differential diagnosis of the patient who develops unexplained anemia and thrombocytopenia following an abdominal surgery. Presence of hemolytic anemia, schistocytosis, and unexplained thrombocytopenia should alert the possibility of TTP.
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PMID:Acute thrombotic thrombocytopenic purpura following abdominal surgeries: a report of three cases. 1096 70

This review describes the current state of knowledge on the hazards of exercise and the potential benefits of physical activity on the gastrointestinal tract. In particular, acute strenuous exercise may provoke gastrointestinal symptoms such as heartburn or diarrhoea. A substantial part (20-50%) of endurance athletes are hampered by these symptoms which may deter them from participation in training and competitive events. Nevertheless, these acute symptoms are transient and do not hamper the athlete's health in the long term. The only exception is repeated gastrointestinal bleeding during training and competition, which in the long term may occasionally lead to iron deficiency and anaemia. In contrast, repetitive exercise periods at a relatively low intensity may have protective effects on the gastrointestinal tract. There is strong evidence that physical activity reduces the risk of colon cancer by up to 50%. Less convincing evidence exists for cholelithiasis and constipation. Physical activity may reduce the risk of diverticulosis, gastrointestinal haemorrhage, and inflammatory bowel disease although this cannot be substantiated firmly. Up to now, underlying mechanisms are poorly understood although decreased gastrointestinal blood flow, neuro-immuno-endocrine alterations, increased gastrointestinal motility, and mechanical bouncing during exercise are postulated. Future research on exercise associated digestive processes should give more insight into the relationship between physical activity and the function of the gastrointestinal tract.
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PMID:Potential benefits and hazards of physical activity and exercise on the gastrointestinal tract. 1117 39

Anemia is common in cancer patients and is associated with reduced survival. Recent studies document that treatment of anemia with blood transfusion in cancer patients is associated with increased infection risk, tumor recurrence, and mortality. We therefore investigated the incidence of preoperative anemia in colorectal cancer and assessed risk factors for anemia. Prospective data were collected on 311 patients diagnosed with colorectal cancer over a 6-year period from 1994 through 1999. Patients were stratified by age, gender, presenting complaint, preoperative hematocrit, American Joint Committee on Cancer (AJCC) stage, and TNM classification. Discrete variables were compared using Pearson's Chi-square analysis. Continuous variables were compared using Student's t test. Differences were considered significant when P < 0.05. The mean age of the study cohort was 67 +/- 9.2 with 98 per cent of the study population being male. The mean AJCC stage was 2.2 +/- 1.2 and the mean preoperative hematocrit was 35 +/- 7.9 with an incidence of 46.1 per cent. The most common presenting complaints were hematochezia (n = 59), anemia (n = 51), heme-occult-positive stool (n = 33), bowel obstruction (n = 26), abdominal pain (n = 21), and palpable mass (n = 13). Preoperative anemia was most common in patients with right colon cancer with an incidence of 57.6 per cent followed by left colon cancer (42.2%) and rectal cancer (29.8%). Patients with right colon cancer had significantly lower preoperative hematocrits compared with left colon cancer (33 +/- 8.5 vs 36 +/- 7.4; P < 0.01) and rectal cancer (33 +/- 8.5 vs 38 +/- 6.0; P < 0.0001). Patients with right colon cancer also had significantly increased stage at presentation compared with left colon cancer (2.3 +/- 1.3 vs 2.1 +/- 1.2; P < 0.02). Age was not a significant risk factor for preoperative anemia in colorectal cancer. We conclude that there is a high incidence of anemia in patients with colon cancer. Patients with right colon cancer had significantly lower preoperative hematocrits and higher stage of cancer at diagnosis. Complete colon evaluation with colonoscopy is warranted in patients with anemia to improve earlier diagnosis of right colon cancer. A clinical trial of preoperative treatment of anemic colorectal cancer patients with recombinant human erythropoietin is warranted.
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PMID:Preoperative anemia in colon cancer: assessment of risk factors. 1207 43

Adenocarcinoma of the colon is an unusual disease in patients under 30 years of age, and generally presents as advanced disease because of a lack of awareness of its occurrence, especially in the pediatric age group. The authors report on 2 cases of colon cancer in children less than 17 years old, whose initial presentations were abdominal pain of unclear etiology and non-specific abdominal complaints. No other abnormal laboratory results were found except that 1 patient had anemia. Barium studies revealed the typical colon lesions in both patients, and colonoscopic pathologic examination disclosed mucinous adenocarcinoma. The first patient was rather unusual in that 2 separate tumors were found simultaneously in the large intestine. The therapeutic approach included surgery and adjuvant chemotherapy, but both patients ultimately died due to poor response and early recurrence. Survival obviously depends on the extent of the disease at diagnosis; the earlier the diagnosis is, the better the prognosis will be. Clinical characteristics, diagnosis, and treatment of colon cancer in pediatric patients are discussed.
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PMID:Adenocarcinoma of the colon in children presenting as abdominal pain: report of two cases. 1214 10

Anemia is common in patients with cancer and is a frequent complication of myelosuppressive chemotherapy. In this study, we investigated the incidence and severity of chemotherapy-induced anemia caused by the most common chemotherapy regimens, including the new generation of chemotherapeutic agents, used in the treatment of the major nonmyeloid malignancies in adults. Five hundred fifty-two patients with histologically proven carcinoma originating from breast (n = 165), lung (n = 128), colon (n = 75), ovary (n = 84), and malignant lymphoma (n = 100) were included in this study. Hemoglobin levels for each patient were measured with an automatic counter during both pretreatment and before each chemotherapy cycle during therapy. To document the incidence of anemia, the National Cancer Institute grading system was used. Before chemotherapy, 44% of patients with breast carcinoma had anemia. There was a 16% increase in the incidence of anemia after chemotherapy. Severe anemia was observed in less than 1% of patients. No difference was found in the incidence of anemia between the fluorouracil, doxorubicin, cyclophosphamide (FAC) and cyclophosphamide, methotrexate, fluorouracil (CMF) regimens used in the adjuvant setting. However, single-agent chemotherapy with newer generation caused more anemia when compared with the FAC regimen (p < 0.005). Chemotherapy resulted in a significant decrease in hemoglobin levels when compared with pretreatment values in patients with lung cancer (p < 0.001). During treatment, the increase in the incidence of grade II anemia was associated with a parallel decrease in the incidence of grade I anemia. The incidence of severe anemia did not exceed 15%. The incidence of anemia was equivalent in both patients with small-cell lung cancer and those with non-small-cell lung cancer treated with the etoposide and cisplatin (EP) combination. Seventy-one percent of patients with colon cancer had anemia before initiation of chemotherapy. No difference was observed in posttreatment hemoglobin values compared with pretreatment values. Patients treated with irinotecan and fluorouracil and leucovorin (FUFA) combination showed similar rates of anemia. Incidence of anemia in patients with ovarian cancer at admission was 68%. Chemotherapy resulted in a prominent increase in incidence of anemia, which increased to 91.5%. There was an increase in grade II anemia, which corresponded to the decrease in grade I anemia. Less than 10% of patients developed severe anemia. No difference in the incidence of anemia was observed in patients with ovarian cancer treated with either cisplatin and cyclophosphamide or cisplatin combination. Showing a high incidence of anemia (82%) at presentation, hemoglobin levels in patients with malignant lymphoma were unaltered with chemotherapy. Severe anemia occurred in less than 3% of patients. There was a higher incidence of anemia in patients with non-Hodgkin's lymphoma receiving the cyclophosphamide, epirubicin, vincristine, prednisone (CEOP) regimen in contrast to patients with Hodgkin's lymphoma treated with the doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) combination. There was a prominent decline in the hemoglobin levels with cisplatin-based combinations in contrast to combinations including noncisplatin agents (p < 0.001). In this study, we have observed equivalent rates of treatment-related anemia when compared with previous data in patients with specific tumor types. The incidence of pretreatment anemia was high in various malignancies. The mechanisms underlying the propensity for a higher risk of pretreatment anemia in patients with malignant disorders and its influence on the outcome has to be elucidated by further population-based and molecular studies.
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PMID:Anemia in oncology practice: relation to diseases and their therapies. 1215 68

While the vast majority of cancers are believed to occur sporadically, most forms of cancer, both adult and paediatric, have a hereditary equivalent. In the case of adult malignancies, these include hereditary breast and ovarian cancer and syndromes such as the multiple endocrine neoplasias types 1 and 2 characterised by specific tumours of the endocrine gland system. In the case of paediatric malignancies, these include syndromes such as retinoblastoma and Wilms tumour. In a little over a single decade, we have seen a tremendous increase in the knowledge of the primary genetic basis of many of the familial cancer syndromes. The majority of familial syndromes are inherited as autosomal dominant traits including hereditary colon cancer and familial malignant melanoma, however, the genetics behind autosomal recessive disorders such as Bloom syndrome and Fanconi anaemia are also being elucidated. A third mode of inheritance less well understood in the setting of familial cancer is that of imprinting recently observed in a subset of families with inherited paraganglioma. In this review, we discuss 31 genes inherited in an autosomal dominant manner associated with 20 familial cancer syndromes. Genes inherited in an autosomal recessive manner linked to familial cancer syndromes are also discussed. The identification of genes associated with familial cancer syndromes has in some families enabled a 'molecular diagnosis' that complements clinical assessment and allows directed cancer surveillance for those individuals determined to be at-risk of disease.
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PMID:Genetic insights into familial cancers-- update and recent discoveries. 1217 30

The present patient was a 54-year-old woman with anemia. After examination to identify the cause of anemia, she was diagnosed with sigmoid colon cancer and multiple liver metastasis. Sigmoid colectomy and insertion of an intra-hepatic arterial catheter were carried out. Histopathological examination of the resection specimen revealed well-differentiated adenocarcinoma, with a depth of tumor invasion of ss and positive lymph node metastasis. Pharmacokinetic modulating chemotherapy (PMC) was performed after the operation. The PMC consisted of oral UFT 300 to 400 mg/day every day and continuous arterial infusion of 5-FU 750 to 1,000 mg/24 h once a week. On a CT scan of the abdomen performed 6 months after the operation, the liver metastasis had disappeared and the patient was in complete remission (CR). PMC was continued, but the hepatic artery became occluded 1 year and 11 months after the operation, and so PMC was replaced by systemic chemotherapy of 5-FU plus levofolinate at 2 years after the operation. This chemotherapy was discontinued after 3 courses. At present, 2 years and 10 months after the operation, the patient remains in CR and is followed as an outpatient.
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PMID:[A case of multiple liver metastases from colon cancer successfully treated with pharmacokinetic modulating chemotherapy]. 1451 21

Mortality from colon cancer could be reduced with routine screening, yet screening rates are low. Current screening tools are limited by expense and suboptimal acceptance. A retrospective case-control study of all cases of colon cancer diagnosed at our institution over a 5-year period was performed to determine the frequency of blood count abnormalities in these patients upon presentation. One hundred twenty-seven patients had right-sided colon cancer: 107 (84%) had an elevated red cell distribution width (RDW); 87 (69%) had anemia; and 70 (55%) had a low mean corpuscular volume (MCV). Ninety-eight patients had left-sided colon cancer: 49 (50%) had an elevated red cell distribution width; 43 (44%) had anemia; and 22 (22%) had a low mean corpuscular volume. The red cell distribution width was 84% sensitive and 88% specific for right-sided colon cancer. An elevated red cell distribution width may help better identify those patients who should be referred for full colonoscopy.
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PMID:The value of a complete blood count in predicting cancer of the colon. 1504 Oct 76

Untreated preoperative anemia and acute perioperative blood loss may add to surgical risk. To understand the prevalence of anemia in surgical patients (with a primary focus on preoperative anemia), and the impact that preexisting anemia has on transfusion rates as well as on clinical and functional outcomes, a systematic review was performed of articles published between January 1966 and February 2003. The estimates of anemia prevalence in the literature ranged widely, from 5% in geriatric women with hip fracture to 75.8% in patients with Dukes stage D colon cancer. Diagnosis of anemia was most strongly associated with an increased risk of receiving an allogeneic transfusion. In general, patients who donated autologous blood preoperatively received less allogeneic blood than those who did not donate. There was some suggestion that lower hemoglobin levels are associated with decreased survival rates, although this was not found universally. Too few studies were found that evaluated the impact of anemia on other outcomes, such as functional status and costs and resource utilization, to draw reliable conclusions. Several other factors also limited the interpretation of the data, including the lack of a uniform definition for anemia and a dearth of studies expressly designed to quantify the prevalence and impact of anemia. Establishing a uniform definition and specifically evaluating the effect of anemia on outcomes are important considerations for future study.
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PMID:Prevalence and outcomes of anemia in surgery: a systematic review of the literature. 1505 Aug 87

About 20 per cent of patients with carcinoma of the colon or rectum present with metastatic disease. Surgeons are frequently asked to consider resection or other operative procedures in these patients for palliation. We performed this review to determine whether patients presenting with known metastatic colorectal cancer derive benefit from surgical intervention. We performed a retrospective review of all patients with M1 carcinoma of the colon or rectum who were identified from the University of Mississippi Medical Center Cancer Registry from April 1985 through February 2003. Patients who underwent hepatic and/or pulmonary resection with curative intent were excluded from analysis, as were patients with metachronous metastases. Eighty patients with M1 colorectal cancer who did not undergo surgery with curative intent were identified, and in 74 of these, complete medical records and follow-up were available. Forty-nine of the 74 patients (66%) underwent an operation, and 25 were managed nonoperatively. Indications for surgery included bowel obstruction, active hemorrhage, severe anemia from gastrointestinal bleeding with requirement for blood transfusions, intractable pain, and perforation of the colon. Average survival was 11.2 months for operative patients versus 6.5 months for nonoperative patients (P < 0.05). Thirty-six patients who underwent resectional procedures had a postoperative hospitalization of 7.5 days and a median survival of 11.5 months. Thirteen patients who had a nonresectional procedure had an average postoperative stay of 9 days and a median survival of 4 months. Median survival in those who did not undergo an operation was 4.8 months. Although metastatic colorectal carcinoma cannot usually be cured by surgical intervention, many patients who present with metastatic disease will benefit from palliative operations with relatively short hospitalizations and reasonable survival. Those who are not candidates for resection of the primary tumor have shorter survival times. Surgery can alleviate many of the distressing symptoms in patients with metastatic colorectal carcinoma.
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PMID:Incurable colorectal carcinoma: the role of surgical palliation. 1515 52


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