How do I know I have it?
The gold standard screening for colonrectal (when do it start) along with others?
Colonoscopy and 45 years old
Sigmoidosscopy
CT
FOBT
FIT
Stool test
This is used for stage 1 and 2 and is bolus dose
5 FU / LCV
The drug that is just as efficacious as 5FU and stage it is used in
CAPEFOX, stage III and IV
This add on therapy improves progression free survival and has to have KRAS WILDTYPE
cetuximab / pantiumumab
VEGF-1 SE
Rash
What are the signs and symptoms
GI symptoms
Rectal bleeding
abdominal pain
Advanced: weight loss and anemia
Capecitabine with Oxaliplatin
This is the first line if you are less than 70 and indicated for stage 3 and 4
FOLFOX
Ramucirumab and ZiV-afiberacept
Regorafenib
Make sure you eat a mela > 30% of fat
PMH:
FH:
SH:
Ethnicity:
FH: colon cancer, FAP
SH: alcoholism, red meat, and low fiber diet
ethnicity: Hispanic and American Indian
The drugs in FOLFOX formaulation
5FU, LCV, OXO
This us used in stage IV and can be used as first line un young healthy patients with PS score of ) 0 or 1
Folfirinox
The treatments that are reserved for if i fail everything
Regorafenib
Tipuracil / Trifluridine
Bevacizumab
Bleeding
Protenuria
VTE
HTN
Delayed wound healing
Labs
Biopsy:
- 9-19 CEA and CBC
Folfirinox
5FU, LCV, OXO, IRI
This is used in stage IV maily but can be used BEFORE FOLFOX and CAPEFOX if someone has CI to Oxaliplatin
FOLFIRI
The immunotherapy tx and reserved for
Pembrolizumab and Nivolumab are options if dMMR or MSI-H
Irinotecan
Diarrhea
How bad is it?
Stage 1 -4
FOLFIRI
5FU, LCV, IRI
Add on therapy to any of the ones mentioned above
Bevacizumab
Targeted Therapy
BRAF
- Dabrafenib
-Encorafenib
HER2
Trantuzumab
LApatinib
Oxaliplatin
cold sensitivity, PN and N/V