Colorectal Cancer - Clinical Medicine

Explore the comprehensive pathophysiology, diagnosis, and treatment of one of the most common malignancies worldwide in this clinical medicine lecture. Delve into the molecular mechanisms driving colorectal carcinogenesis, including the adenoma-carcinoma sequence, microsatellite instability pathway, and CpG island methylator phenotype, while examining critical mutations in APC, KRAS, TP53, and mismatch repair genes. Understand the distinction between sporadic and hereditary forms of colorectal cancer, including Lynch syndrome and familial adenomatous polyposis, and analyze how genetic factors influence tumor development and progression. Learn to recognize the varied clinical presentations based on tumor location, from right-sided versus left-sided lesions, and identify key symptoms including changes in bowel habits, gastrointestinal bleeding, iron deficiency anemia, and unexplained weight loss. Master the diagnostic workup process, focusing on colonoscopy with biopsy techniques, tumor marker interpretation including CEA levels, and staging methodologies using CT imaging. Examine evidence-based treatment approaches tailored to disease stage and anatomic location, covering surgical resection techniques, adjuvant chemotherapy protocols, and targeted therapies for metastatic disease. Gain insights into risk factor assessment, screening strategies, and the clinical significance of hereditary cancer syndromes in patient management and family counseling.