Cancer colorectal en Tunisie - Quiz
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Questions and Answers

Quel est le taux d'incidence du cancer colorectal en Tunisie chez les hommes?

  • 3 (correct)
  • 2,6
  • 1,2
  • 60
  • Quel pourcentage de patients atteints de cancer colorectal a moins de 40 ans?

  • 15%
  • 50%
  • 30% (correct)
  • 10%
  • Quel est le sexe ratio observé pour le cancer colorectal?

  • 1,0
  • 1,2 (correct)
  • 0,8
  • 2,5
  • Quelle est la meilleure approche pour la radiothérapie dans le traitement du cancer rectal?

    <p>Radiothérapie préopératoire (A)</p> Signup and view all the answers

    Quel est le pourcentage de survie globale pour les patients atteints de cancer colorectal?

    <p>50% (B)</p> Signup and view all the answers

    Quel est l'age moyen des patients atteints de cancer colorectal?

    <p>60 ans (B)</p> Signup and view all the answers

    Quelle méthode de diagnostic est utilisée pour le cancer rectal?

    <p>TR + rectoscopie + biopsie (C)</p> Signup and view all the answers

    Dans quel pays le taux d'incidence du cancer rectal est-il le plus élevé selon les données de 1995?

    <p>États-Unis (A)</p> Signup and view all the answers

    Quel est le rôle du sphincter anal externe dans le processus de défécation ?

    <p>Il se relâche pour permettre l'ouverture de l'anus. (C)</p> Signup and view all the answers

    Quelle est la longueur approximative entre le sigmoïde et le plancher pelvien ?

    <p>Entre 12 et 14 cm (D)</p> Signup and view all the answers

    Quel est le principal indice clinique associé à un trouble rectal ?

    <p>Saignement rectal (B)</p> Signup and view all the answers

    Quel positionnement est recommandé pour réaliser un toucher rectal ?

    <p>En décubitus dorsal avec cuisses fléchies (A)</p> Signup and view all the answers

    Quel pédicule lymphatique est associé au drainage du rectum ?

    <p>Pédicule hémorroïdal supérieur (A)</p> Signup and view all the answers

    Quel facteur alimentaire est considéré comme un risque pour le cancer colorectal?

    <p>Une alimentation riche en graisses et viande (D)</p> Signup and view all the answers

    Quels types de maladies sont considérés comme des précurseurs du cancer du côlon?

    <p>Polype adénomateux et rectocolite hémorragique (D)</p> Signup and view all the answers

    Quel est l'âge moyen des personnes atteintes de cancer colorectal?

    <p>50 ans et plus (A)</p> Signup and view all the answers

    Quel matériau est un facteur de risque héréditaire pour le cancer du côlon?

    <p>Polypose recto-colique familiale (A)</p> Signup and view all the answers

    Quel comportement de style de vie constitue un facteur de risque pour le cancer colorectal?

    <p>Consommation d'alcool et tabagisme (B)</p> Signup and view all the answers

    Quel symptôme indique généralement que le rectum est plein?

    <p>L'envie d'aller à la selle (A)</p> Signup and view all the answers

    Quelles maladies inflammatoires chroniques de l'intestin sont des facteurs de risque de cancer colorectal?

    <p>Maladie de Crohn et rectocolite hémorragique (B)</p> Signup and view all the answers

    Quel facteur de mode de vie pourrait contribuer au risque de cancer colorectal?

    <p>Surpoids et inactivité physique (D)</p> Signup and view all the answers

    Quel est le type histologique le plus fréquent des tumeurs du côlon?

    <p>Adénocarcinome (C)</p> Signup and view all the answers

    Dans quel cas un TDM est-il recommandé dans le bilan d'extension locorégional?

    <p>En cas de contre-indication à l'IRM (A)</p> Signup and view all the answers

    Quels signes fonctionnels ne sont PAS typiquement associés à un diagnostic clinique dans les tumeurs du côlon?

    <p>Troubles du sommeil (B)</p> Signup and view all the answers

    Quel aspect macroscopique d'une tumeur permet de la caractériser comme ulcérobougeonnante?

    <p>Ulcérobougeonnant et infiltrant (A)</p> Signup and view all the answers

    Quel examen est essentiel pour confirmer le diagnostic de tumeur après une rectoscopie?

    <p>Biopsie (B)</p> Signup and view all the answers

    Quel est le rôle principal du bilan d'extension locorégional dans le traitement du cancer ?

    <p>Identifier les métastases à distance (D)</p> Signup and view all the answers

    Parmi les techniques de radiothérapie, laquelle est considérée comme délaissée ?

    <p>Radiothérapie conventionnelle (C)</p> Signup and view all the answers

    Quel stade TNM correspond à une atteinte de la sous-muqueuse ?

    <p>T1 (D)</p> Signup and view all the answers

    Quelle technique est recommandée pour la scanographie de repérage lors du traitement ?

    <p>Décubitus dorsal avec bras repliés (C)</p> Signup and view all the answers

    Quel type de métastases le traitement M1 aborde-t-il lorsqu'il s'agit d'une exérèse ?

    <p>Métastases limitées nécessitant contrôle locorégional (C)</p> Signup and view all the answers

    Quel est le volume cible macroscopique dans le cadre de la délinéation en radiothérapie ?

    <p>GTV (B)</p> Signup and view all the answers

    Dans le système TNM, que représente le code N2 ?

    <p>Plus de 3 ganglions envahis (C)</p> Signup and view all the answers

    Quelle est la principale orientation du comité digestif dans la gestion des cas M0 ?

    <p>Contrôle locorégional par un traitement néo-adjuvant (C)</p> Signup and view all the answers

    Quels organes sont considérés comme à risque lors d'un traitement de radiothérapie externe ?

    <p>Vessie et intestins (A)</p> Signup and view all the answers

    Quelle méthode d'imagerie est utilisée pour évaluer les mouvements des volumes cibles pendant le traitement de radiothérapie ?

    <p>CBCT (Cone Beam Computed Tomography) (B)</p> Signup and view all the answers

    Quel est le schéma de traitement avec la dose totale la plus faible dans le cadre de la radiothérapie externe ?

    <p>Hypofractionné (Rapido) : 25GY en 5 fractions (C)</p> Signup and view all the answers

    Quel type de complication aiguë peut résulter d'une radiothérapie ?

    <p>Cystite (A)</p> Signup and view all the answers

    Dans quel cas la chimiothérapie est-elle administrée en concomitant avec la radiothérapie classique ?

    <p>Si la radiothérapie est classique de 50GY (A)</p> Signup and view all the answers

    Quel type de traitement chirurgical permet de conserver l'anus ?

    <p>Résection antérieure et anastomose colo-anale (C)</p> Signup and view all the answers

    Quel est le taux de survie à 5 ans pour les patients atteints de cancer selon les données ?

    <p>30 à 50% (A)</p> Signup and view all the answers

    Quel traitement est considéré comme la dernière étape dans la prise en charge du cancer ?

    <p>Chirurgie (D)</p> Signup and view all the answers

    Quel est l'objectif principal du contrôle de positionnement en radiothérapie ?

    <p>Garantir la précision de la délivrance de la dose (B)</p> Signup and view all the answers

    Dans quel cas la radiothérapie est-elle discutée pour les stades T1-2N0 ?

    <p>Si le risque de chirurgie incomplète est élevé (A)</p> Signup and view all the answers

    Flashcards

    Rectal Cancer Incidence (Tunisia)

    3 cases per 100,000 men and 2.6 per 100,000 women in Tunisia.

    Rectal Cancer Sex Ratio

    1.2; more men than women are affected.

    Rectal Cancer Age

    Average age of 60 years old, but 30% of cases are in people younger than 40.

    Rectal Cancer Diagnosis

    Diagnosis involves a physical exam, colonoscopy, and biopsy.

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    Rectal Cancer Treatment

    Usually involves a combination of local treatments like radiation and surgical procedures.

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    Preoperative Radiotherapy

    Better patient adherence and greater effectiveness.

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    Rectal Cancer Survival

    Global 50% survival rate.

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    Rectal Cancer Treatment Impact

    Majority of cases involve surgery, which can be a mutilating treatment.

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    Rectal Sphincter Relaxation

    The external anal sphincter relaxes under voluntary control, allowing the opening of the anus and the evacuation of stool.

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    Rectum Length

    The rectum is between 12-14 centimeters long, from the sigmoid colon (S3) to the pelvic floor (levator muscles).

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    Rectum Layers

    The rectum has three parts: upper rectum (partially peritoneal), middle/lower rectum (retroperitoneal).

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    Rectal Lymphatic Drainage

    Rectal lymphatic drainage follows the superior & middle hemorrhoidal pedicles to pararectal nodes, then inferior mesenteric pedicle to pre-aortic nodes.

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    Rectal Exam Importance

    Rectal examination, performed with an empty rectum, is crucial to locate, evaluate, and assess the mobility of tumors within the pelvis.

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    Rectoscopy

    A procedure used to examine the rectum and lower part of the colon.

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    Diagnostic Approach

    A multi-step process involving patient history (symptoms), physical exam, and a colonoscopy for biopsy.

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    AdenoCarcinoma

    A type of malignancy, most often seen type of rectal cancer (95%).

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    Staging (rectal cancer)

    Determining the extent of cancer's spread.

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    Locorregional Staging

    Assessing cancer's spread in the nearby body area. (e.g surrounding tissues)

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    Risk factors for colon cancer

    Factors like diet high in fat and meat, low in fruits and vegetables, inflammatory bowel diseases (IBD), hereditary predisposition (familial adenomatous polyposis, Lynch syndrome), age (over 50), and alcohol/tobacco use are linked to increased colon cancer risk.

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    Diet and colon cancer

    A diet high in saturated fats and red meat, paired with a low intake of fruits and vegetables, increases the risk of colon cancer.

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    Inflammatory bowel disease (IBD)

    Conditions like Crohn's disease and ulcerative colitis (UC) significantly increase colon cancer risk due to chronic inflammation in the intestinal tract.

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    Hereditary predisposition

    Genetic conditions like familial adenomatous polyposis (FAP) and Lynch syndrome increase a person's likelihood of developing colon cancer.

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    Age and colon cancer

    Colon cancer risk rises significantly with age, with the majority of cases occurring in individuals over 50 years old.

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    Alcohol and Tobacco use

    Alcohol and tobacco consumption increase risk of colon cancer.

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    Family history of colon cancer

    A family history of colon or rectal cancer is a risk factor and increases the chance of developing the disease.

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    Rectal function

    The rectum stores stool before evacuation, and the process of bowel movement involves relaxation of the internal sphincter.

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    Staging (TNM)

    A system for classifying the extent of cancer, considering tumor size (T), lymph node involvement (N), and the presence of distant metastasis (M).

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    T stages

    Describe the depth of rectal cancer invasion.

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    N stages

    Describe involvement of nearby lymph nodes.

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    M stage

    Indicates the presence of distant metastasis (cancer spreading to other parts of the body).

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    Radiotherapy (3D conformal)

    A precise way to deliver radiation therapy to target cancerous cells while minimizing damage to healthy surrounding tissue.

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    GTV

    Gross Tumor Volume: The area of the tumor that can be seen or felt.

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    CTVT

    Clinically Targeted Volume: The possible cancer spread beyond what can be seen (microscopically affected areas).

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    PTV

    Planning Target Volume: Accounted volume that includes the GTV, CTVT and a margin to account for uncertainty in tumor placement and patient movement during treatment.

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    Organes à risque (Risk organs)

    The organs most likely to be affected by radiation, such as the bladder (vessie) and intestines (intestin).

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    Radiothérapie 3D (3D radiotherapy)

    A type of radiotherapy treatment that uses a 3-dimensional model of the tumor to calculate the radiation doses.

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    Hypofractionné (Hypofractionated)

    A faster radiotherapy treatment method, delivering a large dose in fewer fractions (doses).

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    CBCT (Cone Beam CT)

    Imaging technique used to evaluate the movement of targeted volumes, particularly considering the fullness of risk organs.

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    Radiothérapie externe (External radiotherapy)

    A common treatment where radiation is directed from an external device to the tumor.

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    Siège sous péritonéal (Subperitoneal location)

    Tumor location below the peritoneum, affecting the lower and middle rectum.

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    Complications aiguës (Acute complications)

    Short-term side effects of radiotherapy, like inflammation of the intestines and bladder.

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    Complications tardives (Late complications)

    Long-term side effects of radiotherapy, including tissue damage, scarring, and narrowing of organs.

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    Contrôle de positionnement(Positioning control)

    Processes to ensure accurate radiation delivery to the target. It is done using imaging like Xray or CT.

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    Chirurgie (Surgery)

    Surgical procedures, including conservative and mutilating options, are essential techniques for treating rectal cancer.

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