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Phys Clinical Casesgastrointestinal

Phys Clinical Cases · gastrointestinal

Colorectal Cancer — DCE Clinical Case

DCE long-case and short-case station for Colorectal Cancer.

1 min readVerification in progress

Target exams

FRACP DCEMRCP PACES
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Target exams

FRACP DCEMRCP PACES
Prompt
DCE long-case and short-case station for Colorectal Cancer.

Colorectal Cancer — Clinical Case

DCE Long Case

Patient brief

Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Colorectal Cancer. [1]

Presenting complaint: Subacute or acute symptoms referable to Colorectal Cancer, with enough detail to force prioritisation. [1] [2]

Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]

Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]

Examination: Key positives and critical negatives for dangerous differentials. [1]

Investigations: A small set of results that change management. [1] [2]

Tasks

  1. Present a prioritised problem list. [1]
  2. Defend investigations and immediate therapy. [1] [2]
  3. Provide safety-net and follow-up advice. [2]

Model discussion points

  • Working diagnosis and acuity. [1]
  • Differentials and discriminators. [2]
  • Treatment sequence and monitoring. [1] [2] [3]
  • Multimorbidity and communication. [2]
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References6ShowHide
  1. [1]Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries CA Cancer J Clin, 2024.PMID 38572751
  2. [2]Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study N Engl J Med, 1993.PMID 8474513
  3. [3]Bretthauer M, Løberg M, Wieszczy P, et al. Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death N Engl J Med, 2022.PMID 36214590
  4. [4]André T, Boni C, Mounedji-Boudiaf L, et al. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer N Engl J Med, 2004.PMID 15175436
  5. [5]Sauer R, Becker H, Hohenberger W, et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer N Engl J Med, 2004.PMID 15496622
  6. [6]André T, Shiu KK, Kim TW, et al. Pembrolizumab in Microsatellite-Instability-High Advanced Colorectal Cancer N Engl J Med, 2020.PMID 33264544
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