QuestionSBA
QuestionChoice
These are treatment options for cases of colorectal cancer, however colonoscopy has not demonstrated a malignancy in this patient.
10028444
d
Initiate on chemotherapy and radiotherapy
QuestionChoice
This is correct. This description is suspicious for familial adenomatous polyposis which confers an extremely high chance of developing colorectal cancer and is normally prophylactically treated with a panproctocolectomy at a young age.
10028441
a
Prophylactic panproctocolectomy
QuestionChoice
This may reduce the chances of developing malignancy but given that the polyps in FAP are dispersed through the entire bowel, there is still a high chance of developing colorectal cancer.
10028445
e
Prophylactic right hemicolectomy
QuestionChoice
There is nothing to suggest a palliative approach is required here.
10028443
c
Palliative care
QuestionChoice
This is not ideal given the near certainty the patient will develop colorectal cancer.
10028442
b
Watch and wait approach
Concept
Chapter
2693
6063
Colorectal cancer
Topic
315
Surgery
18086
Familial adenomatous polyposis (FAP) is a hereditary condition marked by the formation of numerous polyps in the colon and rectum, which have a high cancer risk if untreated, and prophylactic panproctocolectomy is a preventive surgery that removes the entire colon, rectum, and anus to greatly reduce this risk.
A 21 year old man presents to the GP with rectal bleeding and fatigue. He reports his dad having bowel cancer for which he had a colostomy bag from early adolescence. Colonoscopy reveals hundreds of polyps throughout his bowel.

Which of the following is likely to form definitive management of this patient?
a