Clinical Examination

Check for the following on clincal examination of a patient with suspected colorectal cancer;

• Colour; Anaemia or Jaundice
• General appearance; Stigmata of recent weight loss
• Lymph node mass in left supraclavicular fossa
• Pleural effusions on posterior percussion of the chest
• Hepatomegaly; nodules on surface, irregular edge
• Mass in the abdomen
• Ascitis
• Rectal examination; beware of confusing extra rectal things with a rectal tumour

  In Women

  • The cervix
  • A ring pessary (for stress incontinence)
  • Tubo-Ovarian mass
  • Metastatic disease in the recto-vesical pouch
  • Metastatic disease along the utero-sacral ligaments

  In Men

  • The prostate gland
  • Metastatic disease in the recto-vesical pouch

• Check the gloved finger for obvious blood, if there is none use some of the stool for a faecal occult blood (FOB ) test.
• If patient is clinically suspicios for rectal cancer, do an office proctoscopy and rigid scope to 30 cm to avoid delay in the diagnosis of rectal cancer.