Patient Evaluation

History 

1. Presenting complaints 
2. Risk factors assessment

Physical examination 

1. General exam 
2. Abdominal exam 
3. Digital rectal examination (DRE) 
4. Vaginal examination in women 

Investigations

1. Complete colonoscopy – looks at the whole inside of the large bowel. A colonoscope (flexible tube) with a light and camera is passed at the back passage to the bowel.
   During this process the bowel is visualized and pictures are seen on a monitor/TV. If a growth is seen tissue samples(biopsy) are taken.

2. Endoscopic biopsy (for histological diagnosis). This is critical a sample is taken for analysis by a pathologist.

3. Laboratory tests: 

Full blood count- may show microcytic anemia (iron deficiency anemia) in bowel cancer.

Liver function tests-  May be abnormal in patients with multiple hepatic metastases.

Kidney function tests

Carcino-Embryonic Antigen- Baseline levels of this marker are obtained before initiating treatment. It is used to assess response to treatment and detect recurrence.

Fecal Occult Stool test

The doctor will perform a digital rectal examination. This involves insertion of a finger on the rectum to feel for masses and check for presence of blood.

Other tests that are done:

1. Flexible sigmoidoscopy-looks inside the lower part of your large bowel (only the rectum)
2. CT Abdomen, Pelvis and Chest / MRI. These Scans are done to determine if the bowel cancer has spread to other areas. In Rectal cancer additional tests can be done.

They include Pelvic MRI and rectal endoscopic ultrasound.