1. Clinical Manifestations of Colon CA

2. Location of the tumor Lesions of the right colon –chronic, insidious blood loss –no change in appearance of the stool Tumors of the ascending colon –fatigue, palpitations, angina pectoris –hypochromic, microcytic anemia (iron deficiency)

3. Presence of iron-deficiency anemia –endoscopic and/or radiographic visualization of entire large bowel

5. Tumors of the transverse and descending colon –abdominal cramping –occasional obstruction –perforation –radiographs of the abdomen annular, constricting lesions ("apple-core" or "napkin-ring")

7. Rectosigmoid cancers –hematochezia –tenesmus –narrowing of the caliber of stool –anemia Uncommon –development of rectal bleeding and/or altered bowel habits digital rectal examination and proctosigmoidoscopy

8. Signs & symptoms present in the pt Hematochezia Mild, abdominal discomfort Constipation (years) Pale Fresh blood on rectal exam