History and Physical

History and physical exam should focus on symptoms of local or distant disease. Frequent sites of metastasis include liver, lung, and bone.

The history should include asking about:

  • ‹‹Bowel, bladder and sexual function with rectal cancer patients
  • Unexplained weight loss / GI complaints, abdominal ascites
  • Fatigue
  • New onset bone pain
  • New headaches, or other neurological symptoms

The physical exam should include:

  • ‹‹Abdominal exam including palpation and scar examination
  • Examine inguinal nodes for rectal cancer
  • Respiratory and cardiovascular assessment
  • Rectal exam annually and more frequently as needed
  • Assessment for pallor and palpable lymphadenopathy
  • Abdominal examination paying particular attention to scar and new onset of mass lesions or organomegaly