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28th February 2025
A 62-year-old retired teacher presents with generalised body weakness. He has no fever or cough
A 62-year-old retired teacher presents with generalised body weakness. He has no fever or cough. He is usually fit and well and enjoys walking 2 miles every evening with his local group. He reports 4 kg of weight loss since joining the local walking group 6 months ago.
His past medical history is only positive for hypertension controlled on 5 mg amlodipine once daily. He is a non-smoker and consumes alcohol only occasionally. He is unaware of any family history of cancer, stroke or cardiac conditions.
On examination he looks well in himself. Temperature is 36.9°C, BP 110/70 mmHg and heart rate 101 bpm, oxygen saturations 99% on room air. Systemic examination is unremarkable.
His blood results are below:
| Hb | 86 g/L | (135 – 180) |
| MCV | 72 fL | (80 – 100) |
| WBC | 10.1 x 10⁹/L | (4.0 – 11.0) |
| Na+ | 133 mmol/L | (135 – 145) |
| K+ | 4.1 mmol/L | (3.5 – 5.0) |
| Urea | 6.1 mmol/L | (2.0 – 7.0) |
| Creatinine | 111 µmol/L | (55 – 120) |
Colonoscopy reveals a 30 mm ulcerated, circumferential mass at the ascending colon.
Given the likely diagnosis, which of the following is the most appropriate management plan?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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