Clinical reference

Colorectal Cancer

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Colon Cancer - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK470380/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD26 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against2 documents

No dose - referral pathway, no medicine given in primary care
Colorectal Cancer - disease-level clinical article (colorectal-cancer-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (1)

Presenting symptoms include rectal bleeding, abdominal pain, weight loss, and a change in bowel habits, which can progress to bowel obstruction in advanced disease [abdominal pain · rectal bleeding · weight loss]

Signs — what you find (3)

Exam may reveal abdominal tenderness, blood in the stool, or, less often, a palpable abdominal or pelvic mass [abdominal mass · abdominal tenderness · bloody diarrhoea · diarrhoea · pelvic mass]
Physical findings are often unremarkable, and no abnormal finding may be present at all
Exam should check for enlarged lymph nodes above the collarbone, in the neck, and in the armpit, plus a digital rectal exam and liver size [lymphadenopathy]

Tests (6)

Anemia, low ferritin from iron deficiency, and a raised alkaline phosphatase or CEA level can raise suspicion for the disease
Full colonoscopy is the gold-standard test, allowing biopsy and lesion removal in one procedure
If colonoscopy cannot be done, CT colonography or a barium enema are alternatives, but a positive finding still needs biopsy confirmation
Contrast CT of the chest, abdomen, and pelvis is used to stage a newly diagnosed cancer
A PET scan can find spread not visible on contrast CT, though infection or healing tissue can also raise its signal
Tumor testing for microsatellite instability or loss of mismatch-repair proteins screens for Lynch syndrome and guides immunotherapy eligibility

If not this — what else fits (3)

Solamen syndrome causes segmental overgrowth with vascular malformations and skin lesions, and sits within the Cowden syndrome spectrum with PTEN mutations
Bannayan-Riley-Ruvalcaba syndrome features intestinal hamartomatous polyps, lipomas, an enlarged head, and genital skin pigmentation
Proteus syndrome causes progressive overgrowth of the skeleton, skin, and fat with only a few hamartomatous polyps, unlike true polyposis syndromes

SourceStatPearls "A Review of Hereditary Colorectal Cancers" - disease-level clinical article

Presentation findings are traced to the source above.

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line

Adult dose and duration

Colon, rectal, or anal cancer requires colonoscopy and surgical/oncology referral. GP recognises red-flag bowel symptoms, gives symptomatic relief, and refers urgently. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Colon, rectal, or anal cancer requires colonoscopy and surgical/oncology referral. GP recognises red-flag bowel symptoms, gives symptomatic relief, and refers urgently.

Cautions

No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
RED FLAG - Where 2 or more first-degree relatives have had colorectal cancer or premalignant colon polyps, investigate for an inherited CRC syndrome.
RED FLAG - Rectal bleeding, unexplained weight loss, a change in bowel habit lasting more than 6 weeks, iron-deficiency anaemia, or a palpable abdominal or rectal mass: refer urgently.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.