A 66-year-old woman comes to her general practitioner (GP) with a 4-month history of tiredness, slight breathlessness on exertion and loss of weight from 71 to 65 kg. Her appetite is unchanged and normal; she has no nausea or vomiting, but over the last 2 months she has had an altered bowel habit with constipation alternating with her usual and normal pattern. She has not seen any blood in her feces and has had no abdominal pain. She has had no post-menopausal bleeding. There is no relevant past or family history, and she is on no medication. She has smoked 20 cigarettes daily for 48 years and drinks 20–28 units of alcohol a week.
Investigation Results: No further reports were available. What could be the likeliest diagnosis? How would you investigate the patient? *This case is from Docplexus Editorial Team for educative purpose only. Source: Medical Cases in Clinical Medicines.
