A 66-year-old retired nurse visits a general practitioner with a 4-month-old history of tiredness, slight breathlessness on exertion, and weight loss from 71 kg to 65 kg. In addition, she has been experiencing an altered bowel habit with constipation for the last two months. However, her appetite is unchanged, with no nausea, no vomiting, and no significant abdominal pain. She has no past family history and is not on any medications.
Upon further investigation, the lady reveals that she smoked 20 cigarettes daily for 48 years and drinks 20-28 units of alcohol per week. Her blood pressure was 148/90 mmHg. Barium enema revealed neoplasm in the sigmoid colon, and blood film showed a microcytic hypochromic appearance.
