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- Physical Examination
- • Digital rectal examination or an examination with local or general anesthesia if necessary.
- • A small anal mass, often like hemorrhoids, may be found. Sometimes the mass protrudes and reaches a
- significant size.
- • Physical examination for local invasion into muscle sphincter or into other adjacent organs such as the vagina
- or prostate.
- • Lymph nodes in the groin may be enlarged in 20 percent of patients, often indicating metastases.
- • Perirectal and mesenteric lymph nodes are involved in 25 percent of patients, but are rarely palpable.
-
- Blood and Other Tests
- • Complete blood count.
- • Liver function chemistries (such as alkaline phosphatase , LDH, SGOT).
- • Tests of kidney function (such as creatinine).
-
- Imaging
- • Abdominal CT scan or ultrasound if the liver is enlarged or if liver function tests are abnormal (fewer than 10
- percent of patients have liver metastases at the time of diagnosis).