A 68-Year-Old Man Comes to the Office Due to Fatigue

question 635

Multiple Choice

A 68-year-old man comes to the office due to fatigue, weight loss, and constipation.  He has refused to undergo screening colonoscopy for several years because "nobody in my family had colon cancers."  Past medical history is notable for emphysema and stable angina.  The patient has smoked a pack of cigarettes daily for 50 years and drinks alcohol occasionally.  Physical examination is unremarkable.  He is referred for colonoscopy, which reveals a circumferential mass encircling the sigmoid colon.  Pathology is positive for adenocarcinoma.  CT scan of the chest, abdomen, and pelvis is negative for signs of metastasis.  Serum carcinoembryonic antigen assay is ordered.  The results of this assay would be most useful for which of the following aspects of this patient's care?

• A)Determining the need for surgery
• B)Determining the type of chemotherapy
• C)Grading of the tumor
• D)Monitoring for residual disease
• E)Staging of the tumor

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