Associate Professor Simon Anderson

Surgeon
Suite 65
City Hospital
25-29 Main Road
Centreville

22/02/14

Dear Doctor Anderson, Comment [teacher1]: Dr

Re: Mr. Daniel McCrae, DOB: 17/10/1962

I am writing this letter to refer this patient, a 52-year-old male whose features are suggestive of
adenocarcinoma of the ascending colon. Your management would be highly appreciated.

Mr. McCrae is a married barrister with 4 children. He is a smoker and has no family history of colorectal
carcinoma or colonic polyps.

On 19/09/13, the patient visited my clinic complaining of typical symptoms of viral infection; therefore, he
was advised to rest and take Panadol for his fever. Four months later, he reported having abdominal
discomfort, change in bowel habits and fatigue for the past several weeks. The patient was ill looking
despite the unremarkable abdominal examination. As a result, CBC, Fecal occult blood test (FOBT) and
colonoscopy were ordered to rule out any suspicion of bowel cancer or inflammatory bowel diseases.

Unfortunately, on today's visit, the Investigations showed decreased Hb, positive FOBT and
adenocarcinoma of the ascending colon which was diagnosed through taking a biopsy during colonoscopy.

In view of the above, I believe this patient needs your urgent assessment. For any queries, please do not
hesitate to contact me.

Yours sincerely,

Doctor

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