<prompt> Features of left side Ca colon areAnemiaObstructionAltered bowel habitMelena  <response>: . Patient can have de novo multiple primary carcinomas in different pas of the colon at the same time, i.e. synchronous 5-10, or can present with growth in different pas of the colon in different periods, i.e. metachronous 10-20. Gross types: Annular, tubular, ulcerative, cauliflower like. Annular stenosing type: It is more common on left side. Here the growth spreads round the internal wall and so it often presents with intestinal obstruction. Left sided growth presents with colicky pain, altered bowel habits alternating constipation and diarrhoea, palpable lump, distension of abdomen due subacute chronic obstruction. Later may present like complete colonic obstruction. Tenesmus, with passage of blood and mucus, with alternate constipation and diarrhoea, is common. Bladder symptoms may warn colovesical fistula. ref:SRB;s manual of surgery,ed 3,pg no 838 