The history and physical examination in oncology

== The change of health status and a suspicion of cancer ==
 * Local changes
 * unusual resistance;
 * altered configuration;
 * konsistation;
 * color changes;
 * organ failure;
 * localized pain;
 * skin nevi changes;
 * altered mucous membranes;
 * blood in stooli;
 * blood in urine.


 * General changes:
 * weight loss (especially 10 % within a half a year);
 * anorexia;
 * fatigue;
 * tiredness;
 * increased sweating (mostly during night);
 * fevers of unknown ethiology;
 * long-term hoarseness;
 * cough;
 * dyspnoea;
 * urinary incontinence;
 * depresion.

History

 * RA (family history): Besides classical heritability we can observe familiar incidence of tumors such as accumulation of mass.
 * OA (personal history): It is important to search for the disease that can have direct link to cancer or can significantly influence therapeutic decisions.
 * AA (allergies) Their significance is getting bigger.
 * SA, PA (social and job history) carcinogen in a workplace
 * Abuse: Smoking, number of cigarettes, alcohol, drugs.
 * GA (gynecology history): etc.

Physical examination.
The basics are: inspection, palpation, percussion, a auscultation.
 * Inspection.
 * We pay attention to skin and mucous; the visible tumor should be well described in relation to it´s surroundings.
 * The overall appearance of the patient is also important.
 * Palpation.
 * Should be careful, we do not unnecessarily repeat the examination. We need to palpate also the organs in cases of metastasis – liver, spleen, lymph nodes.
 * The digital rectal examination should be done routinely in man over the age of 50 let and breast examination in woman (in practice from the age of 25).
 * Percussion and auscultation.
 * They follow the basic principles.

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