The history and physical examination in oncology
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== 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[edit | edit source]
- 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.[edit | edit source]
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.
Links[edit | edit source]
References[edit | edit source]
- BENEŠ, Jiří. Studijní materiály [online]. [cit. 2010]. <http://jirben2.chytrak.cz/materialy/onko_JB.doc>.
