Intro to diagnosis and treatment Flashcards
How do we diagnose cancer
think broad bullet points
- hsotory and clinical examination
- imaging
- blood tests
- for cancer biomarkers
- GOLD standard: taking a tissue biopsy and histological assessment
What histories of certain cancers
like for bowel cancer, what may someone present with
Change in bowel or bladder habits
- Stomach, pancreatic, colon and ovarian cancers may change the bowel and bladder habits
A sore that does not heal
- unusual shape/ border and crusts, with a foul-smelling discharge.
Unusual bleeding
- Blood when passing urine or stools may be a warning sign of kidney, bladder and intestine cancers.
Breast lump or thickening
- Any mass or growth in the breasts Sometimes, may be painful and contain blood or fluid.
Indigestion or difficulty in swallowing
- A constant feeling of having a lump in the throat or difficulty in swallowing
Extreme fever with night sweats
Persistent cough or hoarseness
- with or without chest pain, fatigue and shortness of breath.
What do you need to look for in an examination
- look for lumps
- ulcers
- abodminal distension
- DVT
- nodal masses
What are the major presentig symptoms of lung cancer
-breathlessness
-cough
-pain
-loss of apetitie
-coughing up blood
What do we need to think about if you suspect lung cancer
- Smoking and occupational exposure
- number of cigraates
- can be exposed to chromium, aresneic
- charatcertics of symptom
- need to know how long
- has it become worse recently
- weight loss not a good sign → tells you cancer is affecting the whole body
- need to know how long
Where can lung cancer metastise
what can it cause
- Signs of metastatic disease
- e.g. brain, bone, liver
- Signs attributable to local spread
- Superior vena cava obstruction
- Horner’s syndrome: pupil is small, drooping eyelid, absence of sweating)
- Pancoast syndrome, pleural effusion,
- Check lymph nodes
examine the abdomen looking for signs of enlarge liver
lung cancer it can press on important organs e.g. SVC and sympathetic chain
Lung cancer: sign of ectopic hormone production
idk why this was in notes
Cushing’s syndrome from ACTH secretion
What are non specifc cancer symptoms
weight loss
What things do we need to think about if we suspect colon cancer
- need to know about any family history of cancer
- need to know about symptoms
- how long has this been going n
- has weight changed
- ask about expected symptoms
- blood in motions
What are the major presenting symptoms of bowel cancer
- A change in bowel habits: diarrhoea, constipation…
- Bright red or dark blood in the stool
- Discomfort in the abdomen, bloating & cramps
- Unexplained weight loss or anaemia (iron deficiency)
What do we need to look for upon examination
|colon cancer
Palpable mass in abdomen?
Palpable mass/blood per‐rectum?
Examine abdomen to see if there is an enlarged, (lumpy) liver
What is the link with symptoms and staging
symptoms depend on stage
What techniques do we use to diganose cancer
-Imaging
-ultrasound
- good for thyroid
- CT scan
- lungs
- radioscope scans: bone, PET, MIBG
Then after imaging you would do a biopsy
- visualisation and biopsy
What are the types of bioposy
Core Biopsy
Fine needle biopsy
Surgical Biopsy
What tumor markers can you look for
- alpha-fetoprotein (AFP)
- cancer antigen 125 (CA125)
- cancer antigen 15-3 (CA15-3)
- carbohydrate antigen 19-9 (CA19-9)
- carcinoembryonic antigen (CEA)
- human chorionic gonadotropin (hCG or beta-hCG)
- prostate-specific antigen (PSA)
- Urinary Catecholamines
