Clinical assessment of a patient with malignancy

November 9, 2012 | By | Reply More

Clinical assessment of a patient with malignancy

In order to plan the management of a patient with malignancy, the following information is required:

  • the nature of the primary malignancy (site, type, pathology)
  • the extent of the disease (stage)
  • the patient’s general condition and comorbidity
  • the available treatment options.


The presentation of a malignancy can involve both local and systemic features. The local signs or symptoms are usually due to mass effect or invasion of local tissues. In contrast, systemic features may be the result of metastases or the non-metastatic manifestations of malignant disease.



Symptom Site/tumour
Haemorrhage Stomach, colon, bronchus, endometrium, bladder, kidney
Lump Breast, lymph node (any site), testicle
Pain Bone (primary sarcoma, secondary)
Skin abnormality Melanoma, basal cell carcinoma (rodent ulcer)
Ulcer Oesophagus, stomach, anus, skin
Pain, cough, recurrent infection Odynophagia, dysphagia, early satiety, vomiting Altered bowel habit, pain, distension
Colon, rectum
Abdominal swelling (ascites) Ovary, gastric cancer
Fracture Metastatic cancer (breast, prostate, kidney, bronchus, thyroid)




Feature Common associations
Weight loss and anorexia Gastrointestinal tumours
Fatigue Any
Hypercalcaemia Myeloma, breast, renal tumours
Prothrombotic tendency Pancreas and other gastrointestinal tumours
Hormonal effects
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Small-cell lung cancer
Ectopic adrenocorticotrophic hormone (ACTH)
Neuropathies and myopathies
Eaton-Lambert myasthenia-like syndrome Small-cell lung cancer
Subacute cerebellar degeneration
Skin abnormalities
Acanthosis nigricans Gastro-oesophageal tumours
Dermatomyositis/polymyositis Gastric, lung tumours

Category: Medicine

WARNING: Any unauthorised use or reproduction of content for commercial or any purposes is strictly prohibited and constitutes copyright infringement liable to legal action.