COMMON CANCERS IN ADULTS

• Progressive dysphagia
• Regurgitation
• Weight loss
• Iron deficiency anaemia

• FBC
• Barium Swallow
• Endoscopy;
  visualise and biopsy
  tumour
• CXR

• Anorexia, weight loss, vomiting
• Anaemia
• Haematemesis
• Pain, epigastric mass
• Melaena stool

• Haemogram
• Occult blood in
  stool
• Barium Meal
• Endoscopy;
  visualise and biopsy

• Change in bowel habits;
  constipation, diarrhoea
• Blood in stool
• Anaemia, weight loss
• Tenesmus
• Lower abdominal mass

• Haemogram
• Iron-deficiency
  anaemia
• Occult blood in
  stool
• Barium Enema
  (double contrast)
• Sigmoidoscopy
• Coloscopy;
  visualise and biopsy
  tumour

• A painless lump
• Nipple retraction
• Skin changes such as darkening
  and dimpling appearing like
  orange skin
• Nipple discharge that may be
  bloody
• Ulceration
• Uniform breast enlargement
• Pain is usually a late symptom
• Symptoms and signs of
  metastasis

• Mammography
• FNAC Biopsy
• Excisional biopsy

• No specific signs and symptoms,
  usually over 70% present as late
  stage
• Abdominal discomfort e.g.,
  pressure, poor appetite, nausea,
  vomiting, weight loss
• Urinary frequency
• Pelvic pressure
• Mass/masses in abdomen; if
  mass >15 cm in 40-69 years,
  suspect ovarian cancer
• Abdominal distension
• Irregular vaginal bleeding
• Low back pain, fatigue
• Dyspareunia

• Pelvic ultrasound
• Liver ultrasound
• Ascitic tap for
  cytology, chemistry
  and microscopy
  to rule out
  Tuberculosis
• CXR

• A: Asymmetry
• B: Border irregularity
• C: Colour variegation
• D: Diameter >6 mm
• Ulceration
• Regional lymph nodes

• Wide excision
  punch biopsy
• CXR
• Abdominal U/S

• Vaginal discharge, sometimes
  foul smelling
• Irregular vaginal bleeding
• Post-coital bleeding in women
  of any age
• Post-menopausal bleeding
  (especially if not responding to
  appropriate treatment)

Late stage:

• Urinary frequency and urgency
• Backache, lower abdominal pain

Very late stage:

• Severe back pain
• Weight loss
• Oliguria (due to ureteric
  obstruction or renal failure)
• Urinary/ faecal incontinence
• Oedema of lower limbs
• Dyspnoea (due to anaemia,
  metastasis or pleural effusion)

• Biopsy
• Abdominal
  ultrasound/CT

• Progressive lymph node
  enlargement
• Unexplained weight loss
• Drenching night sweats
• Persistent fever
• Pallor (anaemia)
• Lymphadenopathy
  (generalised)
• Splenomegaly
• Hepatomegaly

• Lymph node
  excision biopsy
• Fine needle
  aspirations (FNA)
• Full blood count
• Bone marrow
  aspirate
• LFTs, RFTs
• LDH
• Viral serology for
  HIV

• Non−healing ulcers
• Bleeding
• Pain
• Lymph nodes

• Wide excision
  incisional biopsy
• X−Rays of bones
• CXR

• Indolent KS: nodular skin
  lesions, fungating nodules, bone
  involvement
• Lymphadenopathic KS: lymph
  nodes, visceral involvement,
  GIT symptoms
• AIDS related KS: skin nodules,
  mucous membranes, mouth
  palate and ENT lesions,
  lymphadenopathy, paraplegias,
  any organ can be impacted

• Biopsies
• Full blood count
• HIV screening
• CXR: pleural
  effusions
• Abdominal X−Ray

• Painless mass
• Local ulceration with or without
  pain
• Referred pain to teeth or ear
• Dysphagia, loosening of teeth
• Alteration of speech: difficulty
  pronouncing words, change in
  character, persistent hoarseness
• Unilateral tonsillar enlargement
  in an adult
• Persistent unilateral “sinusitis”,
  nosebleed or obstruction
• Unilateral hearing loss
• Cranial nerve palsies

• Chest X-Rays and
  other relevant
  X-Rays
• CT scan
• Biopsy

• Urge to urinate often, especially
  at night
• Difficulty in starting or stopping
  urine flow, inability to urinate
• Weak, decreased or interrupted
  urine stream, a sense of
  incomplete emptying of bladder
• Burning or pain during
  urination
• Blood in the urine or semen
• Painful ejaculation

• Digital Rectal Exam
  (DRE)
• Serum PSA
• Ultrasound guided
  biopsy

• Classified into two: CLL and
  CML
• Recurrent infections
• Bleeding or easy bruisability
• Unexplained weight loss
• Drenching night sweats
• Persistent fever
• Waxing and waning lymph node
  enlargement (CLL)
• Swelling and discomfort in
  the left flank due to massive
  splenomegaly (CML)

The following clinical signs
require full physical examination:

• Pallor (anaemia)
• Splenomegaly
• Hepatomegaly
• Bruising (purpura)
• Lymphadenopathy

• FBC
• Peripheral blood
  film
• Bone Marrow
  Aspirate
• Biopsy
• CLL: blood film
  >500 monoclonal
  lymphocytes
• CML: leukocytosis,
  basophilia
  with immature
  granulocytes
• CXR
• LDH
• Viral serology for
  HIV, Hepatitis B&C
• Abdominal US scan
• CT scan
• Echo/ECG