cancer in the primary care setting theodore pollock, do, facoi june 21, 2012 1
TRANSCRIPT
Cancer in the Primary Care SettingTheodore Pollock, DO, FACOI
June 21, 20121
Leading Causes of Death, 2007
Source: CA Cancer J Clin 60:277, 2010.
© 2011 Rising Tide
Probability of Developing Cancer
Source: CA Cancer J Clin 60:277, 2010.
© 2011 Rising Tide
©2010 Rising Tide, Kft. All rights reserved. 4
Cancer in the Office
• Moles• Lymph Nodes• Weight Loss• Fever• Leukocytosis
©2010 Rising Tide, Kft. All rights reserved.
• Definition of Melanoma - A form of cancer that begins in melanocytes (cells that make the pigment melanin). It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines.
• Estimated New Cancer Cases & Deaths from Melanoma in the U.S. in 2012
– New Cases: 76.250– Deaths: 9,180
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The Mole
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• History– Exposure– Recent Change– Bleeding– Pregnancy
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The Mole
©2010 Rising Tide, Kft. All rights reserved.
• Physical Exam– Margins– Ulcer– Lesions in Transit– Lymphadenopathy
• Biopsy
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The Mole
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• History– Co-Existing Factors– Fever– Weight Loss
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Lumps
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• Physical– Location
• Matted
– Consistency• Rubbery• Rock Hard
– Painful
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Lumps
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• Temporal Factors• Coexisting Factors
– Diarrhea– Fevers– Diabetes– Meals-on-Wheels
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Weight Loss
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• CDC Definition of Fever– Temperature of 100°F or higher in the absence of
antipyretics.
• Temporal Factors– Infection
• Rigors
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Fever
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• Infection• Inflammatory Disease• Leukemia• Lymphoma• Renal Cell
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Differential Diagnosis
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• CBC• Differential Diagnosis
– Infection– Leukamoid Reaction– Neoplastic– N/A
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Leukocytosis
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• HGB• Platelets• Differential
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Neoplastic
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• Differential Diagnosis– CLL– CML– MDS / AML– Leukamoid Reaction
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Questions
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