Distant Metastasis
A careful history and physical examination is the first step. If symptoms or signs suggest metastasis, then specialized studies such as MRI of the brain or radioisotopic bone scan are indicated.If the tumor stage is high, e.g. IIIA, then the risk of distant metastasis is high, and screening tests may be indicated even if there is no indication of metastasis on H+P. An abnormal lab test e.g. an elevated serum calcium or an abnormal liver function test, may suggest metastasis and lead to further examinations. The computerized tomogram of the chest should be carefully examined to be sure that there are no abnormalities in the liver and adrenal glands, other frequent sites of metastasis from lung cancer. Some clinicians routinely perform brain and bone screening studies in all patients with lung cancer, but the yield of positive results is generally quite small.
Frederic W. Grannis Jr. M.D If you have trouble contacting me with the address above, I may also be reached at 76516,2333@compuserve.com and at fgrannis@cris.com |