What are the important items in the history of a patient
with suspected lung cancer?
The most important question asked by the physician in the medical history is "have you ever smoked".If the patient has never smoked, then lung cancer is uncommon. If the patient has smoked, then lung cancer is a very high risk. Other occupational exposures, such as asbestos and uranium mining can also cause lung cancer. It is important to ask whether the patient has headaches or other neurologic symptoms to detect whether brain metastasis is present. Similarly, questions regarding bone pain may lead to a suspicion of bone metastasis. Questions regarding non-healing sore of the mouth or tongue, persistent sore throat, change in voice or difficulty in swallowing can help detect other tobacco related cancers of the mouth, throat and esophagus. In order to evaluate whether the patient can safely undergo surgical or other therapy, questions about shortness of breath and production of sputum will help to determine whether COPD and chronic bronchitis exist. A careful history of exercise tolerance will help quantify these problems. In similar fashion, a history of symptoms of present or prior cardiac illness is important.
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 |