Cancer in the Primary Care Setting Theodore Pollock, DO, FACOI June 21, 2012 1.

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


• History– Exposure– Recent Change– Bleeding– Pregnancy

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The Mole


• Physical Exam– Margins– Ulcer– Lesions in Transit– Lymphadenopathy

• Biopsy

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The Mole


• History– Co-Existing Factors– Fever– Weight Loss

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Lumps


• Physical– Location

• Matted

– Consistency• Rubbery• Rock Hard

– Painful

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Lumps


• Temporal Factors• Coexisting Factors

– Diarrhea– Fevers– Diabetes– Meals-on-Wheels

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Weight Loss


• CDC Definition of Fever– Temperature of 100°F or higher in the absence of

antipyretics.

• Temporal Factors– Infection

• Rigors

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Fever


• Infection• Inflammatory Disease• Leukemia• Lymphoma• Renal Cell

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Differential Diagnosis


• CBC• Differential Diagnosis

– Infection– Leukamoid Reaction– Neoplastic– N/A

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Leukocytosis


• HGB• Platelets• Differential

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Neoplastic


• Differential Diagnosis– CLL– CML– MDS / AML– Leukamoid Reaction

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Questions

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Cancer in the Primary Care Setting Theodore Pollock, DO, FACOI June 21, 2012 1.

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