[Oncology] Medical history

Firstly, there is a large difference between a new (potential) cancer patient, and a veteran cancer patient. A cancer patient with a history of tests and treatments will usually have a very long and detailed story.

Patient with a potential undiagnosed cancer

There are many key factors of a cancer history which must not be forgotten.

1. Weight loss
2. Fatigue
3. Systemic signs of chronic inflammation
1. Fever
2. Night sweats
4. Family history
5. Exposure to known carcinogens 
6. Red flag symptoms
1. Blood in urine
2. Blood in faeces (bleeding low in the GI tract)
3. Melena (dark tar-like faeces due to bleeding high in the GI tract)
4. Haematoptysis (bloody cough)
5. Haematemesis (bloody vomit)
6. Signs of immunosuppression
7. Easy bleeding (haemophilia) and bruising (haemotoma)
8. Lympadenopathy (enlarged, painful, unusual lymph nodes)

The patient with a diagnosed cancer 

• Initial symptoms and date of onset
• Initial tests
• Diagnosis (and date)
• Treatment journey
• Number of cycles of chemotherapy
• Which agents were used
• Any surgeries
• Adverse effects of therapy
• Was therapy tolerable
• Any major adverse events
• Any allergic reactions
• Latest results
• Observations during surgeries
• Cancer biomarkers
• Scans
• Any symptoms returning or worsening
• Returning weight loss
• Returning chronic cough
• Returning gastrointestinal symptoms
• Any new symptoms
• Bone pain
• Bone fractures
• Family history (if missing from medical records)
• Exposure to known carcinogens (if missing from medical records)