Cancer Patient Assessment and Surgical Interventions

Physical Assessment of a Patient with Cancer

Skin

• Inspection: Color, integrity, turgor, humidity, temperature.
• Check for: Injuries (type, size, and location), purpura, petechiae, edema, and appearance of nails.

Head and Neck

• Inspect: Face (asymmetry), eyes, mouth, trachea, maxillary sinuses.
• Palpation: Thyroid.

Thorax

• Inspection: Breathing movements and rate.
• Palpation, percussion, auscultation: Tone, intensity, and duration of breath sounds.

Breasts and Armpits

• Inspection and palpation.

Cardiovascular

• Inspection: Tremors and palpitations in the chest.
• Auscultation, palpation, blood pressure.

Musculoskeletal

• Inspection: Hair distribution, abnormal masses or lesions, asymmetries, nodules.
• Palpation: Painful masses, joint range of motion.

Neurologic

• Presence of signs and symptoms: Intermittent dizziness, headache, seizures, papilledema, sudden changes in personality, lateralized sensory deficits, paresthesias, or ataxia.

Hematologic

• Inspection: Hepatomegaly, splenomegaly, pallor, ecchymosis, petechiae.
• Palpation: Tenderness, masses, enlarged spleen, liver, lymph nodes, and sternum.

Female Genitals and Rectum

• Inspection: Hair distribution, masses, asymmetries, abnormal injuries.
• Palpation: Tenderness, masses.
• Vaginal and rectal examination: Integrity and color of mucous membranes and secretions, masses, bleeding, nodules.

Male Genitals and Rectum

• Inspection: Hair distribution, masses, asymmetries, abnormal nodules, lesions.
• Palpation: Tenderness, consistency, masses, form, and content of inguinal and supraclavicular areas, scrotum, breasts.
• Rectal examination: Prostate and rectum.

Abdomen

• Inspection: Masses or absence of bowel sounds.
• Percussion: Liver and spleen.
• Palpation: Tenderness, consistency, edges, masses, lymph nodes, viscera.

Types of Surgery in Cancer

Diagnostic Surgery

Performed to verify tumor involvement and take a sample for histological study. It can be done under general or local anesthesia.

Curative Surgery

Also known as radical or total, involves the excision of the tumor, surrounding tissue, and regional lymph nodes to provide maximum protection against local recurrence.

Palliative Surgery

Carried out when the tumor cannot be entirely removed, but the intervention can improve symptoms of obstruction, infection, and bleeding.

Reconstructive Surgery

Aims to correct and rebuild anatomical areas affected by previous surgery. It is important for achieving maximum rehabilitation, especially in head and neck, breast, and extremity surgeries.

Potential Complications Related to Radiation

Complications depend on the amount of radiation and the exposed area.

Digestive System

Anorexia, taste changes, esophagitis, sore throat, xerostomia, mucositis, tooth decay and loss, diarrhea, and peritoneal irritation.

Medical Treatment

Aimed at minimizing the effects of radiation on the body systems: anti-emetics, analgesics, oral mucosal protectives, gastric protectives, and antidiarrheals.