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Cancer Signs And Symptoms Pdf

cancer signs and symptoms pdf

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Hepatocellular Carcinoma - Future Outlook. Hepatocellular carcinoma HCC is often diagnosed after the tumor manifests clinical signs and symptoms. Early diagnosis is usually performed thanks to HCC screening programs for patients affected by liver cirrhosis or chronic viral hepatopathies using ultrasound and serum alfa-fetoprotien.

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Hepatocellular Carcinoma - Future Outlook. Hepatocellular carcinoma HCC is often diagnosed after the tumor manifests clinical signs and symptoms. Early diagnosis is usually performed thanks to HCC screening programs for patients affected by liver cirrhosis or chronic viral hepatopathies using ultrasound and serum alfa-fetoprotien.

In most HCC cases, clinical signs and symptoms of this tumor may occur several months after development, when therapy can not be curative, given the advanced tumor stage and underlying liver disease, which preclude curative options, such as ablation, resection, or liver transplantation. Clinical features of HCC are often similar to those caused by the underlying hepatic disease. It is very hard for physicians to distinguish signs and symptoms of HCC in contests characterized by an advanced liver disease.

Advanced liver cancer can be responsible for accelerated liver functions deterioration caused by the intrahepatic tumor growth. In this chapter, we review the clinical signs and symptoms induced by advanced carcinoma.

We also discuss particular clinical scenarios caused by metastases and paraneoplastic syndromes, sometimes described case reports in literature. Non-specific systemic signs and symptoms as asthenia, anorexia, weight loss, and nausea, are often present in patients with HCC table 1. HCC should be suspected with the onset of these clinical features in patients at risk for this tumor. Clinical signs and symptoms of hepatic cirrhosis that is often present in patients with HCC, usually mask the presence of an underlying early hepatocellular carcinoma [ 1 ].

Symptoms and signs of cirrhosis are often the only expression of the disease. Because of this, patients affected by HCC usually present at an advanced stage of the disease with clinical signs as jaundice, ascites, peripheral oedemas, neurologic manifestations of hepatic encephalopathy, bleeding, or infections.

Other signs of hepatic cirrhosis include gynecomastia, palmar erythema, spider angiomas, axillary or chest hair loss, hypogonadism testicular atrophy, loss of libido.

A large HCC can worsen the underlying hepatic disease, therefore in case of clinical worsening of a cirrhotic patient, onset of a HCC should be suspected. Hepatomegaly can be an expression of the tumor mass, table 1 [ 1 , 2 ].

In case of HCC, the palpable edge of the liver is more often irregular, hard, with nodular consistency. Hepatomegaly is more often present in patients without advanced cirrhosis [ 2 ].

In case of large tumors, the mass can cause asymmetry of the abdomen [ 3 ]. The costal margin can be deformed and the profile of lower ribs can be asymmetric. The right hemi-diaphragm can be elevated. This alteration of diaphragm profile can be asymptomatic or can cause mild respiratory symptoms. With thorax percussion is possible to detect an area of dullness, while trough auscultation is possible not to hear the vescicular murmur in case of elevation of diaphragm.

HCC can also cause a pleural effusion. All these clinical aspects are difficult to be differentiated from signs and symptoms of the underlying chronic liver disease: Right diaphragm elevation is possible in case of hepatopathy not associated to HCC and pleural effusion can be the expression of an ascending ascitic fluid or of the anasarca state caused by cirrhosis and hypoalbuminemia.

Trough auscultation of the abdomen, an arterial bruit can be heard in patients affected by HCC. This bruit is typically heard throughout the liver and it is described to have different characteristic from other vascular abdominal auscultatory findings.

In fact, usually, arterial bruit caused by abdominal aortic aneurysm or by renal artery stenosis are soft and short. Arterial bruit caused by HCC is usually a hard bruit and it is more prolonged than those caused by other conditions. This clinical sign is thought to be caused by the presence of an arteriovenous fistula in the context of the tumor [ 4 ], suggesting the presence of a highly vascularized HCC [ 5 ]. A frequent manifestation of onset of HCC is abdominal pain. The pain is usually mild, located in right hypochondrium and it can radiate to the right shoulder.

Abdominal pain is more frequent in non cirrhotic patients, and in case of portal thrombosis [ 1 ]. Patients with both cirrhosis and hepatic carcinoma have the highest risk to develop portal vein thrombosis [ 6 ]. Bleeding from esophageal varices or from portal hypertensive gastropathy is the most common presenting symptom of portal vein thrombosis in cirrhotic patients [ 8 , 10 ]. If a cirrhotic patient present an acute pain, then bleeding from rupture of tumor should be suspected.

HCC rupture causes a severe and sudden pain, and the patient can present the clinical features of an acute abdomen, with rebound and tenderness during physician palpation and an abdominal involuntary defense contraction.

A hypovolemic state and signs and symptoms of acute anemia can be present. Clinical features of chronic anemia can be present in case of slow blood loss from HCC. Usually,HCC tumors bleedings are spontaneous, but in rare cases, they can be caused by external causes.

The protrusion of HCC beyond the liver surface seems to be an important risk factor for HCC rupture [ 13 ]: hemorrhages occur more easily and can also be caused by slight external forces. The drainage of hematic peritoneal liquid in patient with acute abdominal pain can suggest the presence of a ruptured HCC, not being specific for this condition. A particular manifestation of HCC can be a bleeding from esophageal varices.

Variceal bleeding is caused by higher pressure in portal district which in turn can be caused by tumor invasion of this venous system and portal hypertension [ 17 ]. If variceal bleeding can be related with portal venous system invasion suggesting an advanced neoplastic disease, it does not seem to exist a relationship between this kind of clinical presentation and the size of the underlying tumor.

Bleeding from esophageal varices is obviously a more frequent clinical presentation of HCC in patients with more advanced liver cirrhosis [ 18 ] and high degree of portal hypertension. However, HCC can present with variceal bleeding also in patients without a known history of hepatopathy [ 17 ]. Variceal bleeding can present with melena or hematemesis. Bleeding can be massive, leading to hypovolemic state and it is one of the known triggers of cirrhotic encephalopathy so that tremors, confusion till to coma, can be present in these patients too.

Jaundice is a frequent sign of presentation of HCC. Different pathologic conditions linked to HCC can explain the onset of jaundice. Jaundice can be expression of hepatic failure, due to extensive tumor infiltration of a cirrhotic liver or by worsening of the underlying hepatitis that can occur in presence of HCC.

In other cases, jaundice result from obstruction of bile ducts by HCC. Clinical manifestation are those of typical cholestatic syndrome. In these cases jaundice is usually accompanied by itchiness, caused by elevation of serum level of bile acids, hypocolic stool and dark urine. All these symptoms can be presents also in the underlying liver disease, not being specific for biliary tract invasion.

The neoplastic obstruction can occur due to intraluminal biliary obstruction, extraluminal neoplastic compression or clot formation secondary to hemobilia caused by tumor invasion of biliary tree [ 23 ]. The presence of an intraluminal free-floating tumor fragment in the extrahepatic biliary tree may show an intermittent jaundice that can be associated with colicky pain [ 24 ]. Also in case of hemobilia a colicky pain can be present [ 5 ].

It can be intermittent, and usually is accompanied by leukocytosis. Imaging studies are often necessary to differentiate an HCC from a liver abscess. Fever occur more frequently in patients with massive HCC and in non cirrhotic individuals [ 1 ].

If HCC invades the inferior vena cava, signs and symptoms of venous insufficiency can appear. In this case relevant pitting edema can appear, usually bilaterally, affecting both inferior limbs, from the inguinal region. The invasion of the venous district, can worsen ascites and hepatomegaly [ 24 ]. Caval tumor thrombus can extend to the right atrium, causing dyspnea and heart failure [ 27 ].

When a patient presents signs and symptoms of right heart failure, such as jugular turgor, dyspnea, new onset of inferior limbs edema and worsening of hepatic insufficiency, heart tumoral invasion should always be suspected [ 28 ].

Anyway atrial invasion is reported to be also asymptomatic [ 29 ]. Pulmonary embolization by venous invasion is a rare, but reported primary manifestation of HCC [ 30 ]. Signs and symptoms at presentation of HCC described in patients affected by hepatitis B are significantly different in patients younger and older than 40 years. Younger patients present more often with pain, hepatomegaly and ruptured HCC. Older patient present more often with ankle oedema and ascites.

This is explained by the fact that in patients affected by viral hepatitis, advanced cirrhosis is more frequent in the older ones [ 2 ]. In younger patients it is more difficult that cirrhosis masks clinical aspect caused by HCC. Metastases from HCC, spread through lymphatic or hematic system, are more frequently placed in abdominal and thoracic lymph nodes, lung, bones, adrenal glands.

Less frequent sites of metastases are brain, spleen and breast [ 31 ]. Rarely metastases can also be detected in digestive tube, pancreas, seminal vesicle and bladder [ 32 ]. Sometimes signs and symptoms caused by metastases are the only clinical manifestation of HCC [ 34 ]. The frequencies of metastases in different sites are reported in Table 2. Pain and pathologic fractures can be caused by osteolytic metastases. Frequently they can also be present in ribs, skull, head of femur and peripheral bones [ 24 , 32 ].

Rarely HCC can have as only presentation pain or other symptoms caused by bone metastases, and this can also occur in non-common bone sites [ 36 , 37 ]. HCC metastases can cause also symptoms linked to nervous system. In fact in case of vertebral fractures, spinal cord compression can occur, causing neurological symptoms, leading to paraplegia in some cases.

Clinical features of spinal compression can occur as complication of advanced known HCC, or rarely they can be the clinical presentation of this tumor [ 38 ]. Lung metastases sometimes are causes of dyspnea, cough, hemoptysis, chest pain [ 40 ].

Brain metastases are not frequent, but often they cause important neurological symptoms, up to causing paralysis in most of these cases [ 39 ]. Rarely, metastases were reported in appendix, and signs and symptoms typical of acute appendicitis, as pain in the right lower quadrant associated with tenderness at the physical examination, can be a clinical presentation of HCC [ 41 ].

Among patients that have paraneoplastic syndromes during the clinical course of HCC, most of them have a single paraneoplastic manifestation. Hypercholesterolemia, erythrocytosis, hypoglycemia and hypercalcemia are some of the most common paraneoplastic manifestations of HCC.

Below, there are described the most common paraneoplastic syndromes and there are also reported other manifestations described in some case reports. See Table 3 for some of the reported paraneoplastc syndromes. Hypoglycemia is caused by the increased demand for glucose by the tumor together with a reduction of gluconeogenesis and glycogenolysis, due to a decreased residual liver tissue coupled with cachectic state and malnutrition that are often present in these patients [ 46 ].

Episodes of hypoglycemia caused by an advanced HCC typically occur in the last weeks before the death of the patients. Another pathologic mechanism involved in causing hypoglycemia is overproduction by the tumor of Insulin-Like Growth Factor II [ 47 ]. Hypoglycemia has been also described as the first clinical manifestation of HCC in some reports [ 44 , 48 ]. A PTH-like humoral factor is probably responsible of this paraneoplastic syndrome [ 50 ].

Hypercalcemia can also be caused by the presence of osteolytic bone metastases [ 51 ].

Everything you need to know about colon cancer

This page is about signs and symptoms of secondary breast cancer, which is when breast cancer has spread to another part of the body. Looking for information about the signs and symptoms of breast cancer? The main symptoms of secondary breast cancer in the bone include:. Symptoms of secondary breast cancer in the lungs include:. Symptoms of secondary breast cancer in the liver include:. Symptoms of secondary breast cancer in the brain include:.

Colon cancer develops when tumorous growths develop in the large intestine. It is now the third most common type of cancer in the United States. The colon, or large intestine, is where the body draws out water and salt from solid wastes. The waste then moves through the rectum and exits the body through the anus. Colon cancer is also the third most common cause of cancer-related death in the U. Healthcare professionals recommend attending regular screenings for colon cancer from the age of 50 years.

cancer signs and symptoms pdf

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Cancer occurs when changes called mutations take place in genes that regulate cell growth. The mutations let the cells divide and multiply in an uncontrolled way. Breast cancer is cancer that develops in breast cells. Typically, the cancer forms in either the lobules or the ducts of the breast.

Cancer refers to any one of a large number of diseases characterized by the development of abnormal cells that divide uncontrollably and have the ability to infiltrate and destroy normal body tissue. Cancer often has the ability to spread throughout your body. Cancer is the second-leading cause of death in the world. But survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment. Make an appointment with your doctor if you have any persistent signs or symptoms that concern you. If you don't have any signs or symptoms, but are worried about your risk of cancer, discuss your concerns with your doctor. Ask about which cancer screening tests and procedures are appropriate for you.

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. The risk of developing certain cancers can be reduced by not smoking, maintaining a healthy weight, limiting alcohol intake, eating plenty of vegetables , fruits , and whole grains , vaccination against certain infectious diseases, limiting consumption of processed meat and red meat , and limiting exposure to direct sunlight. In , about Greek physicians Hippocrates and Galen, among others, noted similarity of crabs to some tumors with swollen veins. The word was introduced in English in the modern medical sense around Cancers comprise a large family of diseases that involve abnormal cell growth with the potential to invade or spread to other parts of the body. A neoplasm or tumor is a group of cells that have undergone unregulated growth and will often form a mass or lump, but may be distributed diffusely.

Associated Data

To study the relative importance of different tools a GP can use during the diagnostic process towards cancer detection. Retrospective cohort study with prospective registration of cancer in general practice. Setting and subjects. One hundred and fifty-seven Norwegian general practitioners GPs reported cancer patients. During 10 consecutive days, GPs registered all patient consultations and recorded any presence of seven focal symptoms and three general symptoms, commonly considered as warning signs of cancer WSC.

Сьюзан набрала полные легкие воздуха и задала неизбежный вопрос: - И где же теперь этот канадец. Стратмор нахмурился: - В этом вся проблема. - Офицер полиции этого не знает. - Не имеет понятия. Рассказ канадца показался ему полным абсурдом, и он подумал, что старик еще не отошел от шока или страдает слабоумием. Тогда он посадил его на заднее сиденье своего мотоцикла, чтобы отвезти в гостиницу, где тот остановился.

Говорила Мидж - излагая серию необычайных событий, которые заставили их нарушить неприкосновенность кабинета. - Вирус? - холодно переспросил директор.  - Вы оба думаете, что в нашем компьютере вирус.

Я был там, внизу. Резервное питание подает слишком мало фреона. - Спасибо за подсказку, - сказал Стратмор.

Шестнадцать часов. Но это не все, сэр. Я запустил антивирус, и он показывает нечто очень странное. - Неужели? - Стратмор по-прежнему оставался невозмутим.  - Что показалось тебе странным.

5 Comments

  1. Racmadivan

    02.06.2021 at 08:53
    Reply

    Cancer can cause signs and symptoms in your body. You can look out for these. Sometimes these signs and symptoms are caused by other illnesses. But it.

  2. Saville M.

    05.06.2021 at 21:28
    Reply

    This video discusses the importance of knowing the signs and symptoms of gynecologic cancer.

  3. Cyprien Г.

    06.06.2021 at 03:23
    Reply

    Early diagnosis programmes for common cancer types that provide early signs and symptoms, such as cervical, breast and oral cancers. This strategy is.

  4. Hans B.

    07.06.2021 at 01:20
    Reply

    Fatigue is very common in patients with blood cancers.

  5. Dumbpreperam

    08.06.2021 at 03:55
    Reply

    nant bowel obstruction that are refractory to medications. Fatigue. The subjective symptom of fatigue—often referred.

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