Primary care physicians are often the first line of defense in catching the earliest signs and symptoms in cancer patients. Eunice Wang, MD, Chief of the Leukemia Service at Roswell Park Comprehensive Cancer Center, offers guidance on what red flags may indicate a hematologic cancer in your patients to help you identify these complex and often difficult-to-treat cancers as early as possible.
How does one make a diagnosis of human biologic cancer in a primary care patient? My name is Dr Yunus Wang, chief of the leukemia service at Roswell Park Comprehensive Cancer Center in Buffalo, New York So what are some warning signs of a potential human logic malignancy in a patient that you're seeing in your primary practice? First of all, it's important to recognize that many patients with Huma to logic malignancies will present with signs and symptoms related to compromise of their human logic system. This often entails leading in patients with low platelets, signs of cardiovascular compromise in patients with severe anemia and even increased infections in patients with a compromised immune system. Work up of such patients often involves physical examination. For patients may have evidence of anemia, pallor, weakness, hypotension north of Stasis. They may also have evidence of petechiae or bruising frequent purpura any signs of unusual bleeding in areas with very little history of prior trauma. In addition, we often see patients that have frequent infections occurring more than two or three or four times a year and often requiring one or more rounds of antibiotics with no improvement. How do we make the diagnosis of human urologic malignancies. Often that starts with a complete blood cell count. Patients will present with unusually high or an unusually low blood cell counts. One area of concern is if the white blood cell count is more than 30 or 50,000, since it's unlikely that causes such as infection or reactive sources will result in a white blood cell count usually greater than 20 or 30,000 at the time of presentation. We also become concerned when the platelet count is under 100,000 or over five or 600,000, suggesting that there may be some bone marrow or primary human to logic diagnosis. Anemia is perhaps the most common presentation that we see on lab work with patients with human logic malignancies, and this needs to be investigated if the anemia is severe, less than five or six or seven persistent I e. Does not improve with transfusion or iron supplementation or is associated with counts that are abnormal. In the other lineages, E patients that have anemia as well as thrombosis, leukemia and leukemia should be referred for further evaluation, in particular, patients that have Pan said a pina or decreased of two or three lineages should be referred for human geologic consultation and likely bone marrow evaluation. Ailments that affect the hematopoietic stem cell will result in pan suppression of all of the blood counts. So it is important to have that referral placed for potential future evaluation. Physical exam findings may include enlarge lymph nodes in addition to an enlarged liver and spleen. These cancers can be picked up both early and late, so referral for further evaluation of a patient with an abnormal human to logic exam, Huma geologic history or an abnormal CBC is recommended for those in the community. So recent evidence has demonstrated that human logic cancers much like ovarian and breast cancers, can occur in families. We have noticed that individuals under the age of 40 which present with primary Hema to logic malignancies, may have an inherited predisposition or increased risk in cancer occurring either in the same patient or in two or more immediate family members. For that reason, it is important to consider human logic cancers as well as solid tumors when evaluating patients for genetic predisposition cancer syndromes. Here at Roswell Park, we have the ability to perform not only benign Huma to logic but malignant hematology consultations for any patients that you are concerned about, the abnormal blood work, abnormal labs or signs and symptoms.
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