Taking a Decision and Ordering Investigations

Abstract

The primary aim of radiotherapy in treating cancers is “to achieve maximum possible tumour remission with minimum possible side effects”. This is decided by tumour staging, patient’s performance status as well as other factors like availability of options, financial implications and socioreligious factors. Sometimes achieving maximal dose to tumour tissue with complete sparing of surrounding normal tissue may not always be achievable, and compromises may need to be done. When a patient first presents, the clinician must recognize initial signs or symptoms which might suggest towards a diagnosis of an underlying malignancy. A good clinical examination gives the clinician a good indication of the possible diagnosis and enables him to selectively focus examination more thoroughly. The next step is confirming the presence and type of malignancy and assessing the stage. Staging describes the extent or spread of the disease at the time of diagnosis and is essential in determining the choice of therapy and in assessing prognosis. Treatments for cancer are either curative or palliative, and many factors decide what treatment is offered to the patient like stage of the disease, patient age, performance status of the patient or prognostic features.