Clinical examination

From Oncology for Medical Students
Ideal oncology curriculum > Clinical examination

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Objective 4.1

At graduation, the student should be able to:

a) discuss clinical manifestations of cancer, considering broad aspects of:
(i) functional anatomy (vascular supply, lymphatic drainage, oncological anatomical relationships)
(ii) oncological pathophysiology
(iii) pathology
b) demonstrate an understanding of the components of the clinical examination of common cancers
c) demonstrate effective clinical examination relevant to common cancers
d) describe the results of clinical examination
e) accurately describe the physical signs of cancer.

Prerequisite knowledge

  • Anatomy of common cancer sites
  • Clinical examination framework and skills


Representative questions that suggest the required depth of knowledge

1. What are the potential areas of spread of a breast cancer recently treated by surgery, radiotherapy and chemotherapy? How would you detect them? Is early detection of recurrence or metastasis worthwhile?

Essential in answer:

  • Knowledge of organ/local/distant cancer spread
  • Knowledge of clinical examination techniques
  • Appropriate clinical examination reasoning


2. Select two commonly occurring cancers (eg. breast and rectal) and discuss how your examination of a patient is determined by your knowledge of the anatomical spread of those cancers? Briefly describe the clinical techniques used for each aspect of the examination of each organ or body part relevant to the examination for each cancer type.

Essential in answer:

  • Knowledge of organ/local/distant cancer spread
  • Knowledge of clinical examination techniques
  • Knowledge of how to self educate patients
  • Appropriate clinical examination reasoning


3. A 55-year-old male presents with his first episode of bright bleeding per rectum. There is no past history of bowel problems. If no other personal history is forthcoming, what investigation would be most appropriate?

(a) faecal occult blood testing x3

(b) CEA.

(c) colonoscopy

Answer: (c)