Metastatic carcinoma and orthopedists.

What is your process for diagnosing patients with metastatic carcinoma? I take a complete patient history, including the nature of the current symptoms, level of activity, previous cancer history, and comorbidities. Although symptoms vary based on location, most patients present with pain at the site of metastasis caused by destruction of the bone. Metastatic carcinoma to the spine can cause neurologic deficits. A careful physical examination with attention to the potential primary locations for a carcinoma and the area of the skeletal lesion is important. Patients also can present with a soft tissue mass or lymph node enlargement. Laboratory studies might reveal anemia or electrolyte abnormalities, such as hypercalcemia. Specific cancer markers for certain diseases can also be used for diagnosis.