Skip to Main Content

++

Introduction

++

Cancers of the tongue and mouth begin with a small hard lump, and sometimes with a little sore; both of which are attended with pricking pains, and they spread in the same manner with cancerous sores in other parts. It is so great an evil, that the slightest suspicion of it occasions very great uneasiness.

William Heberden (1710–1801)

++

The terms malignancy, cancer and neoplasia are usually used interchangeably. The differences between a malignant tumour and a benign tumour are summarised in Table 26.1.

++
Table Graphic Jump Location
Table 26.1

Different characteristics of benign and malignant tumours

++

Malignant disease accounts for 1 in 8 deaths of people under 35 years in Australia and 3 in every 10 (29%) of deaths in those over 45 years.1 Cancer is the only major cause of death in Australia that is increasing in both sexes. At current rates about 1 in 3 males and 1 in 4 females will develop a cancer, excluding non-melanoma skin cancers, by the age of 75.1

++

The six most common causes of death from cancer in Australia and the US are cancer of the lung, bowel, breast, prostate, lymphoma and pancreas.

++

Neoplasia, especially malignancy of the silent areas, can present as undifferentiated illness and be a real masquerade. The so-called ‘silent’ malignancies that pose a special problem include cancer of the ovary, pancreas, kidney, caecum and ascending colon, liver (hepatoma), melanoma and haematological tissue.

++

This chapter focuses on the general features of several of these malignancies in order to promote early diagnosis and urgent referral at the primary care level. Specific common cancers are discussed in other chapters.

++

Acute emergency problems that can develop with various malignancies include spinal cord compression, malignant effusions, disseminated intravascular coagulation and hypercalcaemia.

++

Cancer in children2,3

++

Although uncommon in children under 15 years, cancer is the second most common cause of death in this age group. The most common cancers (in order) are leukaemias, especially acute lymphocytic leukaemia (34%); brain tumours, especially astrocytoma (20%); lymphomas, especially non-Hodgkin (13%); neuroblastoma; Wilms tumour; soft tissue tumours, especially rhabdomyosarcoma; and bone tumours.

++

Survival has improved dramatically in recent decades, indicating the value of early diagnosis and referral for expert treatment.

++

Studies have highlighted the importance of GPs responding to concerns of parents even if they could find no abnormality after examination. Parents of children eventually diagnosed with cancer and who were in dispute with their GP were alerted by signs and symptoms which were often vague, non-specific and common, or unusual or ‘scary’. They felt that ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

Murtagh Collection Full Site: One-Year Subscription

Connect to a suite of general practice resources from one of the most influential authors in the field. Learn the breadth of general practice, including up-to-date information on diagnosis and treatment, as well as key clinical skills like communication.

$145 USD
Buy Now

Pay Per View: Timed Access to all of Murtagh Collection

48 Hour Subscription $34.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.