Physical Examination (PE)

  • Physical examination includes evaluation of the patient's body and may include
    • Location of tumor, including site and sub site
      • Breast, specific quadrant of cancer
      • Clinical size of the tumor by palpation
      • Condition of the skin surrounding the tumor, including changes in skin color and texture and attachment or fixation of the mass
      • Skin, specific body part with the cancer, for example, leg, arm, etc.
      • Appearance of skin
      • Size of skin cancer
      • Direct extension of the tumor to other organs or structures
  • Regional lymph nodes to primary cancer
    • Nodes that are enlarged, matted or fixed are not determined to be involved until there is cytological or pathological confirmation or the physician states, they are involved
    • Not all lymph nodes are palpable by physical exam, most common lymph nodes palpable by physical exam are the axillary nodes for Breast and the cervical lymph nodes for head and neck cancers
  • Distant metastasis are usually not diagnosed via physical exam, but through imaging.

Tumors of the head and neck area are evaluated with a general exam of the face and neck. The eyes, skin, ears, and nasal cavity should be examined in addition to mucosal surfaces of the nasopharynx, oral cavity, oropharynx, hypopharynx, and larynx. Digital and bimanual palpation of the oral cavity, oropharynx, and neck should be included in the physical exam.

  • Neck lymph nodes for head and neck cancers
  • Neck lymph nodes for thyroid cancer

Some organ sites are not easily examined clinically such (i.e., colorectal, GI, GYN, prostate ) and may require noninvasive diagnostic procedures and/or invasive procedures to determine involvement of cancer.

  • As part of the physical exam, a patient suspected of having a gastrointestinal tumor should have external palpation of the liver and abdomen. Females should have both a digital rectal exam and a pelvic exam.
  • As part of the physical exam for males suspected of having prostate cancer a digital rectal exam should be done.

Updated: March 4, 2024