Determining the extent of the cancer and clinical planning for cure

The patient with presumed localized cancer should be carefully surveyed both for evidence of spread of the disease, and in order to obtain baseline data which may be relevant to interpret any later clinical changes. The procedures used—a careful medical history, complete physical examination, laboratory tests, biopsy and cytology preparations, radiographic procedures and radioactive isotope scans of selected organ system—are listed. The recommended procedures in the individual patient are related to the primary site and apparent local extent of the cancer, a knowledge of the natural history of the particular cancer, and the practicalities of the situation. Proper study will direct an attempt at optimal curative therapy or spare the patient with metastatic disease unrewarding and possibly disabling therapeutic efforts.