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DIAGNOSIS OF CANCER AND ITS COMPLICATIONS
癌症的诊断与并发症
General evaluation. The diagnosis of cancer can be simple or it can challenge all the skills of clinical investigation.
普遍诊断。癌症的诊断可非常容易，也可挑战临床研究的所有技能。
In some instances metastatic tumors may be the first indication of cancer, and the primary lesion may escape efforts at detection.
有时转移癌可能是癌症的第一指征，而原发损害却难以发现。
The challenge is to detect cancer as early as possible, when it is most likely to be cured.
我们所面临的挑战是尽早发现癌症，尽早发现增加治愈可能。
One third of new patients have in situ or localized cancer, one quarter have regional lymph node disease,
在所有新病人中，三分之一是原位癌，四分之一患局部淋巴结疾病，
and one third have distant disease；the remaining few per cent have disease of undefined stage.
三分之一有转移性疾病，少数病患的病情阶段尚未明确。
Early detection of localized disease is aided by an awareness of risk factors in the family history, personal habits (tobacco, alcohol, sun exposure) and occupational exposure (asbestos, chromium, benzene).
为尽早发现原位癌，我们要通过家族史、个人习惯（抽烟、饮酒、光照）以及职业性照射（石绵、铬、苯）的危险系数来扶助检测。
It also requires attention to subtle and nonspecific symptoms of fatigue, weakness, weight loss, depression, headache, pain, changes in bowel habits,
还要注意疲劳、虚弱、减重、抑郁、头疼、疼痛、排便、
persistent cough or hoarseness, rectal bleeding，and other clues from the history.
持续咳嗽、声音嘶哑、直肠出血、家族史等细微或非特定症状。
In evaluating a patient who presents with nonspecific symptoms that might be indicators of malignancy, such as weight loss, fever, or fatigue,
在诊断有非特定症状的病患时，例如减重、高烧或疲劳，这些或是恶性肿瘤的标志，
the physician should carefully examine all mucosal surfaces, the sigmoid colon, and the rectum for masses or ulcerated lesions.
医生要细心检测所有粘膜表面、乙状结肠，直肠肿块或溃疡性病变。
In addition to elements of a routine examination, stool should be tested for occult blood.
除了常规检测，粪便要进行隐血试验。
More subtle clues may be seen in the skin with finding such as petechiae, hyper-pigmentation of skin folds (acanthosis nigricans) , or atypical moles (dysplastic nevi).
我们还可以在皮肤上发现细微征兆，例如淤点、皮皱深度过度（黑棘皮症）或是非典型痣（发育不良性痣）
Attention should be paid to the presence of systemic cancer-associated effects, such as neuromyopathies.
要对出现的全身性癌症病症给予关注，比如神经肌病。
Leads from laboratory testing may be found in unexplained anemia, thrombocytopenia, hypercalcemia, or elevation of serum LDH and acid or alkaline phosphatase levels.
实验室检测提示不明原因的贫血，血小板减少，高钙血症以及血清乳酸脱氢酶、酸性磷酸酶和碱性磷酸酶水平的升高。
Other frequent harbingers of cancer are pulmonary nodules or radiolucent bone lesions associated with new bone pain.
其它常见先兆有肺结节，以及与新骨痛有关的透析性骨病。
译文属可可英语原创，未经允许，不得转载。
