Medical History & Physical Exam

One of the first steps in a diagnosis of blood cancer is the medical history and physical exam.

What happens in a medical history?

A medical history generally consists of written and verbal questions to understand the symptoms the patient is experiencing and how long the symptoms have been present. Additional questions in a medical history will cover the health history of close family members, any medications or dietary supplements the person may be taking, previous surgeries, previous or current illnesses, allergies, immunizations, and any exams or tests that may have already been run.1,2

What happens in a physical exam?

During a physical exam, the doctor examines the patient’s body for signs of disease. The physical exam often includes a visual inspection (looking), palpation (feeling), auscultation (listening, often with a stethoscope), and percussion (producing sounds through tapping).3

During the visual inspection, the physician will look for signs such as unusual bleeding, bruising, or any changes on the skin. The doctor will also feel areas of the body to detect any changes in certain areas and note whether they are hard, soft, or painful to touch. For example, some blood cancers can cause lymph nodes, the spleen, or the liver to swell. In males, the testicles may also be examined as they can become enlarged with some forms of blood cancer. The doctor will often also listen to the heart, lungs, and intestines.4

Common symptoms of blood cancer

Some of the symptoms of blood cancer can also be caused by other conditions, and tests will be run to determine the cause of the symptoms. While different types of blood cancer have unique combinations of symptoms, some common symptoms of leukemia and lymphoma may include:

Common symptoms of myeloma may include:

  • Bone pain or fractures
  • Fatigue
  • Increased thirst
  • Loss of appetite and subsequent weight loss
  • Frequent infections
  • Confusion or mental fogginess
  • Frequent urination1

Cancer cells can rapidly multiply and may crowd out the production of normal, healthy blood cells. When this happens, blood cancers may cause conditions such as:

  • Anemia, which is a lack of red blood cells and can cause fatigue
  • Neutropenia, which is a lack of neutrophils (a type of white blood cell) that puts a person at increased risk for infections
  • Thrombocytopenia, which is a lack of platelets and puts and person at increased risk for bleeding or bruising
  • Pancytopenia, which is a lack of all three: red blood cells, white blood cells, and platelets5

Additional tests used to diagnose blood cancer

In addition to the physical exam and medical history, a number of other tests may be used to diagnose blood cancer or to rule out other conditions that may be causing symptoms. Additional testing may include blood tests, urinalysis, bone marrow tests, imaging tests, or biopsies.1,4

Written by: Emily Downward | Last reviewed: February 2018
View References
  1. American Cancer Society. Available at https://www.cancer.org/. Accessed 9/28/17.
  2. National Cancer Institute. Available at https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=689078. Accessed 9/28/17.
  3. Physical examination, MedlinePlus, U.S. National Library of Medicine. Available at https://medlineplus.gov/ency/article/002274.htm. Accessed on 9/28/17.
  4. NCCN Guidelines for Patients: Acute Lymphoblastic Leukemia, Version 1.2017. Available at https://www.nccn.org/patients/guidelines/all/index.html. Accessed 9/27/17.
  5. Leukemia & Lymphoma Society. Available at http://www.lls.org/leukemia/acute-lymphoblastic-leukemia/. Accessed 9/28/17.