Vague Symptoms and Cancer

Dr. Liu presented a perplexing case of vague symptoms in a patient who was ultimately diagnosed with a small renal cell carcinoma. It brought up several important points around cognitive reasoning, specifically how we think about the cost-conscious approach to care in patients with vague symptoms while maintaining a therapeutic relationship. While there is little evidence to guide us in the evaluation of vague symptoms, the general approach of starting with minimally invasive and inexpensive tests first and progressing forward in diagnostics with shared decision-making as necessary seemed to be consensus. Some takeaways regarding the surgical management of low-grade renal cell carcinoma:

  • Partial nephrectomy probably achieves similar OS rates compared to radical nephrectomy
  • Preferred for low-grade RCC, likely surgical cure
  • Save nephrons when you can
Courtesy Uptodate

Courtesy Uptodate