History & Physical Exam

Clinical diagnosis is the most important medical intervention. An accurate diagnosis is directly related to the physician's knowledge, professional compromise and critical view. Based on disease signs and symptoms, the physician should propose a clinical hypothesis, which usually anticipates the results of confirmatory exams. The physician's commitment to this sequential process creates the best scientific scenario for a well-succeed medical investigation. When browsing the items below, you will understand the medical rational.

  • The section of Medicine that deals with disease signs and symptoms is called semiotics. Signs are objective manifestations, described on physical exam, according to predefined criteria. Symptoms are subjective manifestations, usually reported by the patient. Cancer can be expressed by a set of signs and symptoms, sequentially or simultaneously, translating the disease biological behavior. Unfortunately, there are some situations where cancer is asymptomatic, making advisable the use of routine screening tests.

  • Doctors are trained to propose diagnostic hypotheses. The hypotheses are based on disease's symptoms and signs collected from the patient’s history and physical examination. Usually, the most common tumors have predefined patterns of clinical expression, leading to more specific diagnostic hypotheses. The physicians are well trained to recognize these clinical patterns. The creation of hypotheses is an essential step on the medical rational.

  • Tests are chosen and interpreted according to the diagnostic hypothesis, allowing its confirmation. All tests, including blood, diagnostic imaging, endoscopies and even pathological examination, are not 100% accurate. The doctor should validate them, as long as they are in accordance with the tumor's clinical expression patterns. The final diagnosis relies on the physician's critical view.

  • Cancer requires diagnostic accuracy, which is based on multi-professional approach. Medical knowledge is too extensive, leading to a progressive specialization. Doctors are trained to work together in an interdisciplinary team. The diagnosis is a result of adding efforts of multiple specialties including clinicians, surgeons, radiologists and pathologists, among others. 

  • One of the most important characteristics of medical activity is the critical view. The diagnosis accuracy is proportional to the critical view of the physician. Medicine is not an exact science, like mathematics or physics. It is a science with a sustained reasoning on probabilities. The diagnosis is supported by the physician's ability to integrate collective information provided by multiple professional opinions.