An approach to general oncology: principles and procedures.

The obstetrician-gynecologist is frequently the only physician to attend women during their reproductive years. Malignant disease outside the pelvic organs is a fairly frequent occurence in this age group. Certain findings in the patient's history and physical examination can suggest malignant disease. The routine laboratory examination can also provide indications of the presence of a neoplastic process. Once this process is suspected, histologic proof of malignancy must be obtained before further staging and therapy are considered. The extent of the disease is important for the planning of therapy, i.e., whether it is to be surgery, radiotherapy, chemotherapy or some combination of the three. Adjuvant chemotherapy is recognized as a form of treatment designed to eradicate micrometastases, prevent the occurrence of subsequent clinical metastatic disease and, as a result, improve survival.