Presenting an oncology patient
Cancer history is a timeline. When you present a patient who has received any treatment for a malignancy, you need every date and every step. “I don’t know” and “I didn’t write it down” are not answers.
The oncologic history, in order
- Date of diagnosis, how it was found, histology and stage at diagnosis.
- Molecular and biomarker results (for example PD-L1, HER2, EGFR, MSI).
- Surgery: date, type, pathologic stage, margins negative or positive, lymph nodes.
- Systemic therapy: neoadjuvant, adjuvant or palliative. Regimen, start and end dates, number of cycles.
- Interruptions or dose reductions, and the reason for each.
- Radiation: site, dose if known, start and end dates.
- Recurrence or progression: date, site and how it was found.
- Current line of therapy, current cycle and day, and date of the last dose.
If something is truly unavailable, know the reason. “The surgery was done at an outside hospital, and the operative note has been requested” is an answer. Silence is not.
What it sounds like with practice
As you get comfortable, the whole history fits in one sentence:
“This is a 64-year-old man with esophageal adenocarcinoma, localized at diagnosis in 2019, status post neoadjuvant chemoradiation and esophagectomy, followed by one year of adjuvant nivolumab. He relapsed in the liver in 2025, is now on FOLFOX plus nivolumab, cycle 3, day 9, and presents with diarrhea and fever.”
Notice what that sentence tells the team immediately: he may be neutropenic, he may have immune-related colitis, and we know exactly where he is in treatment.