Malignancy

Most Common (U.S)

  1. Breast (266k/year)

  2. Lung (234k/year)

  3. Prostate (164k/year)

  4. Colorectal (140k/year)

  5. Melanoma (91k/year)

Most Deadly (U.S)

  1. Lung (154k/year)

  2. Colorectal (50k/year)

  3. Pancreatic (44k/year)

  4. Breast (40k/year)

  5. Hepatobiliary (30k/year)

Additional Considerations

Multiple Myeloma

  • Symptoms: Bone pain, fatigue, unintentional weight loss, paresthesias

  • Signs: Hepatosplenomegaly

  • Laboratory

    • Common findings: Anemia, elevated creatinine, elevated serum protein, hypercalcemia

    • Obtain serum protein electrophoresis/immunofixation electrophoresis (84165/86334), serum free light chain assay

  • Imaging: PET scan to locate focal disease

  • Diagnosis requires clonal bone marrow plasma cells ≥ 10% OR or extramedullary plasmacytoma on biopsy + one of the following

    • Hemoglobin < 10 mg/dL

    • Cr/Cl < 40 mL/min

    • Serum calcium > 11 mg/dL

    • Clonal bone marrow plasma cell percentage ≥ 60%

    • Involved:uninvolved serum free light chain ≥ 100

    • Osteolytic lesions on one of the following modalities: Skeletal radiography, CT, PET-CT, MRI

  • Treatment: Refer to hematology/oncology for chemotherapy +/- hematopoietic cell transplantation