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The knowledge of the usual development of cancer should provide the basis for the extension check-up necessary for classifying the tumours. These check-ups should be relatively comprehensive, of as little discomfort as possible to the patient and should avoid unnecessary health costs.

Multiplying examinations is not the proof of good medicine: a thorough medical history, provided by a confident patient, together with a well conducted and complete clinical examination (including pelvic examination on a calm patient) will orient the check-up towards the essential paraclinical examinations required for complete and rapid diagnosis. Patients are reassured by a competent and energetic approach. The multiplication of radiographies and endoscopies often translates the weakness of intellectual medical diagnosis or the physician's fear to announce bad news.

For this reason, with a complete preoperative diagnosis, the multidisciplinary team can decide on the best therapeutic association depending on the patient's specific situation (including general status, associated pathologies and the patient's and his/her family's wishes.

Here are a few examples to understand how check-ups are elaborated.

BREAST

• standard check-up according the usual location of metastases,
• metastasis risk factors in breast carcinoma
• check-up for a non palpable mammary tumour
• check-up for a palpable mammary tumour.

COLON

• check-up for an operable colic tumour

LUNG

• check-up for an operable bronchial tumour

Since we only have few therapeutic weapons to endeavour to cure our patients from cancer, we need to be sure to use the right weapons in the right circumstances.