Possible signs of cognitive disorders and delirium include sudden personality changes, impaired thinking, or unusual anxiety or depression.
A patient who suddenly becomes agitated or uncooperative, experiences personality or behavior changes, has impaired thinking, decreased attention span, or intense, unusual anxiety or depression, may be experiencing cognitivedisorders or delirium. Patients who develop these symptoms need to be assessed completely.
Definitions of TNM
The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define neuroendocrine tumors.
This staging system is new for the 7th edition of the AJCC Cancer Staging Manual.
Neuroendocrine Tumors: Stomach
Table 2. Primary Tumor (T)a
a Reprinted with permission from AJCC: Neuroendocrine tumors. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 181-9...
Early symptoms of delirium are similar to symptoms of anxiety, anger, depression, and dementia. Delirium that causes the patient to be very inactive may appear to be depression. Delirium and dementia are difficult to tell apart, since both may cause disorientation and impair memory, thinking, and judgment. Dementia may be caused by a number of medical conditions, including Alzheimer disease. Some differences in the symptoms of delirium and dementia include the following:
Patients with delirium often go in and out of consciousness. Patients who have dementia usually remain alert.
Delirium may occur suddenly. Dementia appears gradually and gets worse over time.
Sleeping and waking problems are more common with delirium than with dementia.
In elderly patients who have cancer, dementia is often present along with delirium, making diagnosis difficult. The diagnosis is more likely dementia if symptoms continue after treatment for delirium is given.
In patients aged 65 or older who have survived cancer for more than 5 years, the risk for cognitive disorders and dementia is increased, apart from the risk for delirium.
Regular screening of the patient and monitoring of the patient's symptoms can help in the diagnosis of delirium.