Signs and symptoms of cancer
Cancer can often be managed more easily when it is diagnosed in the early stages. Being aware of your body and what is 'normal' for you, and reporting symptoms to your GP, can help to make sure that, if you do have cancer, it is diagnosed as early as possible.
There are some common signs and symptoms that may alert you to the fact that something is new or different. You should contact your doctor if you have any of the following:
●Coughing, breathlessness and hoarseness
●Changes in bowel habit
●Unexplained weight loss
●What to do if you have worrying symptoms
Knowing how your body normally looks and feels can help you spot any early changes that could be caused by cancer. You should see your GP if you notice a lump anywhere in your body. It can be useful to tell them how long it’s been there and whether it is getting bigger, or causes discomfort. Cancerous lumps are often (but not always) painless.
It can be difficult to tell what a lump is just by feeling it, but if your GP suspects that you might have a cancer, they will refer you to the appropriate specialist for further tests.
It is important to remember that lumps and bumps often occur in the body, and most of these will not be cancer.
◆Coughing, breathlessness and hoarseness
There are many medical conditions that can cause 'chesty' symptoms like coughing and breathlessness (for example, infections and inflammations), but in some cases these symptoms may be a sign of lung cancer. If you have a cough or feel breathless for more than two weeks you should see your GP. You should also tell your GP if you have any blood in your sputum (phlegm) when you cough.
Laryngitis (inflammation of the larynx) is common and can cause a hoarse voice. In a small number of people, a hoarse voice may be a sign of cancer of the larynx (voice box). If hoarseness continues for longer than two weeks, you should tell your GP.
◆Changes in bowel habit
Symptoms of bowel cancer may include blood in your stools (bowel motion). The blood would usually be dark but can be bright red in colour. Fresh, bright red blood is usually a sign of piles (haemorrhoids).
You may notice a change in your normal bowel pattern (such as diarrhoea or constipation) for no obvious reason. You might have a feeling of not having emptied your bowel properly after a bowel motion. Some people also notice that they have pain in the abdomen or back passage.
Remember that altered bowel habits aren't always caused by cancer, but can be caused by changes in diet, some medicines, anxiety, and other medical conditions. If any changes last for more than a few weeks it's important to rule out cancer as a possible cause, so you should see your GP.
Any unexplained bleeding is a sign that there is something wrong and should always be checked out by your GP.
As previously mentioned, bleeding from the back passage is most commonly caused by piles, but can sometimes be due to cancer of the bowel or rectum.
Cancer of the womb or cervix can cause women to bleed between periods or after sex. Women who have any vaginal bleeding after they have had their menopause should see their GP. If necessary your GP will refer you to a gynaecologist.
Blood in your urine may be caused by bladder or kidney cancer. It can also be caused by infection. If you notice blood in your urine it is important to see your GP for a check-up.
Coughing up blood in your sputum may be caused by serious chest infections, but can sometimes be a sign of lung cancer.
Vomiting blood can be a sign of stomach cancer, although it can also be due to a stomach ulcer. Therefore, it is important to have this checked out by your GP.
Bruising and nosebleeds are rarely signs of cancer, but can in some cases be caused by leukaemia. However, people with leukaemia often have other troublesome symptoms too.
Malignant melanoma is a type of skin cancer that often starts with a change in the appearance of normal skin. This can look like an abnormal new mole. Less than a third of melanomas develop in existing moles. It can be difficult to tell the difference between a mole and a melanoma, but any of the following changes should be checked out:
Asymmetry Moles are usually regular and symmetrical in shape. Melanomas are likely to be irregular or asymmetrical.
Border Moles usually have a well-defined regular border. Melanomas are more likely to have an irregular border with jagged edges.
Colour Moles tend to be a single brown. Melanomas often have more than one colour. They may be varying shades of brown mixed with black, red, pink, white or a bluish tint.
Size Moles are normally no bigger than the blunt end of a pencil (about 6mm (½ inch) across). Melanomas are usually more than 7mm (½ inch) in diameter.
Itching, crusting or bleeding may also occur in melanomas – these are less common signs but should not be ignored.
It is important to see your GP if you have any unusual marks on the skin that last more than a few weeks, or an existing mole which shows any of the above signs. If necessary they will arrange for you to see a doctor who specialises in skin conditions (a dermatologist) or a surgeon.
◆Unexplained weight loss
If you have lost a lot of weight over a short period of time (a couple of months), that cannot be explained by changes in your diet, increased exercise or stress, it is important to tell your GP. Other symptoms, such as sickness, pain and fatigue also tend to occur when a person experiences weight loss due to cancer.
◆What to do if you have worrying symptoms
You usually begin by seeing your GP who will examine you, ask questions about your symptoms, and might ask you to have some tests, such as a blood test or x-ray.
If your GP suspects that you may have cancer, an urgent referral will be made to a specialist. There are guidelines produced by the National Institute for Health and Clinical Excellence (NICE) to help GPs identify when symptoms could be due to cancer or some other condition. An urgent referral usually means that the specialist will see you within two weeks. The specialist can carry out other investigations, such as a biopsy or various scans, to find the cause of your symptoms and plan any treatment necessary.
If your GP thinks your symptoms are not caused by cancer they may still refer you to a specialist for advice, but the referral is likely to be non-urgent and it will take longer for you to be seen.
Remember – in most cases, your symptoms will turn out to be caused by something other than cancer, but they can still be signs of illness and so you won't be wasting your doctor's time by getting them checked out.
This section has been complied using information from a number of reliable sources including;
Clinical Guidelines CG027: Referral for Suspected Cancer. National Institute for Clinical Excellence (NICE). June 2005.
Souhami and Tobias. Cancer and its Management (5th edition). Blackwell Scientific Publications. Oxford. 2005.
Souhami et al. Oxford Textbook of Oncology (2nd edition). Oxford University Press. Oxford. 2002.
DeVita, Vincent T. et al. Cancer: Principles and Practice of Oncology (6th edition). Lippincott. Philadelphia. 2001.
For further references, please see the general bibliography.