A disease that affects millions, few people are familiar with cancer signs. Healthista Editor Anna Magee spoke with the experts about what not to miss
Blood in the stools, a lump on the breast, sudden weight loss. We think we know the signs of cancer. Except we don’t. Now, experts are encouraging people to be aware of the less well-known symptoms that could signal early disease; to forget about any fear of making a fuss and report them to their GPs.
It’s these that people need to be aware of and report to their doctors. But part of being British is not paying attention to our own bodies
A staggering one in two people in the UK will be diagnosed with cancer in their lifetimes and the disease is responsible for a quarter of all deaths in the UK. According to the National Instititute for Health Care and Excellence (NICE) who last year released new guidelines making it easier for GPs to refer patients for tests for suspected cancer (including some symptoms that now warrant a two-week referral turnaround) around 5,000 lives a year could be saved by making earlier diagnoses. But what are we looking for? ‘A lot of the early symptoms of cancer will be vague and non-specific,’ says Peter Johnson, professor of medical oncology at Southampton University and lead clinician for Cancer Research UK. ‘It’s these that people need to be aware of and report to their doctors. But part of being British is not paying attention to our own bodies; to what’s normal for us so we ignore minor symptoms which occasionally can be caused by early cancer.’
Only around ten out of every 100 patients referred for testing will be diagnosed with cancer
The good news is that most cancers are curable if got in the early stages, says Dr David Bloomfield, clinical oncologist at the Sussex Cancer Centre, Royal Sussex County Hospital and Medical Director for the Royal College of Radiologists. ‘Be aware of the red flags [see side panel] but if something else is unexplained and unusual for you and doesn’t get better in a couples of weeks, get it checked out’.
The following list has come from Cancer Research UK and Britain’s leading oncologists. These are vague symptoms that are probably not – but could be – cancer. Hearteningly, only around ten out of every 100 patients referred for testing will be diagnosed with the disease, according to NICE. But if you’re one of the ten per cent, being a stoic about it could cost you your life. Tell your doctor.
Hoarseness or a croaky voice
Being croaky or hoarse is common with a cold but if it doesn’t get better within 2-3 weeks, it needs checking. ‘Persistent hoarseness can indicate an early, curable head or neck cancer such as one of the vocal cords,’ says Dr Bloomfield. Today’s surgery techniques usually mean minimally invasive removal of the cancer so your voice remains intact – if it’s caught early enough, he explains. A stubborn cough too should be checked out with a chest X-ray especially if it has lasted more that three weeks, says Prof. Johnson, as it could indicate lung cancer (and though 33 times more common in smokers, it’s not unheard of in non-smokers).
2. Heavy night sweats
It’s more than likely your duvet or the menopause, but heavy night sweats could also be a sign of lymphoma, a tumour developing in the lymph cells. ‘People with lymphoma have high metabolisms because lymphoma cells use a lot of energy so they get severe, drenching night sweats where they need to change their pyjamas and sometimes the bedding,’ explains Dr Shankara Paneesha, consultant haematologist at Spire Parkway Hospital in Birmingham. Other symptoms may include a lump around two centimetres or more in diameter in the armpit, groin or side of the neck, he explains.
3. Persistent heartburn
It’s normal to feel pain or discomfort after a fatty or spicy meal but if it’s lasted 2-3 weeks and you need to take antacids regularly, stubborn heartburn or indigestion could signal cancer of the stomach or oesophagus, says Prof. Johnson. ‘See your doctor to ensure you don’t have something growing in the bottom of the gullet.’ Occasionally, it may also be a sign of pancreatic or ovarian cancer, he explains.
4. Middle back pain
In the UK some 2.5 million people suffer with back pain. ‘For around 99 per cent, it’s going to be musculoskeletal but back pain is also one of the more common symptoms of pancreatic cancer,’ says, Prof. Pippa Corrie, consultant and associate lecturer in medical oncology at Cambridge University Hospitals NHS Foundation Trust. ‘The classic symptom is pain in the upper abdomen that spreads out across the back,’ she explains. The pancreas sits at the back of the abdomen and as it grows it starts to invade into the nerves that signal pain in the back. ‘While most musculoskeletal back pain will occur in the lower back, that associated with pancreatic cancer is about a hand’s breadth above that and may also come with other symptoms such as people being off their food, tiredness and weight loss.’
5. Pink discharge after menopause
Pink discharge from subtle bleeding – or any kind of vaginal bleeding after the menopause – should be reported to your doctor who can urgently refer you for testing within two weeks as it’s an early sign of endometrial cancer, explains Dr Bloomfield. The bad news is that endometrial cancer is on the rise in the UK because it’s associated with being overweight and as a nation we’re getting fatter. But there’s good news. ‘The earliest sign is a bit of bleeding and at this stage most women can have a hysterectomy and have it all removed. This is a highly treatable cancer if caught early.’
6. Problems peeing
As a man gets older his prostate gland grows by a gram a year and this enlargement can cause more frequent urination, especially at night. ‘But if you can’t go for a few hours without peeing or you’re having difficulty in starting to pass urine, this could indicate an obstruction, such as a prostate cancer,’ says Prof. Johnson. Your doctor can refer you for tests and a biopsy. ‘If the test is positive, most men won’t need treatment as their cancer may not be the harmful type, but they need to be tested so we can identify whether it’s aggressive,’ says Dr Bloomfield.
7. Difficulty swallowing
Strokes, brain injuries and other medical conditions can cause difficulty swallowing but occasionally, it may be a key early symptom of a head and neck cancer such as of the vocal cords, oesophagus, mouth or tongue. ‘Caught early, these are often curable,’ says Dr Bloomfield. Other symptoms include pain at the back of the mouth. Though more common inn those that drink or smoke heavily, such cancers are on the increase in young people, believed to be caused by transmission of the Human Papilloma Virus (HPV), through unprotected oral sex, explains Prof. Johnson.
8. Looser poo (or pooing more)
You know about blood in your poo but anything significantly different to what’s normal for you – colour, texture, frequency or pain – that sticks around for two weeks or more should be reported. ‘Any sudden changes in your bowel habits including constipation, looser than usual or pain with a strange dragging sensation or dull ache, should be looked into,’ says Prof. Johnson. ‘It may indicate bowel cancer or in rare cases ovarian or pancreatic cancers.’
9. A sore that won’t heal
Most people know to look for changes to moles such as bleeding, itching or irregularity. ‘But other signs of skin cancer can include small lumps on the skin that get bigger, sometimes with an ulcer on top that doesn’t heal for 2-4 weeks,’ says Prof. Johnson. ‘Often they’re painless but they may bleed or be itchy.’ Good news he explains, is that GPs are good at recognising and referring skin cancers quickly. Lots of people get mouth ulcers from viral infections, but these usually clear up withn a few days and are quite painful when you have them, says Prof. Johnson. ‘But a mouth ulcer that is there 3-4 weeks – with or without pain – needs looking at because it could be a cancer on the tongue or around the mouth,’ he says. ‘White marks on the tongue as well as thick, white area on the tongue also need to be checked out because they can indicate realy changes in the lining of the mouth which can lead onto cancer.’
…and 5 red flags to NEVER ignore
Any sudden weight loss when not dieting
Blood in your poo or urine
Coughing up blood
A lump in the breast, groin, testes, side of the neck or armpit
Severe, unexplained pain or ache
World Cancer Day is February 4.
Anna Magee is the editor of Healthista.com. This story first appeared in The Telegraph online