A symptom is felt or noticed by an individual, but may not easily be noticed by other. It maybe an indication of disease, illness or just that something is not right in the body. Chills, weakness, body ache, shortness of breath, cough etc. maybe symptoms of pneumonia. Signs are those that can be seen by a health care professional. It is also an indication that something is not right in the body. Fever, rapid breathing, and abnormal breathing sounds heard through a stethoscope maybe signs of pneumonia. Signs and symptoms together give a doctor the clues towards diagnosis. In many cases signs and symptoms do not indicate much to diagnose the cause of an illness, medical tests such as x-rays, blood tests or a biopsy may then be needed to reach to a definitive conclusion.
Cancer is a group of diseases that may cause almost any sign or symptom or give no symptoms or signs that exclusively indicate the disease. In initial stages cancer often presents non-specific indications that may also be explained by more common non-cancerous causes. The signs and symptoms depend on the location of cancer, its size, and its effect on nearby organs or structures. In the later stages when a cancer metastasizes, the symptoms may involve different parts of the body to where the cancer spreads. The common mechanisms that cause symptoms are compression, occlusion, erosion and invasion of adjoining organs and structures, such as nerves, joints and vessels because as the cancer grows it begins to push on nearby organs, blood vessels, and nerves.
When the cancer is in a critical area, such as certain parts of the brain, even the smallest tumor can cause early symptoms. In contrast some cancers start in spacious organs like stomach, intestine, uterus etc. where it does not cause any symptoms until the cancer has grown quite large. Few cancers like those of the pancreas do not usually grow large enough to be felt from the outside of the body. They do not cause symptoms until they begin to grow around nearby nerves (this causes a backache). Others grow around the bile duct, which blocks the flow of bile and leads to a yellowing of the skin known as jaundice. By the time a pancreatic cancer causes these signs or symptoms, it has usually reached an advanced stage. In some cancers, the metastases may produce symptoms before the primary tumour. In prostate cancer, it is not uncommon for bone and or joint pain to precede any urinary symptoms.
A cancer may also cause non-specific symptoms such as fever, fatigue, or weight loss. This usually is due to the cancer cells, which use up much of the body’s energy supply or release substances that change body’s metabolism. The cancer causes the immune system to react in ways that produce the symptoms.
Sometimes, cancer cells release substances into the bloodstream that causes symptoms not usually thought to result from cancers. For example, some pancreatic cancers can release substances that cause blood clots to develop in veins of the legs. Some lung cancers make hormone-like substances that affect blood calcium levels, affecting nerves and muscles and causing weakness and dizziness. Some Ovarian cancers can lead to hirsuitsm.
Treatment is most successful when cancer is detected early hence it is important that cancer be diagnosed as early as possible before it spreads. Finding cancer early usually means it can be treated while it is still small and is less likely to spread to other body parts. This often means a better chance for cure especially if initial treatment is surgery.
A good example of the importance of finding cancer early is cancer of cervix. Screening for cervical cancers is done by Pap smears. Early detection of cervical cancer by regular Pap smear screening is completely treatable, and the 5-year survival rate (percentage of people living at least 5 years after diagnosis) at this stage is nearly 100%. But once the cancer has spread further into the uterus and/or adjoining areas or to other parts of the body the survival rate drops dramatically.
Symptoms are usually ignored due to lack of sufficient information that they could mean something wrong or due to the fear about what they might actually mean when medical help is sought. General symptoms, such as weight loss are more likely to have a cause other than cancer and can seem unimportant, especially if they have an obvious cause or only last a short time. Similarly one may reason that a more specific symptom like a breast mass will go away by itself. But neither of these symptoms should be discounted for nor overlooked. In majority of cases symptoms mentioned may not be caused by cancer, but it’s important to have them checked out. Being proactive is usually the difference between success or failure in the fight against cancer.
Some of the general (non-specific) signs and symptoms are mentioned below, but it is important to remember that they may not necessarily indicate cancer, there are many other conditions that can cause these signs and symptoms too.
Sudden Weight Loss – Cancer will result in weight loss at some stage of the disease. An unexplained weight loss of 10 pounds or more may be the first sign of cancer, particularly cancers of pancreas, stomach, esophagus, or lung.
Fever or night sweats – High temperature is common with cancer but more often in advanced stages. Almost all cancer patients will have fever at some stage especially when the cancer or its treatment affects the immune system making it harder for the body to fight infection. Less often, fever may be an early sign of leukemia or lymphoma.
Fatigue – Exhaustion may be an important symptom as cancer progresses. It may happen early, though, in cancers such as leukemia, or if the cancer is causing a continuous blood loss as in some colon or stomach cancers.
Pain – Pain may be an early symptom with some cancers such as bone cancers or testicular cancer. But most often pain is a symptom of advanced disease. Back pain, pelvic pain, bloating or indigestion are common problems but they can also be seen in ovarian cancer. This cancer is particularly difficult to treat, because it is frequently diagnosed in the advanced stages of the disease. Similarly, a common headache when turns severe and unrelenting and feels different from usual can be a sign of cancer.
Skin Changes – Some internal cancers can also cause skin signs other than cancers of the skin. These changes include the darkening skin (hyper pigmentation), yellow (jaundice), or redness (erythema); itching; or excessive hair growth. Precancerous or cancerous conditions of the skin of the genital or anal areas can cause persistent itching or changes in skin color of the anus or genital area. Several infections or skin conditions may also cause these symptoms so If itching does not stop a doctor should be consulted.
In addition to the above-mentioned general symptoms following organ specific symptoms also merit attention and could be an early indication of cancer. Again, there may be other causes for each of these, but it is important to bring them to your doctor’s attention as soon as possible so that they can be investigated.
Thickening or Lump in Breast or Other Body Parts: Persistent lumps or swollen glands most frequently represent harmless conditions but any new lump or a lump that won’t go away needs examination. Lymph nodes swell from infection and other causes and may take 1-2 weeks to shrink again. A lump or gland that remains swollen for 3-4 weeks should be evaluated.
Many cancers can be felt through the skin, mostly in the breast, testicle, lymph nodes (glands), and soft tissues of the body. Any lump especially if it grows in size may indicate cancer. Breast lumps maybe noncancerous tumors such as fibroadenomas or cysts but all breast lumps need thorough investigation. A negative mammogram result is not sufficient diagnosis also requires a needle aspiration (FNAC) or biopsy (a small tissue sample). Women are advised to conduct monthly breast self examinations.
A painless or uncomfortable lump on a testicle usually indicates testicular cancer. Other conditions, such as infections and swollen veins, can also cause changes in your testicles, but any lump must be evaluated. Men are advised to conduct monthly testicular self-examinations.
Recent Change in a Wart or Mole: Obvious change in a wart or a mole should be taken seriously. Any wart, mole, or freckle that changes in color, size, or shape, or loses its definite borders should be reported to the doctor without delay.
Multicolored moles that have irregular edges or bleed may be cancerous. Larger moles are more worrisome. A dark pigmented skin lesion may be a melanoma which, if diagnosed early, can be treated successfully. The doctor takes a biopsy of the lesion and will send it for examination under a microscope for diagnosing skin cancer.
Non-healing Sores: Sores generally heal quickly but if a sore fails to heal even with passage of time it may be an indication of cancer. Non- healing sores in the mouth or persistent white or red patches on gums, tongue, or tonsils should also raise concerns especially in India where oral cancer is very common. Skin cancers may bleed and look like sores that do not heal. A long-lasting sore in the mouth could be an oral cancer and should be dealt with right away, especially in patients who smoke, chew tobacco, or frequently drink alcohol. Persistent sores on the penis or vagina may either be signs of infection or an early cancer, and should not be overlooked.
Unusual Bleeding or Discharge: Unusual bleeding may happen in either early or advanced cancer. Persistent cough or blood-tinged saliva usually represents simple infections such as tuberculosis, bronchitis or sinusitis but they could also be symptoms of cancer of lung, head, and neck. Anyone with a cough that lasts more than a month or with blood in the mucus should see a doctor.
Cancer of the cervix or the endometrium (lining of the uterus) can cause vaginal bleeding. Unusual vaginal bleeding or bloody discharge may be an early sign of cancer of the uterus. Women should be evaluated when they have bleeding after intercourse or bleeding between periods. Bleeding that comes back, lasts 2 or more days longer than expected, or is heavier than usual could be dangerous.
Discharge from a breast is common. But some forms of discharge may be signs of cancer. If discharge is bloody or from only 1 nipple it should be evaluated.
Change in Bowel Habits or Bladder Function: Prolonged constipation, diarrhea, or a change in size of the stool may be a sign of colon cancer. Sometimes pencil-thin stools are seen in colon cancer. Some people with cancer feel as if they need to have a bowel movement both before and even after they have had it. If any of these abnormal bowel complaints last more than a few days, they require evaluation. Blood in the stool should also be immediately investigated. Hemorrhoids frequently cause rectal bleeding, but they may coexist with cancer. Therefore, even when you have hemorrhoids, you should have a doctor examine your entire intestinal tract if stools contain blood. Only if the source of the bleeding is entirely clear these studies may not be needed.
Frequent urination, small amounts of urine, and slow urine flow are typical urinary symptoms. They can be caused by urinary infections or even by an enlarged prostate gland. While most men suffer from harmless prostate enlargement as they age and often have these urinary symptoms. In some individuals these symptoms may signal prostate cancer. Men experiencing urinary symptoms need to undergo a specific blood test called PSA and a digital rectal examination. Cancer of the bladder and pelvic tumors can also cause irritation of the bladder and urinary frequency. Also while blood in urine or hematuria can be caused by urinary infection, kidney stones etc. it also is a symptom of cancer of the bladder or kidney. Any episode of blood in the urine requires urgent investigation.
Indigestion or Trouble in Swallowing: While they commonly have other causes, indigestion or swallowing problems may be a sign of cancer of the esophagus, stomach, or pharynx (throat). Most people with chronic heartburn do not have serious problems. People who suffer from chronic or lasting symptoms despite using over-the-counter antacids may need to have an upper GI endoscopy. A condition called Barrett esophagus, which in a few cases can lead to cancer of the esophagus, can be treated with medication and then monitored by a doctor.
Difficulty in swallowing is a common problem especially in elderly people, and has many causes which may include infective conditions. Difficulty in swallowing solids is however a very important symptom associated with cancer of the esophagus.
Nagging Cough or Hoarseness: Hoarseness can be caused by simple allergy or by vocal cord polyps, but it could also be the first sign of cancer of the throat. Hoarseness not caused by a respiratory infection or that lasts longer than 3-4 weeks should be evaluated. Hoarseness can be a sign of cancer of the larynx (voice box) or thyroid.
A cough that does not go away may be a sign of lung cancer. Blood mixed sputum may indicate infective conditions like bronchitis, tuberculosis, or in few cases may indicate lung cancer.
Unexplained Anemia: Anemia is a condition in which you have fewer than the expected number of red blood cells in your blood. Anemia should be investigated. There are many kinds of anemia, but blood loss almost always causes iron deficiency anemia. Unless there is an obvious source of ongoing blood loss, as there is for menstruating women, this anemia needs to be explained.
Many cancers can cause anemia, but bowel cancers most commonly cause iron deficiency anemia. Evaluation should include endoscopy or x-ray studies of your upper and lower intestinal tracts. Another important cause of anemia is a blood cancer which needs to be investigated.
While the signs and symptoms listed above are the more common ones seen with cancer, there are many others that are less common and are not listed here. If you notice any major changes in the way your body functions or the way you feel, especially if it lasts for a long time or gets worse, let your doctor know. If it has nothing to do with cancer, your doctor can investigate it and treat it, if needed. If it is cancer, you'll give yourself the best chance to have it treated early, when treatment is most likely to be effective.