Cancer, Early Warnings

Early warning signs of cancer

The prognosis in most cases of cancer depends largely on the availability of

treatments, and how early the cancer is detected. If a tumour can be detected at

an early stage, the possibilities for curative treatment are generally significantly

better than if a patient presents with more advanced disease. One approach is

therefore to educate the public on the early warning signs of cancer. These are

sometimes divided into the following 7 groups of signs and symptoms.

Unusual bleeding or discharge

The cause of any unexplained bleeding should always be ascertained. For example

haematuria is commonly caused by infection and may also result from trauma;

however it may also be a feature of malignancy. Blood in the urine may derive

from any part of the urinary system so may be from the kidneys, ureters, bladder

or urethra. Any blood in urine is an abnormal finding. If a trace of blood is

detected on a routine dip stick test, this is abnormal and so should be explained.

In females blood in the urine during menstruation should not be assumed to

be menstrual contamination. This means the test should be repeated in two

weeks time when the woman is mid-cycle.

Bleeding from the gastrointestinal tract also has many possible causes, however

if haematemesis or melaena are seen, malignancy is a possibility. Detection of

occult blood in faeces is also an abnormal finding and should be explained.

Discharges may be a feature of early malignant disease. Discharges themselves

usually indicate infection and are composed of inflammatory fluids, bacteria

and white blood cells. When a tumour grows it distorts the normal anatomy of

an area. This results in a disordered local tissue structure which may increase

the probability of infection. For example, a tumour in a bronchial passage may

partly obstruct the bronchial lumen. This will inhibit the normal clearance of

mucus, leading to an area of stasis in the airways, distal to the tumour. Stasis

will lead to infection which may be difficult to clear and is likely to recur.

Therefore infection may be an early indicator of malignancy.

Discharges from the urethra may indicate a urinary malignancy. An early

sign of breast cancer may be a discharge from the nipple. Vaginal discharges are

also abnormal andcould indicate infection, secondary to malignancy in the

cervix or uterus.

A sore which does not heal

A sore on any part of the body could be a malignant ulceration. These will not

heal as a normal lesion does because the malignant process is ongoing, making

the condition progressively worse. Warning signs may include a lesion which

does not seem to be healing as normal or is getting bigger for no apparent

reason. Other potential features of malignancy are increasing pain or a lesion

starting to bleed.

A skin lesion which progresses and does not heal may be a basal cell carcinoma

(also sometimes called a rodent ulcer). These are normally caused by excessive

exposure to direct sunlight and are the most common malignant tumour of

the skin. Basal cell carcinomas grow locally but fortunately they rarely metastasize.

Squamous cell carcinomas may also arise in the skin and these are highly likely

to metastasize if not resected. Collectively these skin lesions are classified as

non-melanoma skin cancer (NMSC).