Lumps, bumps and cancers

Talks with Professor Angus Dalgleish, MBBS. BSc. FRCP. FRACP. FMedSci. FRCPath.

Cancer: Early Warning Signs — Summary

Cancer is often much more treatable when it is diagnosed at an early stage. The purpose of this discussion is therefore not to cause anxiety, but to encourage awareness of new, persistent or unexplained changes in the body.

Most possible warning symptoms will have causes other than cancer. However, symptoms that persist, recur or progressively worsen should be medically assessed.

Important warning signs include:

Unexplained bleeding — blood in the urine or stools, coughing or vomiting blood, unexplained vaginal bleeding, or unusual bruising.

Changes in bowel or bladder habits — persistent constipation or diarrhoea, altered stool pattern, urinary frequency or difficulty passing urine.

Persistent digestive symptoms — indigestion, difficulty swallowing, abdominal swelling, persistent bloating or loss of appetite.

A new lump or swelling — particularly in the breast, testicle or lymph nodes, but also anywhere else in the body.

Persistent cough or hoarseness — especially when there is no obvious explanation or symptoms fail to resolve.

A sore or ulcer that does not heal — including persistent ulcers in the mouth or on the tongue.

Changes in a mole or skin lesion — particularly changes in size, shape, colour, border or appearance.

Unexplained weight loss — particularly when accompanied by loss of appetite or weakness.

Persistent fatigue, fever or night sweats without an obvious cause.

Persistent or unexplained pain, including bone pain.

Recurrent infections or other unexplained changes in general health.

Occasionally, an unexplained blood clot, such as a deep-vein thrombosis, can be associated with an underlying malignancy.

Many cancer symptoms occur because a growing tumour interferes with normal anatomy and physiology. It may obstruct an organ or duct, cause bleeding, compress neighbouring structures or nerves, or produce wider inflammatory and metabolic effects throughout the body.

The most important principle is therefore change.

Know what is normal for you. If something changes and does not return to normal, particularly if it persists for several weeks or becomes progressively worse, seek medical advice.

Even if a symptom has previously been assessed, continued or worsening symptoms may justify reassessment.

Early investigation does not mean assuming that a symptom is cancer. It means making sure that, if cancer is present, it has the best possible chance of being diagnosed at an early and potentially curable stage.