Cancer Signs and Symptoms

Although most signs and symptoms arrive in the late stages of cancer, it is still important to know what they are and what cancers they correspond to. A doctor’s evaluation of signs and symptoms can lead to further tests or perhaps nothing at all, which can be the difference between life or death. A sign is a signal which can be seen and measured and indicate that something is not right in the body, and a symptom cannot be seen nor measured. For instance, related to colorectal cancer, blood in the stool is a sign while pain in the abdomen is a symptom.
Symptoms are noticed by the person who has them, but may not be easily seen by a physician. Having one sign or symptom may not be enough to figure out what's causing it. Sometimes, a patient's signs and symptoms still don't give the doctor enough clues to figure out the cause of an illness. Then medical tests, such as x-rays, blood tests, or a biopsy may be needed.
Cancer is a group of diseases that can cause almost any sign or symptom. The signs and symptoms will depend on where the cancer is, how big it is, and how much it affects the organs or tissues. If a cancer has spread (metastasized), signs or symptoms may appear in different parts of the body. As a cancer grows, it can begin to push on nearby organs, blood vessels, and nerves. This pressure causes some of the signs and symptoms of cancer. If the cancer is in a critical area, such as certain parts of the brain, even the smallest tumor can cause symptoms.
A cancer may also cause symptoms like fever, extreme tiredness (fatigue), or weight loss. This may be because cancer cells use up much of the body's energy supply, or they may release substances that change the way the body makes energy from food. Or the cancer may cause the immune system to react in ways that produce these symptoms. Sometimes, cancer cells release substances into the bloodstream that cause symptoms which are not usually linked to cancer. For example, some cancers of the pancreas can release substances which cause blood clots in veins of the legs. Some lung cancers make hormone-like substances that raise blood calcium levels. This affects nerves and muscles, making the person feel weak and dizzy.
There are some general signs and symptoms of cancer. But having any of these does not mean that it is cancer - many other things cause these signs and symptoms, too.
• Unexplained weight loss: Most people with cancer will lose weight at some point. When a person loses weight with no known reason, it's called an unexplained weight loss. An unexplained weight loss of 10 pounds or more may be the first sign of cancer. This happens most often with cancers of the pancreas, stomach, esophagus, or lung.
• Fever: Fever is very common with cancer, but it more often happens after cancer has spread from where it started. Almost all patients with cancer will have fever at some time, especially if the cancer or its treatment affects the immune system. This can make it harder for the body to fight infection. Less often, fever may be an early sign of cancer, such as blood cancers like leukemia or lymphoma.
• Fatigue: Fatigue is extreme tiredness that does not get better with rest. It may be an important symptom as cancer grows. It may happen early, though, in cancers like leukemia. Some colon or stomach cancers can cause blood loss. This is another way cancer can cause fatigue.
• Pain: Pain may be an early symptom with some cancers like bone cancers or testicular cancer. A headache that does not go away or get better with treatment may be a symptom of a brain tumor. Back pain can be a symptom of cancer of the colon, rectum, or ovary. Most often, pain due to cancer is a symptom of cancer that has already spread from where it started (metastasized).
• Skin changes: Along with cancers of the skin, some other cancers can cause skin symptoms or signs that can be seen. These signs and symptoms include:
o Darker looking skin (hyperpigmentation)
o Yellowish skin and eyes (jaundice)
o Reddened skin (erythema)
o Itching (pruritis)
• Excessive hair growth
o Along with the general symptoms, there are certain other common symptoms and signs which could suggest cancer. Again, there may be other causes for each of these, but it is important to see a doctor about them as soon as possible.
• Change in bowel habits or bladder function: Long-term constipation, diarrhea, or a change in the size of the stool may be a sign of colon cancer. Pain when passing urine, blood in the urine, or a change in bladder function (such as needing to pass urine more or less often than usual) could be related to bladder or prostate cancer. Report any changes in bladder or bowel function to a doctor.
• Sores that do not heal: Skin cancers may bleed and look like sores that do not heal. A long-lasting sore in the mouth could be an oral cancer. This should be dealt with right away, especially in people who smoke, chew tobacco, or often drink alcohol. Sores on the penis or vagina may either be signs of infection or an early cancer.
• White patches inside the mouth or white spots on the tongue: White patches inside the mouth and white spots on the tongue may be leukoplakia. Leukoplakia is a pre-cancerous area that is caused by frequent irritation. It is often caused by smoking or other tobacco use. People who smoke pipes or use oral or spit tobacco are at high risk for leukoplakia. If it is not treated, leukoplakia can become oral cancer.
• Unusual bleeding or discharge: Unusual bleeding can happen in early or advanced cancer. Blood in the sputum (phlegm) may be a sign of lung cancer. Blood in the stool (or a dark or black stool) could be a sign of colon or rectal cancer. Cancer of the cervix or the endometrium (lining of the uterus) can cause abnormal vaginal bleeding. Blood in the urine may be a sign of bladder or kidney cancer. A bloody discharge from the nipple may be a sign of breast cancer.
• Thickening or lump in the breast or other parts of the body: Many cancers can be felt through the skin. These cancers occur mostly in the breast, testicle, lymph nodes (glands), and the soft tissues of the body. A lump or thickening may be an early or late sign of cancer and should be reported to a doctor, especially if you've just found it or notice it has grown in size.
• Indigestion or trouble swallowing: Indigestion or swallowing problems may be signs of cancer of the esophagus (the swallowing tube that goes to the stomach), stomach, or pharynx (throat). But like most symptoms on this list, they are most often caused by something other than cancer.
• Recent change in a wart or mole or any new skin change: Any wart, mole, or freckle that changes color, size, or shape, or that loses its sharp border should be seen by a doctor right away. Any other skin changes should be reported, too. A skin change may be a melanoma which, if found early, can be treated successfully.
• Nagging cough or hoarseness: A cough that does not go away may be a sign of lung cancer. Hoarseness can be a sign of cancer of the voice box (larynx) or thyroid gland.
• The signs and symptoms listed above are the ones more commonly seen with cancer, but there are many others that are less common and are not listed here.
But sometimes cancer starts in places where it will not cause any symptoms until it has grown quite large. One example is cancers in the pancreas. They usually do not cause symptoms until they grow large enough to press on nearby nerves or organs (this causes back or belly pain). Others grow around the bile duct and block the flow of bile. This causes the eyes and skin to look yellow (jaundice). By the time a pancreatic cancer causes these signs or symptoms, it is usually in an advanced stage. This means it has grown and spread beyond the place it started -- the pancreas.
Another good example of the importance of finding cancer early is melanoma skin cancer. It can be easy to remove if it has not grown deep into the skin. The 5-year survival rate (percentage of people who live at least 5 years after diagnosis) at this stage is nearly 100%. Once melanoma has spread to other parts of the body, the 5-year survival rate drops below 20%.
While colorectal cancer is often found after symptoms appear, most people with early colon or rectal cancer have no symptoms. Symptoms usually appear only with more advanced disease. This is why getting the screening tests before any symptoms develop is so important. Screening for colorectal cancer may find it at an earlier stage, when it is more likely to be curable. Screening tests can also help prevent cancer by finding polyps that can be removed before they become cancerous.
Early detection of lung cancer is critical for improving survival of this disease because only 15% of lung cancers are found when they are localized. Since there are few or no symptoms in the early stages of the disease, the majority of lung cancers are diagnosed in the late stages of the disease. Symptoms of later-stage disease may include a persistent cough, sputum streaked with blood, chest pain, voice change, and recurrent pneumonia or bronchitis. Treatment at early stages of cancer can lead to more treatment options, less invasive surgery, and a higher survival rate. For example, in recent years, the five-year survival rate of persons whose cancers were diagnosed when they were still localized (had not spread) was almost 50%. This drops to 2% for persons whose cancers were diagnosed after their cancers had spread distantly.
If prostate cancer is found during screening, it will likely be at an early, more treatable stage than if no screening were done.
Breast cancers that are found because they are causing symptoms tend to be larger and are more likely to have already spread beyond the breast. In contrast, breast cancers found during screening are more likely to be smaller and still confined to the breast. The size of a breast cancer and how far it has spread are some of the most important factors in predicting the prognosis (outlook) of a woman with this disease. Most doctors feel that early detection tests for breast cancer save many thousands of lives each year, and that many more lives could be saved if even more women and their health care providers took advantage of these tests.
Use of symptoms to trigger medical evaluation for ovarian cancer may not greatly increase early detection of ovarian cancer, and would result in a diagnosis of ovarian cancer in only 1 out of 100 women with symptoms. These results were published in the Journal of the National Cancer Institute (3). One of the reasons that ovarian cancer tends to be so deadly is that it is often detected at a late stage when it is difficult to treat. Therefore it is crucial to employ the effective screening tests that will allow for the earlier detection of ovarian cancer.
Treatment works best when cancer is found early. Finding cancer early usually means it can be treated while it is still small and is less likely to have spread to other parts of the body. This often means a better chance for a cure, especially if the cancer can be removed with surgery. The American Cancer Society and other health groups recommend cancer-related check-ups and certain tests for people even though they have no symptoms. This helps find certain cancers early, before symptoms start.

This article is brought to you by GenWay Biotech Inc. GenWay offers a cancer assessment aimed to detect 20 different types of cancer in the early stages under the brand name You Test You™, www.youtestyou.com.

References: All the data in this article are provided by the American Cancer Society.

1. American Cancer Society. 2010
2. American Cancer Society. Cancer Facts & Figures 2009. Atlanta: American Cancer Society, 2009
3. Cass I, Karlan BY. Ovarian cancer symptoms speak out—but what are they saying? Journal of the National Cancer Institute [early online publication]. January 28, 2010