A LUMP in the breast, sudden weight loss and blood in the stools.
We think we know the signs of cancer. Except we don’t — and now experts are encouraging people to be more aware of less-known symptoms that could signal early disease and report them to their GPs.
By the time we reach the age of 85, half of men and a third of women will be diagnosed with cancer, according to Cancer Council Australia.
Prostate, breast, bowel, melanoma and lung cancer make up 60 per cent of cases. In the next four years, it’s estimated that the number of new cases diagnosed yearly in Australia will rise to 150,000.
One of the keys to saving lives is early diagnoses, but what are we looking for?
“A lot of the early symptoms of cancer will be vague and non-specific,” professor of medical oncology Peter Johnson says.
“It’s these that people need to be aware of and report to their doctors. But we’re not good at 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.”
The good news is that most cancers are curable if caught in the early stages, clinical oncologist Dr David Bloomfield says.
“Be aware of the red flags, but if something else is unexplained and unusual for you and doesn’t get better in a couple of weeks, get it checked out.”
These are the vague symptoms that shouldn’t be ignored.
1. 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 two to four weeks,” Johnson says.
“Often they’re painless but they may bleed or be itchy.”
The good news, he explains, is that GPs are great at recognising and referring skin cancers quickly.
2. Heavy night sweats
It’s more than likely your doona or menopause causing heavy night sweats, but they 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,” haematologist Dr Shankara Paneesha says.
Other symptoms may include a lump about 2cm or more in diameter in the armpit, groin or side of the neck.
3. Persistent heartburn
It’s not unusual to feel pain or discomfort after eating a fatty or spicy meal, but if these symptoms have lasted more than two or three weeks and you need to take antacids regularly, it could signal cancer of the stomach or oesophagus, Johnson says.
Occasionally, it may also be a sign of either pancreatic or ovarian cancer.
4. Pink discharge after menopause
Pink discharge from subtle bleeding — or any kind of vaginal bleeding or spotting after menopause — should be reported to your doctor right away as it can be an early sign of endometrial cancer, Bloomfield says.
Endometrial cancer is on the rise in Australia because it’s associated with being overweight, and as a nation we’re getting fatter.
The earliest sign is a bit of bleeding and this is a highly treatable cancer if caught early.
5. Problems urinating
As a man ages, his prostate gland grows, which can cause frequent urination, especially at night.
“If you can’t go for a few hours without peeing, or you’re having difficulty starting to pass urine, this could indicate an obstruction, such as a prostate cancer,” Johnson says.
Your GP can refer you for tests.
“If the test is positive, most men won’t need treatment as their cancer may not be harmful, but it needs to be tested to see if it’s aggressive,” Bloomfield says.
6. 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,” Bloomfield says.
Other symptoms include pain at the back of the mouth.
Though more common in those who 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, Johnson explains.
7. Looser stools
You know about blood in your stools, but anything significantly different to what’s normal for you — such as a change in the colour and texture of your stool, frequency or pain — that lasts for two weeks or more should be reported to your doctor immediately.
“Any sudden changes in your bowel habits, including constipation, looser than usual stools or pain with a strange dragging sensation or dull ache, should be looked into,” Johnson says.
“It may indicate bowel cancer — or in rare cases ovarian or pancreatic cancers.”
8. Middle back pain
About three million Aussies suffer from back pain.
“For about 99 per cent, it’s going to be musculoskeletal, but back pain is also one of the more common symptoms of pancreatic cancer,” professor Pippa Corrie, from Cambridge University Hospitals, says.
“The classic symptom is pain in the upper abdomen that spreads out across the back,” she says.
The pancreas sits at the back of the abdomen and, as it grows, it starts to invade the nerves that signal pain in the back.
“While musculoskeletal back pain will mostly 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 tiredness and weight loss.”
9. Hoarseness or a croaky voice
Being croaky or hoarse is common with a cold, but if it doesn’t get better within two or three weeks, it needs checking out.
“Persistent hoarseness can indicate an early, curable head or neck cancer such as one of the vocal cords,” Bloomfield says.
Today’s surgery techniques usually mean minimally invasive removal of the cancer so your voice remains intact — if it’s caught early.
A stubborn or worsening cough should also be checked out with a chest X-ray, especially if it has lasted for more than three weeks, as it could also indicate lung cancer, Johnson says.
10. Mouth or tongue ulcers
Lots of people get mouth ulcers from viral infections, but these usually clear up within a few days and are quite painful, Johnson says.
“But a mouth ulcer that’s there three to four 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 patches on the tongue also need to be checked out because they can indicate changes in the lining of the mouth, which can lead on to cancer.”