Given that one in two people will develop cancer in their lifetime, it’s in everyone’s interest to stay informed about the symptoms of the disease.
More than half of the 420,000 new cancers diagnosed in the UK each year are caused by the “big four” cancers – breast, prostate, bowel and lung. Recognizing their symptoms can lead to early diagnosis so treatment is more likely to be successful.
Here, doctors who treat these cancers share some of the most overlooked symptoms and what to do if you develop them.
breast cancer
Overlooked Symptom: Texture Changes
Dr Alicia Okines, consultant medical oncologist and breast cancer specialist at leading cancer center The Royal Marsden, said most breast cancers are discovered because they cause lumps in the breast.
However, changes in breast texture are a lesser-known and harder-to-detect symptom of breast cancer. It is caused by lobular breast cancer, the second most common type of breast cancer, with 8,400 new cases in the UK each year.
“Lobular breast cancer cells more commonly grow in lines than lumps due to the loss of specific proteins that normally hold the cells together,” Dr. Okins explains.
“Women may just notice that their breasts are a little thicker or their nipples are a little flat or inverted, which are subtle changes. When they self-exam, they can’t feel the lump, so it’s not always possible to detect it quickly, and [the tumour] When it becomes noticeable, it can cover quite a large area. “
Dr Alicia Okines says changes in breast texture are harder to spot than lumps and require a visit to your GP – Dominick Tyler/The Royal Marsden
Additionally, lobular breast cancer is not always visible on a mammogram and may be missed during breast screening. As a result, they are usually caught later – in the second or third stage – She explains that this means it has spread to surrounding lymph nodes or tissue, rather than in stage one, when the cancer is better contained and easier to treat.
If you notice a change in breast texture, Dr Okines recommends seeing your GP, especially if you are a postmenopausal woman as 90% of cases fall into this group. If concerned, she says, your doctor will refer you to a one-stop breast clinic, where a breast exam and ultrasound will be performed, and a needle biopsy will be done if anything suspicious is found.
However, there is no need to worry once the breast changes disappear. “For example, breasts may swell before your period,” she says. “If you notice a change, check yourself in a week or two, and if it’s still there, be sure to get it checked out.”
lung cancer
Ignored symptoms: persistent or recurring chest infections
49,300 cases of lung cancer are diagnosed in the UK each year. Robert Rintoul, professor of thoracic oncology at the University of Cambridge and honorary consultant respiratory specialist at the Royal Papworth Hospital, said they did not always cause symptoms, but a cough lasting more than three weeks was one of the most common symptoms.
However, less attention has been paid to persistent chest infections, which can cause not only coughing but also wheezing, shortness of breath and other cold or flu-like symptoms, he said. “Recurrent chest infections are a common problem for me, but often not taken seriously [as a cancer symptom] Like a constant cough,” he said.
Professor Robert Lintoul says if a chest infection is slow to clear, or it’s the second or third infection in the past year, it should sound alarm bells
Lung cancer can cause chest infections if the tumor blocks the airway, he explained. “The lungs are constantly clearing themselves by moving mucus to the back of the throat. You’re constantly swallowing these secretions without even realizing it.
“But if the airways are blocked, these clearance mechanisms don’t work properly, and infection can then enter the lungs, causing pneumonia. Airways are not sterile, they do contain bacteria, and if the airways are blocked, bacteria can easily multiply and cause infection.”
Lung cancer can also lead to chest infections, he noted, because cancer compromises the immune system, meaning infections are more likely to occur.
“Most people with chest infections will not develop lung cancer,” he points out. “But if clearance is slow or it’s your second or third chest infection in the last year or so, then alarm bells should start ringing.” This is especially true for smokers, who account for 85 per cent of lung cancer cases, Professor Rintoul said.
If concerned, he recommends asking your GP for a chest X-ray or CT scan. He also urged former and current smokers to take part in the National Lung Cancer Screening Scheme, which provides CT scans to people aged 55 to 74 in England.
prostate cancer
Overlooked Symptom: Continuously Feeling Unwell
Declan Cahill, director of urology at the Royal Marsden and consultant urologist, points out that prostate cancer often shows no symptoms in its early stages.
Difficulty urinating, frequent urination, and poor urine flow are often labeled symptoms of prostate cancer, but are more likely to be signs of benign prostate growth that occurs with age. “Curable prostate cancer has no symptoms,” he stressed. “Men who are asymptomatic don’t think there’s a problem and therefore don’t get a PSA test.”
In contrast, symptoms of prostate cancer usually appear only after it has spread. He noted that patients may experience general discomfort, but this may happen gradually over time because prostate cancer grows slowly. “Even in aggressive prostate cancer, the doubling time is two years,” Cahill said. “It creeps up on people and they tend to feel like crap.”
Declan Cahill points out that prostate cancer often has no symptoms in its early stages, but over time patients may experience general discomfort – Kirsten Holst/The Royal Marsden
“Patients with advanced prostate cancer also experience bone pain, often hip pain and back pain, that doesn’t go away,” he said. “Ibuprofen and paracetamol are not enough [to ease it]”. He noted that this was a sign that the cancer had spread to the bones, an advanced stage four symptom.
More than 60,000 men are diagnosed with prostate cancer each year, and approximately 12,000 men die from prostate cancer each year.
Cahill urged all men over 50 to ask their GP about a prostate-specific antigen (PSA) test. If PSA levels are high, it may be a sign of prostate cancer.
“Everyone complains that this test isn’t a very good test, but actually, it’s pretty good,” he said. “The prostate is the only organ where blood tests can be done.”
For example, due to reasons such as infection, a PSA test can give a false-positive result, reporting a high score when no cancer is present. “If your PSA is elevated for other reasons, you will have an MRI, which costs £139 to the NHS and will tell you whether you need a biopsy,” Cahill points out. “Only if the MRI looks significant do you do a biopsy.”
“The only way as an individual to avoid becoming one of the 1 in 10 men who are diagnosed too late with prostate cancer or the 3 in 10 men who die from prostate cancer is to get tested.”
bowel cancer
Symptoms that are easily ignored: loose stools
“People often think constipation is a sign of bowel cancer,” says Shahnawaz Rasheed, consultant colorectal surgeon at the Royal Marsden University and senior lecturer at Imperial College London.
“In fact, it’s quite the opposite. You’re more likely to have persistent changes in your bowel habits and make them looser than with constipation from bowel cancer.”
He points out that not every bowel movement will necessarily be affected. “It’s probably a general trend. One day you might not go at all, but the next day you’ll go two or three times. Generally speaking, people will know their bowel movements – some bowel movements are like clockwork. [With bowel cancer]in a few months, [stools] May become more relaxed. “
In many cases, this symptom is caused by a stomach bug or infection and goes away within a week or two. “That’s not what you’re worried about,” he said. “Loose stools that persist for more than four to six weeks are cause for concern.”
He explained that bowel cancer causes this symptom because glandular cells in the colon produce small amounts of mucus to facilitate the passage of stool through the intestines, but when cancer develops, they start producing abnormally large amounts of mucus. In some cases, this mucus may be visible in the stool.
“Generally, people think it must be hemorrhoids or irritable bowel syndrome,” says Rashid. “They justify the symptoms because no one really thinks they have cancer. They’ll come up with 100 reasons why they might not have cancer. The only way to know is to rule out cancer through testing. You can’t ignore new symptoms.”
If you suffer from this condition, your GP may recommend a fecal immunochemical test (FIT) to check for blood in your stool. He explains that “if the result is over 10, it means there are microscopic levels of blood in your stool” and your GP should refer you to your local hospital and you will most likely have a colonoscopy.
“We need to alleviate the fear of the whole process,” Rashid said. “People are afraid of colonoscopies, but it’s actually not that bad. You have medication to clear your system, which is kind of rubbish, but you can get it done under sedation and it’s really not a big deal.”
Around 44,100 cases of bowel cancer are diagnosed in the UK each year. “There’s no way of knowing whether you have it until you do a FIT test,” he said. “If it’s negative, then you’re pretty sure there’s nothing there.
“The earlier a cancer is caught, the better. If you don’t go to your GP, you’re going to have a miserable feeling anyway. To convince yourself that nothing is wrong, it’s best to go to your doctor and get tested. You don’t want to wait months to get a diagnosis or treatment.”
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