FOR some women, cancer comes hand-in-hand with another syndrome: denial. They may not want to face the reality that they have cancer, or may not want to go through treatment because they think they are doomed to death anyway.
In some cases, denial starts early on at the symptom stage, because they may not even want to consider that it could be cancer at all.
When women neglect to pay attention to cancer symptoms out of denial, fear or ignorance, they could be missing out on a valuable opportunity to detect cancer and treat it early.
Since there are so many different types of cancers that could affect us, the symptoms vary widely between different conditions and different people as well. There are also many instances where cancers do not produce symptoms at all, or symptoms only appear at late stages.
However, we can easily identify about 10 symptoms that should immediately send up warning flags in our minds and prompt us to seek medical advice. These symptoms can be easily mistaken for other conditions or as benign symptoms, but you shouldn't be so quick to shrug them off without proper medical advice.
I will explain each of these 10 symptoms below.
#1: Unexplained weight loss
Say you haven't been exercising more than usual lately, or have not even been exercising at all. Or you haven't gone on a diet and have been eating the amounts that you usually do. Yet you've been steadily losing a significant amount of weight, for instance 4kg or 5kg within a month.
This kind of unexplained weight loss is not necessarily a reason to be happy. It could be a sign of cancer, especially cancer of the colon or other parts of the digestive system.
You should see your doctor and provide as much details as possible about when you began losing weight and how much you have lost. Your doctor will conduct some tests to rule out an overactive thyroid and ask you to undergo CT scans to look at your internal organs.
Bloating is something that most women have become used to. We experience bloating at some point or other in our lives, whether due to PMS, water retention, or indigestion.
If you start to experience bloating that is unusual and not related to your menstrual cycle, you should start to pay close attention to what's happening. Are you so bloated that your jeans, trousers or skirts can't fit? Did it appear suddenly and is now occurring regularly over a few weeks?
Is the bloating accompanied by pain or tenderness in the abdomen or pelvis? Do you constantly feel full and unable to eat, even though you haven't eaten much?
All these signs have been known to occur in women with ovarian cancer. If you experience any of the above, it would be wise to see a doctor to check your ovaries because this type of cancer is difficult to detect in the early stages.
If you are able to catch it early, your chances of a better outcome are higher.
#3: Unusual bleeding
Any instance of vaginal bleeding that is out of the ordinary should be cause for concern. As a woman, you should know your body and your monthly cycle well enough to be familiar with when you should bleed, how much bleeding you experience, and how you feel.
Basically, you should not ignore any bleeding that is abnormal from what you normally have. If you have very regular cycles, but suddenly experience bleeding or spotting between periods, then it is abnormal.
If you usually have light flows, but suddenly have heavy and painful periods, then you should also have it checked out.
Other symptoms that may accompany unusual bleeding are unpleasant odours or discharge, bleeding after intercourse or blood in the urine. All these types of unusual bleeding should be checked out because they could be signs of cervical or uterine cancers.
Bleeding may also originate from the gastrointestinal tract or parts of the urinary system, such as the bladder or kidney.
If you discover blood in your urine or your stool, it could be due to a number of things, such as haemorrhoids, or blood from the vagina. But it could also be a sign of bladder, kidney or colorectal cancer, so you should see a doctor to rule these out.
Bladder, kidney or colon cancer can also trigger symptoms like changes in bowel and bladder habits. You should be concerned if you develop unusual bowel and bladder movements, such as continual constipation, diarrhoea or stomach aches. More frequent urination, or pain during urination or during a bowel movement, are also worrying signs.
Finally, if you cough up blood more than once, you should also get medical advice.
#4: Breast changes
The breasts hold a lot of clues for women. We've been told countless times that we need to know our breasts intimately and examine them once a month for lumps and other changes within the breasts, on the surface of the skin, as well as on and around the nipples.
Redness and thickening of the skin on the breasts should be looked at immediately as this could indicate inflammatory breast cancer, which is a very rare but aggressive form of breast cancer. A rash, flaking of the skin, or itchiness that persists over weeks should also be examined.
Changes to the skin surface may also include swelling, dimples, puckerings or rough spots.
Observe your nipples as well and look for changes in appearance that are not normal. If your nipples suddenly start producing discharge (if you aren't breastfeeding), become flattened, or turn in or out (contrary to what it usually is), it is best to see your doctor or gynaecologist.
#5: Skin changes
Changes in your skin texture, warts, moles or pigmentation, are well-known signs of skin cancer.
Melanoma is a common type of skin cancer and has symptoms like spots on your skin that have unusual changes in colour, size, shape or border. If certain spots on your skin appear to be funny-looking or different from your usual skin pigmentation, get it checked out.
Look out for moles or warts that change, such as growing excessively, sprouting hair, or changing colour or shape. Be wary if you suddenly develop bleeding on your skin or excessive scaling too. Observe the changes for one or two weeks, and if they persist, see your family doctor or a skin specialist.
#6: Difficulty swallowing and constant indigestion
Have you found it difficult to swallow your food lately? If you feel as if food is always caught in your throat when you eat, take note of this, as it could be a symptom of oesophageal or throat cancer.
Repetitive indigestion, not linked to pregnancy or any other apparent reason, is also a red flag. If you constantly feel nauseous, discomfort or a burning feeling in your upper abdomen, or vomit blood, you could be showing early signs of oesophageal, stomach or throat cancer.
#7: Persistent pain, fever or cough
These are three of the most vague and common symptoms that accompany many illnesses. It is extremely difficult to pinpoint them to cancer or any particular condition, but they are also not to be ignored or neglected.
Unexplained pain, in any part of the body, may point to some cancers. If it persists over a period of time, and cannot be attributed to any obvious physical wounds or conditions, then you should see your doctor and describe it in as much detail as possible.
Take note of when the pain arises, what kind of pain it is, and what exacerbates it.
A fever is often a sign of an infection, like influenza or some other viral or bacterial infection, but it can also point to certain types of cancer. The American Cancer Society says that fever is one of the symptoms that occur with early blood cancers such as leukaemia or lymphoma.
Of course, you do not have to run to your doctor in fear every time you have a fever. The point is that unexplained and prolonged fever needs to be examined, not ignored.
A very prolonged cough (one that lasts more than three or four weeks) that is unrelated to a cold or influenza, should also be noted. If lung cancer is suspected, especially if you are a smoker, your doctor should examine your throat, check your lung functioning and ask for X-rays.
#8: Swollen lymph nodes
Your lymph nodes are found in the sides of your neck, under your armpits, and around the groin area. Usually, they may become mildly swollen if you have an infection, and will subside once the infection has been treated or healed.
However, if the lymph nodes get progressively larger for more than a month, or develop lumps that do not go away, and are not related to a treatable infection, then the concern may be that it is linked to cancer, such as blood and lymphatic cancers.
#9: Mouth changes and sores
If you smoke or used to, you should look out for signs of oral cancer. Symptoms include white patches in the mucosa of the mouth, white spots on the tongue, or sores on the lips or in the mouth.
Other sores on the skin and genital area that won't heal, or cause excessive bruising or bleeding, should also be examined by a doctor.
#10: Fatigue and weakness
Finally, we come to the last potential symptom of cancer that is most commonly ignored - fatigue. Obviously, fatigue is such an everyday symptom of so many conditions that we cannot jump to the conclusion that it must be caused by cancer.
However, fatigue caused by cancer will probably be unlike the usual tiredness that you experience after a long day at work. It may plague you even when you have had sufficient rest or have not exerted yourself. It will be prolonged, unabated by rest, and may be accompanied by unexplained weakness.
You will realise that the 10 signs and symptoms described above are very subtle and vague indications of a problem. It is not easy to distinguish symptoms of cancer, and you should not work yourself up into a panic just because you suddenly have a mole on your arm or you are feeling a little tired.
Just keep in mind that if these symptoms persist, or appear without due cause, then it is a good idea to discuss your concerns with your doctor. It could be nothing, but it could also save your life.
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). The information provided is for educational and communication purposes only and it should not be construed as personal medical advice.