Cancer, Early Warnings

Early warning signs of cancer
The prognosis in most cases of cancer depends largely on the availability of
treatments, and how early the cancer is detected. If a tumour can be detected at
an early stage, the possibilities for curative treatment are generally significantly
better than if a patient presents with more advanced disease. One approach is
therefore to educate the public on the early warning signs of cancer. These are
sometimes divided into the following 7 groups of signs and symptoms.
Unusual bleeding or discharge
The cause of any unexplained bleeding should always be ascertained. For example
haematuria is commonly caused by infection and may also result from trauma;
however it may also be a feature of malignancy. Blood in the urine may derive
from any part of the urinary system so may be from the kidneys, ureters, bladder
or urethra. Any blood in urine is an abnormal finding. If a trace of blood is
detected on a routine dip stick test, this is abnormal and so should be explained.
In females blood in the urine during menstruation should not be assumed to
be menstrual contamination. This means the test should be repeated in two
weeks time when the woman is mid-cycle.
Bleeding from the gastrointestinal tract also has many possible causes, however
if haematemesis or melaena are seen, malignancy is a possibility. Detection of
occult blood in faeces is also an abnormal finding and should be explained.
Discharges may be a feature of early malignant disease. Discharges themselves
usually indicate infection and are composed of inflammatory fluids, bacteria
and white blood cells. When a tumour grows it distorts the normal anatomy of
an area. This results in a disordered local tissue structure which may increase
the probability of infection. For example, a tumour in a bronchial passage may
partly obstruct the bronchial lumen. This will inhibit the normal clearance of
mucus, leading to an area of stasis in the airways, distal to the tumour. Stasis
will lead to infection which may be difficult to clear and is likely to recur.
Therefore infection may be an early indicator of malignancy.
Discharges from the urethra may indicate a urinary malignancy. An early
sign of breast cancer may be a discharge from the nipple. Vaginal discharges are
also abnormal andcould indicate infection, secondary to malignancy in the
cervix or uterus.
A sore which does not heal
A sore on any part of the body could be a malignant ulceration. These will not
heal as a normal lesion does because the malignant process is ongoing, making
the condition progressively worse. Warning signs may include a lesion which
does not seem to be healing as normal or is getting bigger for no apparent
reason. Other potential features of malignancy are increasing pain or a lesion
starting to bleed.
A skin lesion which progresses and does not heal may be a basal cell carcinoma
(also sometimes called a rodent ulcer). These are normally caused by excessive
exposure to direct sunlight and are the most common malignant tumour of
the skin. Basal cell carcinomas grow locally but fortunately they rarely metastasize.
Squamous cell carcinomas may also arise in the skin and these are highly likely
to metastasize if not resected. Collectively these skin lesions are classified as
non-melanoma skin cancer (NMSC).