If you are one of the estimated 15 million people in the US who will be told "you have cancer" this year, much of your medical fate will depend on how advanced the malignancy is when it is diagnosed.
When cancer is caught early-before the abnormal cells multiply and spread—the odds of defeating the disease improve dramatically.
Problem: Because cancer is tricky-early symptoms most often (but not always) are painless, and they often mimic common noncancerous conditions-many people ignore red flags that could help them get an early diagnosis.
For the best possible chance of beating cancer: Be alert for subtle symptoms of the disease. Here are nine such cancer symptoms that you should never ignore—and how to distinguish them from more benign causes.
1. Difficulty swallowing. When you swallow, you've probably had the uncomfortable or painful experience of food getting stuck-for example, high in the esophagus or in the middle of the upper chest.
It may be cancer if: You have this sensation all or most times that you eat, and it's usually not painful. Difficulty swallowing is common in people with esophageal or stomach cancer and may be a sign that a tumor is obstructing the esophagus or that inflammation and scarring have narrowed the opening. Inflammation can be a precursor to cancer and also can indicate that a malignant tumor has irritated surrounding healthy tissue.
*Important: If you have a troubling symptom that is not listed in this article, see your doctor.
Because difficulty swallowing evolves slowly many people adjust the way they eat, taking smaller bites, chewing longer and perhaps even switching to a diet that is mostly liquid. If eating becomes difficult for any reason-see a doctor.
2. Excessive bleeding and/or unexplained bruising. Leukemia causes a shortage of blood platelets (cellular elements responsible for clotting), which results in easy and excessive bleeding and unexplained bruising. (Normal bleeding, such as that caused by a cut, should stop after application of direct pressure.)
It may be cancer if: You have an unusual number of unexplained nosebleeds (for example, not due to dry air, a common trigger) and/or develop unexplained bruises (a change in frequency or severity from the norm) that tend to be painful when touched, dark purple and large the size of a fist or bigger).
Important: Bleeding gums may be a sign of poor dental care or a serious medical problem, such as leukemia. If brushing causes bleeding, see your dentist for an evaluation to determine the cause.
3. Exhaustion. Everyone gets tired, but extreme fatigue due to cancer is quite different. Although all cancers can cause fatigue, this symptom is most common with colon cancer, leukemia and other cancers that may cause anemia.
It may be cancer if: For no apparent reason, you experience overwhelming and debilitating fatigue similar to that caused by the flu.
Important: Fatigue due to cancer is sometimes mistaken for depression.
Key difference: A person with depression often lacks the will and desire to perform daily activities, while a person with cancer-related fatigue wants to stay active but lacks the physical ability to do so.
4. Fever and night sweats. The presence of cancer causes a storm of chemical processes as the body ramps up its immune defenses to fight cancer cells. Fever is one indication that your immune system is fending off an illness, such as a cold or the flu, or even cancer.
It may be cancer if: You have fevers (typically 100°F or higher) that come and go over a period of days or weeks. Cancer-related fevers occur most often at night—often along with drenching night sweats.
Important: Menopausal women often have hot flashes that may lead to night sweats—but sweats due to menopause also occur during the day. Anyone who experiences night sweats, including menopausal women who have night sweats but no daytime hot flashes-should see a doctor.
5. Lumps. Any new, firm, painless lump that is growing in size or that is bigger than a nickel should be immediately examined by a doctor. Worrisome lumps typically feel firmer than the tip of your nose, while spongy or painful lumps are less of a concern. Lumps can be caused by several types of cancer, including breast, testicular and throat malignancies, and melanoma (skin cancer).
The immune response launched by your body when it is fighting a serious disease-including cancer-may lead to enlarged lymph nodes (the small filtering structures that help prevent foreign particles from entering the bloodstream). Painful and/or swollen lymph nodes are common signs of infection and usually return to normal size within a few days of the infection resolving.
It may be cancer if: Enlarged lymph nodes do not return to normal size and/or have the characteristics described above.
Helpful: Lymph nodes can be found throughout the body, but enlarged ones are easiest to feel behind the neck at the base of the skull or behind the ears) in the armpit...in the groin (at the junction of the torso and leg)...in the hollowed space above the collarbone (clavicle). in back of the knee.. and at the crook of the elbow.
6. Persistent cough. Longtime smokers get used to coughing, so they tend not to notice this important symptom of lung cancer. Nonsmokers can experience persistent cough as well, which also can be a symptom of other cancers, including malignancies of the throat and esophagus.
It may be cancer if: You have a cough—with or without breathlessness—that persists for longer than one month. Coughing up blood also can be a cancer symptom.
7. Skin changes. Most people know that changes in a mole can be a sign of skin cancer. But the moles that are most prone to cancerous changes are the type that are flat (as opposed to raised or bumpy in shape).
It may be cancer if: You have a mole that becomes darker...changes color...changes shape (especially in an asymmetrical pattern)...or grows larger. Guidelines recommend seeing a doctor if you have a mole that grows larger than a pencil eraser, but don't wait to see your doctor if you have a mole that undergoes any of the changes described above.
Important: A sore that doesn't heal also can be skin cancer. In healthy people, most superficial wounds heal within days.)
8. Stumbles or falls. If you suddenly become *clumsy," it may signal a neurological problem, such as nerve damage from diabetes or multiple sclerosis, or it could be a sign of a brain tumor.
It may be cancer if: Your clumsiness is accompanied by confusion, difficulty concentrating and an inability to move your arms and/or legs. Although paralysis is an obvious sign that something is wrong, it is rarely the first sign of a brain tumor. Check with your doctor immediately if your body's basic functions change in any way.
9. Unexplained weight loss. If you experience significant weight loss (about 10 pounds or more of your body weight) that is not a result of an intentional weight-loss regimen, it often is a symptom of a potentially serious medical condition, such as cancer or depression.
It may be cancer if: Weight loss is due to a reduced appetite. Always see your doctor promptly if you experience unexplained weight loss.
New Therapy Saves Esophagus
Esophageal cancer is usually treated by removing the esophagus (swallowing tube). Patients spend a week in the hospital, have a 50% rate of postsurgical complications and face lifelong dietary restrictions.
New: With outpatient endoscopic mucosal resection, a scope inserted into the esophagus shaves off cancer cells...patients can eat full meals within days. Both procedures have similar five-year survival rates.
