A practical guide to understanding cancer signs and symptoms of cancer what to be aware of
More than a quarter of a million people are diagnosed with cancer in the UK each year. The earlier a cancer is found, the more likely it is that treatment will be successful. Knowing what changes to look for and when to see your GP could make a real difference. This leaflet explains: why and when to see your GP general signs and symptoms of cancer signs and symptoms of the most common cancers in men and women. Signs and symptoms of cancer 2
Why and when to see your GP Knowing how your body normally looks and feels can help you spot early any changes that could be caused by a cancer. Having any of the following symptoms doesn t necessarily mean you have cancer, but it s sensible to get them checked out by your GP. A lump anywhere on your body. Changes on your skin or to an existing mole (such as itching, bleeding, or a change in shape or colour). A cough or hoarseness that lasts for more than three weeks. A change in bowel habit that lasts for more than six weeks. It's sensible to get any symptoms checked out by your GP. Any abnormal bleeding from your vagina or back passage, in your urine or when being sick (vomiting). Unexplained, significant weight loss (5kg/10Ibs over a couple of months). Coughing up blood. Your doctor will want to know if you have any of these symptoms. Some people worry about what the doctor will say. It s natural to be concerned about changes to your body and what they may mean. But the sooner you see your doctor, the sooner they can arrange any tests and explain what s going on. Usually, the sooner a cancer is found the more successfully it can be treated. Signs and symptoms of cancer 3
Some cancers have very specific symptoms, but not all cancers will have symptoms in the early stages. Some cancers are diagnosed by accident, while someone is being investigated or treated for another condition. Cancer can t be diagnosed based on symptoms alone. Investigations, such as x-rays, scans and biopsies, are nearly always needed to make a diagnosis. The signs and symptoms described in this leaflet can be caused by many conditions other than cancer. Seeing your GP will help you find out what s happening. General signs and symptoms Lumps The following are the most common signs and symptoms of cancer. If you have a symptom that isn t listed here and that s lasted for a few weeks, it s a good idea to discuss it with your GP. You should see your GP if you notice a lump or swelling anywhere on your body. It can be useful to tell your GP how long it s been there and if it s getting bigger or causes discomfort. It can be difficult to tell what a lump is just by feeling it. But if your GP suspects that you might have a cancer, they will refer you to an appropriate specialist for further tests. Signs and symptoms of cancer 4
Coughing and breathlessness Change in bowel habit If you have a cough or feel breathless for more than three weeks, you should see your GP. Tell them if you have any blood in your sputum (phlegm) when you cough. Blood in your stools (bowel motions) can be a symptom of bowel cancer. The blood is usually dark but can be bright red in colour. You may notice a change in your normal bowel pattern, such as diarrhoea or constipation, for no obvious reason. Some people may have alternating episodes of diarrhoea and constipation. You may have a feeling of not having emptied your bowel properly after a bowel motion. Some people have pain in the tummy (abdomen) or back passage. If any changes in bowel habit last for more than six weeks, you should check them out with your GP. The signs and symptoms here can be caused by many conditions other than cancer. Signs and symptoms of cancer 5
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Abnormal bleeding Any unexplained bleeding is a sign that something might be wrong and should always be checked out by your GP. Bleeding between periods or after sex may be caused by cancer of the womb or cervix. Women who have any vaginal bleeding after they have had their menopause should always see their GP. Blood in your urine may be caused by bladder or kidney cancer. Unexplained bleeding should always be checked out by your GP. Unexplained weight loss Coughing up blood in your sputum (phlegm) can sometimes be a sign of lung cancer. Vomiting blood can be a sign of stomach cancer, although it can also be due to a stomach ulcer. Bruising and nosebleeds are rarely signs of cancer, but can in some cases be caused by leukaemia. However, people with leukaemia usually have other symptoms too. If you ve lost a lot of weight over a short period of time (a couple of months or less) that can t be explained by changes in your diet, increased exercise or stress, it s important to tell your GP. Signs and symptoms of cancer 7
Suspicious moles or skin changes Malignant melanoma is a type of skin cancer that often starts with a change in the appearance of normal skin. This can look like an abnormal new mole. Fewer than one third of melanomas develop in existing moles. Any of the following changes should always be checked out. Asymmetry Melanomas are likely to be irregular or asymmetrical. Ordinary moles are usually symmetrical (both halves look the same). Border Melanomas are more likely to have an irregular border with jagged edges. Ordinary moles usually have a well-defined, regular border. Colour Moles tend to be one shade of brown. Melanomas often have more than one colour. Malignant melanoma is a type of cancer that often starts with a change in the appearance of normal skin. Diameter (width) Melanomas are usually more than 7mm in diameter. Moles are normally no bigger than the blunt end of a pencil (about 6mm across). Evolving (changing) Look for changes in the size, shape or colour of a mole. It s important to see your GP if you have any unusual marks on the skin that last for more than a few weeks, or if you have a mole that shows any of the above signs. Signs and symptoms of cancer 8
See your GP if you have any unusual marks on the skin that last for more than a few weeks. Hoarseness Pain A hoarse voice may be a sign of cancer of the larynx. Hoarseness can occasionally be a symptom of other cancers, such as thyroid cancer, cancer of the gullet (oesophagus) or lung cancer. If hoarseness continues for longer than two weeks, you should tell your GP. People often think that pain is a symptom of cancer, but many people with cancer have no pain in the early stages. Some people with cancer will never have pain. Signs and symptoms of cancer 9
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The most common cancers in men and women There are more than 200 types of cancer. Some are very common and others are very rare. In the UK, the four most common cancers in men are: prostate cancer lung cancer large bowel cancer bladder cancer. The four most common cancers in women in the UK are: breast cancer large bowel cancer lung cancer ovarian cancer. Signs and symptoms of cancer 11
Lung cancer symptoms Lung cancer is common in both men and women. Smoking cigarettes is known to be the cause of most lung cancers. The symptoms of lung cancer may include any of the following: continued coughing for three weeks or longer, or a change in a long-standing cough a chest infection that doesn t get better increasing breathlessness and wheezing coughing up blood in your sputum (phlegm) a hoarse voice Smoking cigarettes is known to be the cause of most lung cancers. a dull ache or a sharp pain when you cough or take a deep breath loss of appetite or loss of weight difficulty swallowing excessive tiredness (fatigue) and lethargy. It s important to have any of these symptoms checked by your GP as early as possible. Large bowel cancer symptoms The large bowel is made up of the colon and the rectum, and is part of the digestive system. Most cancers of the large bowel develop in the colon. Signs and symptoms of cancer 12
The following can all be symptoms of large bowel cancer: dark or bright red blood in or on your stools a change in your normal bowel habit, such as diarrhoea or constipation, for no obvious reason that lasts for longer than six weeks unexplained weight loss Most cancers of the large bowel develop in the colon. pain in the tummy (abdomen) or back passage a feeling of not having emptied your bowel properly after a bowel motion general discomfort, such as gas, bloating or cramps, in the tummy (abdomen). Sometimes tiredness (fatigue) is a symptom of a bowel cancer. This can happen if the cancer has been bleeding, which means that the number of red blood cells in your body is reduced (anaemia). Anaemia may also make you feel breathless. Sometimes a cancer can cause a blockage (obstruction) in the bowel. The symptoms of this are being sick (vomiting), constipation, pain in the abdomen or a bloated feeling. Although these symptoms can be caused by conditions other than large bowel cancer, it s important to get them checked by your doctor. Signs and symptoms of cancer 13
Prostate cancer symptoms The prostate is a small gland found only in men. It s about the size of a walnut and surrounds the first part of the tube (urethra) that carries urine from the bladder to the penis. Many men with early prostate cancer are unlikely to have any symptoms, as these only occur when the cancer is large enough to put pressure on the urethra. Many enlargements of the prostate are not caused by cancer. In men over the age of 50, the prostate gland often gets larger due to a noncancerous condition known as benign prostatic hyperplasia or benign prostatic hypertrophy (BPH). The symptoms of both benign enlargement of the prostate gland and a malignant tumour (cancer) are similar and can include any of the following: difficulty in starting to pass urine a poor or weak flow of urine urgently needing to pass water passing urine more frequently than usual, especially at night blood in the urine, although this is uncommon. If you have any of these symptoms, you should discuss them with your GP. Signs and symptoms of cancer 14
Getting symptoms checked by your GP is the best way to find out the cause. Bladder cancer symptoms The bladder is a hollow, muscular, balloon-like organ that collects and stores urine. The most common symptoms of bladder cancer are: Blood in the urine This usually happens suddenly and may come and go. It s not usually painful. Sometimes the blood in your urine can t be seen and is picked up by a urine test. Bladder changes You may have a burning feeling when you pass urine, or need to pass urine more often or urgently than usual. These are all symptoms of bladder irritation and are more likely to be due to an infection than cancer. Your GP may want to investigate further if you have repeated infections. If you have any worrying symptoms, getting them checked out with your GP is the best way to find out the cause. Signs and symptoms of cancer 15
Breast cancer symptoms Breast cancer mainly affects women, but in rare cases can affect men too. In most cases, the first symptom of breast cancer is a painless lump. You should visit your doctor straight away if you notice a lump or other changes in your breast(s). Although most breast lumps are not cancerous (benign), they still need to be checked carefully to rule out the possibility of cancer. Other, less common signs of breast cancer may include: a change in the size or shape of a breast dimpling of the skin on the breast a thickening in the breast tissue a nipple becoming inverted (turned in) a lump or thickening behind the nipple a rash (like eczema) affecting the nipple Breast cancer mainly affects women, but in rare cases can affect men too. a swelling or lump in the armpit blood in discharge from the nipple. Pain in the breast is not usually a symptom of breast cancer, but it can occur. Signs and symptoms of cancer 16
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Ovarian cancer symptoms Symptoms of ovarian cancer can be quite vague and may not occur until the cancer is at a late stage. When symptoms occur, they can include any of the following: loss of appetite feeling sick (nausea) excessive gas (wind) a bloated, full feeling unexplained weight gain swelling in the abdomen this may be due to a build up of fluid (ascites), which can also cause shortness of breath pain in the lower abdomen changes in bowel or bladder habits, such as constipation, diarrhoea or needing to pass urine more often than usual lower back pain pain during sex The symptoms of ovarian cancer can be quite vague. abnormal vaginal bleeding. If you have any of the above symptoms, it s important to have them checked by your doctor. Signs and symptoms of cancer 18
Screening Screening is a way of testing healthy people, either to see if a cancer can be found early or to detect changes that may develop into cancer at a later date. There are national screening programmes for bowel, breast and cervical cancer that monitor people regularly. Speak to your GP for further details. Usually, the sooner a cancer is found, the more successfully it can be treated. Signs and symptoms of cancer 19
Further information We have more information about cancer types, tests, treatments and living with and after cancer. We also have details of other helpful organisations and support groups in your area. You can contact us using the following details: Macmillan Cancer Support 89 Albert Embankment, London SE1 7UQ Questions about cancer? Call free on 0808 808 00 00 (Mon Fri, 9am 8pm) Alternatively, visit macmillan.org.uk Hard of hearing? Use textphone 0808 808 0121, or Text Relay. Non-English speaker? Interpreters available. To order any of our booklets, log on to be.macmillan.org.uk or call us on 0808 808 00 00. Signs and symptoms of cancer 20
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Disclaimer We make every effort to ensure that the information we provide is accurate, but it should not be relied upon to reflect the current state of medical research, which is constantly changing. If you are concerned about your health, you should consult a doctor. Macmillan cannot accept liability for any loss or damage resulting from any inaccuracy in this information or third-party information, such as information on websites to which we link. We feature real-life stories in all of our articles. Some photographs are of models. Thanks This leaflet has been written, revised and edited by Macmillan Cancer Support s Cancer Information Development team. With thanks to: Dr Sinead Clark Macmillan GP; Dr Martin Johnson Honorary Senior Lecturer in Community Pain; Dr MH Tseung GP Advisor; and the people affected by cancer who reviewed this edition. Sources Cancer Research UK. http://info.cancerresearchuk.org/cancerstats/incidence/ commoncancers/ (accessed August 2011). Clinical guidelines CG027. Referral for Suspected Cancer. June 2005. National Institute for Health and Clinical Excellence (NICE). Clinical guideline 121. Lung cancer: The diagnosis and treatment of lung cancer. April 2011. National Institute for Health and Clinical Excellence (NICE). Tobias & Hochhauser. Cancer and its management. 6 th edition. Wiley-Blackwell. Signs and symptoms of cancer 22
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Cancer is the toughest fight most of us will ever face. If you or a loved one has been diagnosed, you need a team of people in your corner, supporting you every step of the way. That s who we are. ww We are the nurses and therapists helping you through treatment. The experts on the end of the phone. The advisers telling you which benefits you re entitled to. The volunteers giving you a hand with the everyday things. The campaigners improving cancer care. The community supporting you online, any time. The fundraisers who make it all possible. You don t have to face cancer alone. We can give you the strength to get through it. We are Macmillan Cancer Support. Questions about living with cancer? Call free on 0808 808 00 00 (Mon Fri, 9am 8pm) Alternatively, visit macmillan.org.uk Hard of hearing? Use textphone 0808 808 0121, or Text Relay. Non-English speaker? Interpreters available. Macmillan Cancer Support, 2012. 2 nd edition. MAC12919. Next planned review 2014. Macmillan Cancer Support, registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). Printed using sustainable material. Please recycle.