Before Cancer Reaches Stage 4: 10 Warning Signs You Should Not Ignore, According to WHO, NCI and ACS
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| Cancer Form |
By Victor Olubiye
Different cancers affect the body in different ways, while some may produce no noticeable symptoms in their early stages. Health authorities therefore stress the importance of paying attention to unusual changes and seeking appropriate medical evaluation rather than trying to diagnose cancer from symptoms alone.
The World Health Organization says cancers detected and treated early are more likely to respond to treatment, with a greater chance of survival. It also distinguishes early diagnosis from screening: early diagnosis involves investigating symptoms in people who already have them, while screening aims to identify certain cancers or precancerous changes before symptoms appear.
The US National Cancer Institute and American Cancer Society similarly identify several changes that can occur with cancer, while warning that most of these symptoms can also be caused by other illnesses or non-cancerous conditions.
Here are 10 warning signs that should not simply be ignored:
1. Unexplained weight loss
Losing weight without deliberately changing your diet, exercise or lifestyle can sometimes be a sign of cancer.
The NCI lists weight loss for no known reason among possible cancer symptoms, while the ACS also includes unexplained weight change among common symptoms that may occur with cancer.
Unexplained weight loss, however, has many possible causes. The concern is not that every person who loses weight has cancer, but that persistent or significant weight loss without an obvious explanation deserves medical attention.
2. A new lump or swelling
A new lump or swelling in the breast, neck, armpit, abdomen or elsewhere on the body should be assessed, particularly when it persists or changes.
The NCI lists swelling or lumps anywhere on the body among possible cancer symptoms. But such changes can have many causes other than cancer.
Breast changes deserve particular attention. The ACS says a new breast lump or mass is the most common symptom of breast cancer, although most breast lumps are not cancerous. Other possible breast changes include swelling, skin dimpling and changes affecting the nipple or breast skin.
3. Unexplained or persistent bleeding
Bleeding without an obvious explanation should not simply be dismissed.
Possible warning signs include blood in the stool or urine, unusual bleeding or unexplained bruising. The NCI and ACS both list unusual bleeding and blood in the stool or urine among changes that can occur with cancer.
The presence of blood does not automatically mean cancer. There are many other possible causes. The important step is to establish the cause, particularly when the bleeding is unexplained, persistent or recurring.
4. A persistent cough or hoarse voice
A cough or hoarseness that does not go away can be associated with several conditions, including some cancers.
Both the NCI and ACS include a cough or hoarseness that does not go away among possible cancer symptoms.
Rather than repeatedly treating a persistent symptom without knowing its cause, a person should seek medical assessment, particularly when the problem continues or worsens.
5. Persistent changes in bowel habits
A lasting change in bowel habits may include diarrhoea or constipation that does not resolve, changes in the appearance of stool or blood in the stool.
The ACS lists changes in bowel habits and blood in the stool among possible cancer symptoms, while the NCI similarly identifies bowel changes and blood in the stool as symptoms that may need investigation.
The issue can be particularly important in younger adults. An NCI-reviewed study involving 5,075 people aged 18 to 49 with colorectal cancer and 22,378 people without the disease found four symptoms that were more common among those subsequently diagnosed: abdominal pain, rectal bleeding, diarrhoea and iron-deficiency anaemia.
Having one of the symptoms was associated with nearly twice the likelihood of an early-onset colorectal cancer diagnosis compared with having none. Three or more were associated with six times the likelihood. The findings do not mean that a young person with one of these symptoms has cancer, but they reinforce the need to investigate persistent or recurring symptoms.
6. Persistent digestive problems or difficulty swallowing
Indigestion or heartburn that does not go away, abdominal discomfort, nausea, vomiting, appetite changes and difficulty swallowing can have many causes.
They are also among the symptoms listed by the NCI as possible signs of cancer.
For example, the NCI notes that stomach cancer can initially be difficult to detect because it may produce no symptoms. When symptoms occur, they can include indigestion, stomach discomfort, bloating after eating, nausea, loss of appetite and heartburn.
Persistent or worsening digestive symptoms should therefore not automatically be attributed to ordinary stomach upset.
7. A sore that does not heal or unusual skin changes
A sore that refuses to heal, a new mole or a change in an existing mole can warrant medical attention.
The NCI lists non-healing sores, new or changing moles and other skin changes among possible cancer symptoms.
The ACS similarly identifies a new mole or a change in an existing mole, as well as a sore that does not heal, among possible signs of cancer.
Not every unusual skin change is cancer. But a persistent change should be checked rather than ignored.
8. Persistent, unexplained pain
Pain that is new, does not go away, becomes worse or has no clear explanation should be evaluated.
Cancer can cause pain when a tumour affects nearby organs, tissues, nerves or other structures. But pain is also extremely common in conditions that have nothing to do with cancer.
The NCI makes another important point: people should not wait until they experience pain before seeking medical attention because cancer does not always cause pain.
A lack of pain, therefore, should not be taken as proof that there is no serious illness.
9. Persistent fatigue, fever or night sweats
Severe tiredness that does not improve with adequate rest can sometimes occur with cancer. Unexplained fever and night sweats can also be associated with some cancers.
The ACS lists extreme fatigue that does not improve with rest, fever and night sweats among possible cancer symptoms.
Again, these symptoms are not specific to cancer. Fatigue, for example, can be caused by anaemia and numerous other health conditions. The significance comes from symptoms that are unexplained, persistent or accompanied by other concerning changes.
10. Unusual changes in the breast, mouth or other body areas
Some cancer-related changes can be specific to particular parts of the body.
Breast changes may include a new lump, swelling, skin dimpling, changes in the skin or nipple discharge. The NCI and ACS both advise that unusual breast changes should be assessed, even though many breast changes are not caused by cancer.
Changes in the mouth can also require attention. The NCI lists persistent white or red patches, bleeding, pain or numbness in the mouth or lip among possible symptoms. The ACS similarly identifies non-healing mouth sores, white or red patches, persistent pain and numbness among possible signs of oral cancer.
One symptom does not mean you have cancer
The most important caution is that none of these symptoms, on its own, confirms cancer.
The NCI says cancer symptoms are more often caused by illness, injury, benign tumours or other problems. It advises people with symptoms that do not improve after a couple of weeks to see a doctor so the cause can be identified.
The ACS also advises people to speak with a healthcare provider about major changes in how the body works or feels, especially when they last for a long time or become worse.
That distinction matters. A person with persistent stomach pain, for example, should not conclude that they have cancer. But neither should they automatically assume that the symptom is harmless without finding out what is causing it.
Younger adults should not dismiss persistent colorectal symptoms
The NCI-reviewed study on early-onset colorectal cancer provides a particular warning for younger people.
Researchers analysed medical claims involving 5,075 people aged 18 to 49 who had colorectal cancer and 22,378 people without the disease. They found that abdominal pain, rectal bleeding, diarrhoea and iron-deficiency anaemia were more common among people who subsequently developed early-onset colorectal cancer.
The researchers found that one of the four signs was associated with nearly twice the likelihood of an early-onset colorectal cancer diagnosis, while three or more were associated with six times the likelihood.
The findings should not be interpreted as a diagnosis. Instead, they show why persistent or recurring symptoms in younger adults should not automatically be dismissed because of age.
Cancer detection does not depend entirely on waiting for warning signs.
WHO separates early diagnosis from screening. Early diagnosis involves recognising symptoms and getting them assessed promptly. Screening, on the other hand, is intended to identify certain cancers or precancerous changes in people who may have no symptoms.
Screening is not the same for every cancer or every person. Recommendations depend on the cancer involved, age, risk factors and the screening guidelines applicable to the individual.
This is important because some cancers may not cause obvious symptoms early. WHO says screening can help identify certain cancers or precancerous changes before symptoms develop, while the NCI notes that some cancers can be found before they cause symptoms.
Symptoms cannot tell you whether cancer is at stage four
A person should not attempt to determine the stage of cancer from symptoms alone.
Cancer staging is established through medical assessment and diagnostic investigations. Depending on the suspected cancer, doctors may use physical examination, laboratory tests, imaging and biopsy or other procedures to establish a diagnosis and determine how far the disease has progressed.
The NCI notes that symptoms do not necessarily indicate a particular diagnosis, and the presence or absence of pain, for example, cannot be used to determine whether cancer is present or how advanced it is.
WHO's message is more straightforward: when cancer is detected early and treatment begins without unnecessary delay, the disease is more likely to respond to treatment and the chances of survival can improve.
For anyone experiencing a new, unexplained, persistent or worsening change in the body, the safest response is not to guess the diagnosis. It is to seek appropriate medical advice and establish what is causing the change.
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