After being diagnosed with cancer, more than one patient has looked back and remembered those early symptoms they neglected – the hoarse voice that seemed to linger or the sudden, inexplicable loss of weight. These are the clues that shouldn’t be ignored – they might turn out to be benign, but equally they could indicate a burgeoning cancer. And the fact is a cancer detected early is a cancer that is easier to treat, says Dr. Prasad Abeysinghe, a Consultant Oncologist at the Maharagama Cancer Hospital. While an annual consultation with your doctor is important, it’s paying careful attention to your body that will provide your best clues.

Here are some symptoms you shouldn’t ignore:

1. Ulceration, lumps and discoloration of the lining of the mouth or tongue: In the early stages, tongue and mouth cancer can be entirely painless, and most are caught during a routine dental examination (a reason to never miss your annual appointment with your dentist). If neglected, an oral cancer could spread to the lymph nodes of your jaw and neck – making a cure that much more difficult. What to look out for? A brown, flat, freckle-like mark which develops where a cigarette, pipe or betel quid habitually comes into contact with, a slow growing wart, thickening on the inside of your cheeks, red or white patches along the sides of the tongue and an ulcer that lasts more than 10 days. These are all worth taking to your doctor.

2. Painless breast lump or scaly or painful nipple or chest, nipple discharge:  Women will frequently neglect a painless breast lump, which is unfortunate as it is one of the earliest signs of cancer. Other signs of breast cancer include patches of red, scaly, or dimpled skin or changes to the nipple such as turning inward or leaking fluid. While breast cancer in women is well known, what’s seldom discussed is that men also get breast cancer, with similar signs.

3. Unexplained weight loss: If you’re rapidly shedding weight for no apparent reason, it’s very important to have it checked out. Your doctor will tell you that it could be an early sign of colon and other digestive cancers, Lymphomas or lung cancers – a result of your appetite being affected and the declining ability of your body to digest and excrete food normally.

4. Change of voice lasting more than two weeks: In most cases, 3 – 5 days of rest and plenty of fluids are all you need to heal a hoarse voice. However, hoarseness for any extended period of time is a warning sign of throat cancer – it is often the first symptom patients notice. If it persists or gets progressively worse and is accompanied by difficulty swallowing, coughing up blood or a lump on the neck or in the throat, it should not be neglected.

5. Difficulty swallowing: Most commonly associated with oesophageal or throat cancer, trouble swallowing could also indicate lung cancer. A feeling of pressure – as if food were stuck in your chest – and recurring irritation that keeps you wanting to clear your throat or a sore throat that doesn’t go away like one brought on by a bout of flu are all warning signs. They can signal a narrowing of the oesophagus that could mean the presence of a tumour.

6. Chronic cough/chest pain and wheezing or shortness of breath: Unable to catch your breath? The symptoms of several types of cancer mimic a bad cough or bronchitis. When these problems persist or keep recurring it’s a cause for concern. Some patients complain of chest pain that extends up into the shoulder or down the arm.

7. Abnormal vaginal discharge: Many women can mistake the signs of cervical cancer for PMS or ovulation pains, but bleeding between menstrual cycles and an abnormal vaginal discharge warrant a trip to your gynaecologist. Increased amounts of vaginal discharge as well as dramatic changes in its appearance are clues: it might be foul smelling, watery, thick, or containing mucus.

8. Rectal bleeding or blood in the stool or bowel problems: The early symptoms of colorectal cancer are often mistaken for haemorrhoids. Blood in the toilet should never be ignored. Constipation, diarrhoea, and changes in stools can all be signs of cancer. As with some of the other symptoms you should consider bringing these to the attention of your doctor if they persist for more than a few days without a clear cause. Rectal cancer can leave you feeling like your bowels aren’t emptying completely, while one of the early signs of pancreatic cancer is ‘fatty stools’, i.e. frequent, large stools that are paler than normal and smelly. All these are signs that your body is not absorbing and excreting food as it does normally.

9. Swollen lymph nodes or lumps on the neck, underarm, or groin: a lump or an enlarged lymph node in the neck is sometimes a sign of thyroid, head, or throat cancer while a painless lump on the neck, underarm, or groin can be an early sign of leukaemia or Lymphoma. An enlarged lymph node indicates a change in the lymphatic system, a possible sign of cancer.

10. Difficulty urinating or changes in flow: Many men who were diagnosed with prostate cancer have reported not being able to urinate comfortably – they are unable to control the flow or find it weaker than normal. Many patients might find waking up frequently with the urge to urinate. Pain or a burning sensation might be a symptom of a urinary tract infection or a sexually transmitted disease, but always warrants further investigation.

11. Erection problems and blood in urine or semen: Blood in your urine or semen is a danger sign for prostate cancer – however, you might not always recognize it as blood. In urine, it could turn your urine a light pink or even smoky brown colour and in semen it could appear just as a pink streak. Erectile dysfunction is another reason to have an exam and a PSA (Prostate Specific Antigen) test.

12. Upset stomach, stomach ache or acidity: Unexplained stomach aches are one of the early signs of pancreatic cancer – many patients describe a dull ache that feels like it’s pressing inward. Stomach cramps and upsets are sometimes confused with ulcers, but need to be looked into. Catching a liver or pancreatic tumour early can make all the difference in treatment. When it comes to stomach cancers, heartburn or acidity in the upper or middle abdomen are clear warning signs, while an unexplained pain or ache in the lower right side can be the first sign of liver cancer. Feeling full after a small meal is a common sign of liver cancer as well.

13. Frequent fevers or infections: A patient complaining of fever, achiness, and flu-like symptoms over an extended period of time is considered a possible candidate for leukaemia.

14. Excessive bruising or bleeding: Bleeding that doesn’t stop and strange bruises are indications that your blood isn’t clotting normally, a symptom of leukaemia.

15. Weakness and fatigue:  Generalized fatigue and weakness is a symptom of so many diseases (including many types of cancer) that it can be difficult to diagnose the underlying cause. Bringing it to the attention of your doctor is always recommended though.

16. Testicular swelling or lump: Testicular cancers are almost always painless, leading men to ignore the problem. In some cases, the testicle is just enlarged or swollen.

17. Jaundice: Liver cancers, bile duct or Pancreatic cancers can cause jaundice which is most commonly thought of as a yellowing of the skin or whites of the eyes, but dark urine is also a sign as are clay-coloured stools. Jaundice can also cause itching, a result of the bile in the bloodstream.

18. Changes in nails: Unexplained changes to the fingernails can be a sign of several types of cancer. A brown or black streak or dot under the nail is associated with skin cancer, while ‘clubbing’ or the enlargement of the ends of the fingers is a sign of lung cancer. Pale or white nails can be an indication that your liver is not functioning properly, sometimes a sign of liver cancer.

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