Catching Cancer

I think that cancer is perhaps the most terrifying diagnosis. It is a virulent disease that destroys our healthy cells and spreads quickly, particularly when left undiagnosed and untreated.

I lost my aunt to ovarian cancer. Only 14 years older than I, she was more like a big sister and I adored her. Her loss was awful to me and to all our family members, particularly to her mom, who never really recovered from losing one of her children.

In my aunt’s case, she went misdiagnosed for almost two years. When she was finally diagnosed properly, it was too late for any protocol to work, including several experimental procedures my aunt tried for the benefit of others when we found that nothing was going to work.

The last three years of her life were awful. Every month she endured terrible treatments that caused her to be violently ill for two weeks. The week prior to the treatments she struggled with depression that came with psychologically preparing for the pain of the treatments and the resulting nausea and vomiting. She had only one week a month for any rest at all.

She had been a strikingly beautiful woman, but with the weight and hair loss, she had, of course, become gaunt and colorless. She hated looking in the mirror, but until the end, she tried to stay strong for her family. She’d be the one to redirect the conversation or even tell a joke if any of us would get emotional or tear up.

When she and I had our last serious and, for me, most memorable conversation before her death (and she took time to have one of those with each of us), she told me that she was finally at peace with it all, that she was in fact ready for the end. She said her only regret was that she would not be there for her two daughters when they married and had children. She hated the thought of not being around to help her family. She was a remarkable woman and her loss was awful and unnecessary.

Diagnosing cancer in its earliest stages is the key to treatment and recovery. Please watch for the following symptoms and see a doctor immediately. If you are not comfortable with their diagnosis or their suggestions for testing, seek a second opinion. Doctors can be and often are wrong.

Common Symptoms and Signs of Cancer

•Change in mole or new skin lesions - A mole with irregular shapes or borders, uneven distribution of color or new growth in a mole larger than 1/4 inch, a change in texture, itching, oozing or bleeding.
•Abnormal discharge from any external opening in your body including your nose, eyes, ears, mouth, vagina, anus, sweat glands, and nipples.
•Unilateral pain and swelling in one knee or shoulder but not the other.
•Tumor / bulge / bump / lump anywhere
•Increasing lymph gland - Swollen lymph nodes may be felt in your neck, groin, and armpit, under your jaw and chin, behind your ears or on the back of your head.
•Obstinate fatigue, lethargy - Feeling tired most of the time and your energy does not seem to come back. Don't be too quick to blame your busy schedule. And no you are not a "wimp" if you are worried about fatigue.
•Neurologic deficit - A decrease in brain, spinal cord, muscle, or nerve function such as an inability to speak, numbness or tingling, loss of balance, weakness, visual changes, abnormal reflexes, incessant headache and intractable vomiting.

Source: Archie Bleyer, MD
Medical Director, Clinical Research, St. Charles Regional Cancer Center, Bend, Oregon Clinical Research Professor, Oregon Health and Science University, Professor of Pediatrics, University of Texas Medical School at Houston, Director, Aflac/CureSearch Adolescent and Young Adult Cancer Research


15 Cancer Symptoms Women Ignore
written by Kathleen Doheny and reviewed by Louise Chang, MD

No. 1: Unexplained Weight Loss
Many women would be delighted to lose weight without trying. But unexplained weight loss -- say 10 pounds in a month without an increase in exercise or a decrease in food intake -- should be checked out. Expect your doctor to run tests to check the thyroid and perhaps order a CT scan of different organs. The doctor needs to rule out the possibilities, one by one.

No. 2: Bloating
Bloating is so common that many women just live with it. But it could point to ovarian cancer. Other symptoms of ovarian cancer include abdominal pain or pelvic pain, feeling full quickly -- even when you haven't eaten much -- and urinary problems, such as having an urgent need to go to the bathroom. If the bloating occurs almost every day and persists for more than a few weeks, you should consult your physician. Expect your doctor to take a careful history and order a CT scan and blood tests, among others.

No. 3: Breast Changes
Most women know their breasts well, even if they don't do regular
self-exams, and know to be on the lookout for lumps. But that's not the only breast symptom that could point to cancer. Redness and thickening of the skin on the breast, which could indicate a very rare but aggressive form of breast cancer, inflammatory breast cancer, also needs to be examined. If you have a rash that persists over weeks, you have to get it evaluated. Likewise, if the look of a nipple changes, or if you notice discharge (and aren’t breastfeeding), see your doctor. If it's outgoing normally and turns in, that's not a good sign. If your nipples are inverted chronically, no big deal. It's the change in appearance that could be a worrisome symptom. If you have breast changes, expect your doctor to take a careful history, examine the breast, and order tests such as a mammogram, ultrasound, MRI, and perhaps a biopsy.

No. 4: Between-Period Bleeding or Other Unusual Bleeding
Premenopausal women tend to ignore between-period bleeding. They also tend to ignore bleeding from the GI tract, mistakenly thinking it is from their period. But between-period bleeding, especially if you are typically regular, bears checking out. So does bleeding after menopause, as it could be a symptom of endometrial cancer. GI bleeding could be a symptom of colorectal cancer. Your doctor will take a careful history and, depending on the timing of the bleeding and other symptoms, probably order an ultrasound or biopsy.

No. 5: Skin Changes
Most of us know to look for any changes in moles -- a well-known sign of skin cancer. But we should also watch for changes in skin pigmentation. If you suddenly develop bleeding on your skin or excessive scaling, that should be checked, too. It's difficult to say how long is too long to observe skin changes before you go to the doctor, but most experts say not longer than several weeks.

No. 6: Difficulty Swallowing
If you have difficulty swallowing, you may have already changed your diet so chewing isn't so difficult, perhaps turning to soups or liquid foods such as protein shakes. But that difficulty could be a sign of a GI cancer, such as in the esophagus. Expect your doctor to take a careful history and order tests such as a chest X-ray or exams of the GI tract.

No. 7: Blood in the Wrong Place
If you notice blood in your urine or your stool, don’t assume it's from a hemorrhoid. It could be colon cancer. Expect your doctor to ask questions and perhaps order testing such as a colonoscopy, an exam of the colon to look for cancer. Seeing blood in the toilet bowl may actually be from the vagina if a woman is menstruating. But if not, it should be checked to rule out bladder or kidney cancer. Coughing up blood should be evaluated, too. One occasion of blood in the wrong place may not point to anything, but if it happens more than once, go see your doctor.

No. 8: Gnawing Abdominal Pain and Depression
Any woman who's got a pain in the abdomen and is feeling depressed needs a checkup. Some researchers have found a link between depression and pancreatic cancer, but it's a poorly understood connection.

No. 9: Indigestion
Women who have been pregnant may remember the indigestion that occurred as they gained weight. But indigestion for no apparent reason may be a red flag. It could be an early clue to cancer of the esophagus, stomach, or throat. Expect your doctor to take a careful history and ask questions about the indigestion before deciding which tests to order, if any.

No. 10: Mouth Changes
Smokers should be especially alert for any white patches inside the mouth or white spots on the tongue. Both can point to a precancerous condition called leukoplakia that can progress to oral cancer. Ask your dentist or doctor to take a look and decide what should be done next.

No. 11: Pain
As people age, they seem to complain more of various aches and pains, but pain, as vague as it may be, can also be an early symptom of some cancers, although most pain complaints are not from cancer. Pain that persists and is unexplained needs to be checked out. Expect your physician to take a careful history, and based on that information decide what further testing, if any, is needed.

No. 12: Changes in the Lymph Nodes
If you notice a lump or swelling in the lymph nodes under your armpit or in your neck -- or anywhere else -- it could be worrisome. If you have a lymph node that gets progressively larger, and it's [been] longer than a month, see a doctor. Your doctor will examine you and figure out any associated issues (such as infection) that could explain the lymph node enlargement. If there are none, your doctor will typically order a biopsy.

No. 13: Fever
If you have a fever that isn't explained by influenza or other infection, it could point to cancer. Fevers more often occur after cancer has spread from its original site, but it can also point to early blood cancers such as leukemia or lymphoma. Other cancer symptoms can include jaundice, or a change in the color of your stool. Expect your doctor to conduct a careful physical exam and take a medical history, and then order tests such as a chest X-ray, CT scan, MRI, or other tests, depending on the findings.

No. 14: Fatigue
Fatigue is another vague symptom that could point to cancer -- as well as a host of other problems. It can set in after the cancer has grown, but it may also occur early in certain cancers, such as leukemia or with some colon or stomach cancers.

No. 15: Persistent Cough
Coughs are expected with colds, the flu, allergies, and sometimes are a side effect of medications. But a very prolonged cough -- defined as lasting more than three or four weeks -- should not be ignored. You would expect your doctor to take a careful history, examine your throat, check out your lung functioning and perhaps order X-rays, especially if you are a smoker.