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March 10, 2008

7 Warning Signs of Cancer You May Miss
Joan Liebmann-Smith, PhD and Jacqueline Nardi Egan

We all know the important warning signs of cancer: a breast or testicle lump, unusual bleeding, and a change in a skin mole. Unfortunately, by the time some of these are noticed, the cancer is often in its later, more difficult-to-treat stage. But there are some lesser-known, more subtle signs that are frequently the earliest clues of cancer. Unfortunately, they're easily missed or even ignored usually because they're vague and may mimic other far-less serious problems. But by paying close attention to them, you can discover the cancer when it's most treatable, thus saving precious time, and, most importantly, lives.

Here are 7 early and all-to-often overlooked signs of cancer that you shouldn't ignore in yourself or your loved ones:

1. Abdominal Bloating
Having a bloated or distended abdomen can be an early and sometimes the only warning sign of ovarian cancer. One of the deadliest cancers in women, ovarian cancer kills nearly 15,000 women a year in this country. About 80% of ovarian cancers have spread (metastasized) before they're diagnosed. But like many cancers, prognosis is good if detected and treated early.

Persistent abdominal bloating - that's bloating lasting for more than 2 or so weeks - must be taken seriously. Some other early warning signs of are difficulty eating or feeling full quickly or having frequent or urgent needs to urinate. (See below).

Abdominal bloating can also signal other cancers, in particular, colorectal cancer. Colorectal cancer is one of the most common cancers in the US, striking more than 150,000 and killing more than 50,000 every year. Other subtle warning signs are a change in bowel habits (such as diarrhea, constipation, or narrowing of the stool) that lasts for more than a few days or a feeling that you need to have a bowel movement but the urge isn't relieved when you do.

2. Frequently Feeling Full
As mentioned above, often feeling full, even after eating a small meal, can be a sign of ovarian cancer. But it can also signal cancer of the pancreas or stomach. About 38,000 people in the US die from pancreatic cancer every year, making it the fourth leading cause of cancer death. Other commonly overlooked signs of pancreatic cancer, which affect men and women equally, are loss of appetite and loosing weight without trying (see below), yellowed eyes and/or skin (jaundice) and pale, bulky, greasy, floating stools.

A feeling of fullness in the upper abdomen after a small meal is one of the more common signs of stomach cancer. Unfortunately, even this sign often isn't noticed until stomach cancer is more advanced. As might be expected, unintentional weight loss is another sign of stomach cancer, which usually affects older adults and men more than women. Once the leading cause of cancer deaths in the US, it still kills 11,000 people annually. (Lung cancer now heads the list of deadliest cancers in both men and women.)

3. Frequent Urination
Having to urinate a lot, or feeling that you need to go but can't, are both insidious signs of bladder cancer, which strikes more than 67,000 Americans annually. Men are about 3 times more likely than women to develop it, and older people are more likely to be affected. Reddish-yellow or occasionally dark red urine are also possible signs.

And, as mentioned above, needing to urinate frequently or feeling you have to go right away can also be subtle signs of ovarian cancer. Like many other nonspecific signs of cancer, urinary problems can also signal other conditions besides cancer, especially urinary tract infection or prostate enlargement in men.

4. Breast Swelling or Other Changes
Finding a lump in her breast can make any woman's heart sink. While a lump is the most common sign of breast cancer, there are other more subtle signs to look out for. Swelling of the whole breast or part of it, especially if there is skin redness or discoloration, can signal a rare, highly aggressive, and deadly form of cancer, inflammatory breast cancer (IBC). Skin irritation, dimpling, itching, or scaliness; thickening of the nipple or breast skin; and nipple discharge other than milk can be other warning signs of IBC and other types of breast cancer.

And it's not just women who should look for these signs. About 2000 men in the US were diagnosed with breast cancer last year, and about 450 died from it. Men who've been exposed to chest radiation should be particularly vigilant. The good news is that whether you're a man or a woman, breast cancer that's found early is highly treatable.

5. Unintended Weight Loss
Most of us seem to be forever trying to shed a few pounds. But losing weight when not trying can be an important tell-tale sign of cancer. Indeed, according to the American Cancer Society, losing more than 10 pounds unintentionally is the first sign of many cancers. Unexplained weight loss is particularly common in cancer of the stomach, pancreas, lung, and occasionally kidney cancer. As might be expected, loss of appetite is also common - although some patients lose weight despite having a good appetite and eating normally. Some also report nausea, vomiting, and fatigue.

6. Hoarseness
Hoarseness is easily chalked up to a cold or allergy, or even to straining your voice. But persistent hoarseness should be heeded. People who suffer from GERD (gastrointestinal reflux disease) often complain of hoarse voice, which is caused when stomach acids push up into the esophagus. However, as one might suspect, chronic hoarseness is common among smokers and can be a sign of throat or lung cancer. A hoarse voice can also signal esophageal, stomach, and thyroid cancer.

7. Stripped Nail
A dark band down a finger or toenail - particularly the thumb or big toe - may not seem like much to worry about. But this often-ignored sign may signal one of the most deadly types of skin cancer, melanoma. Unfortunately, melanoma is on the rise, especially in young people. More than 56,000 people in the US are estimated to be diagnosed with the killer skin cancer this year, and more than 8,000 will die from it. Often written off as a bruise, these dark-streak melanomas are responsible for more than one-third of melanomas in people of color.

Take Note of All Your Body Signs
Many of the body signs discussed above, as well as a myriad of others, can point to less serious medical problems than cancer. But the only way to know for sure is to discuss them with your doctor. More than likely, an occasional, short-lived bout of belly bloating, hoarseness, or frequent visits to the bathroom is inconsequential. But if any of these subtle signs lasts more than just a couple of weeks, it should be brought to your doctor's attention. Remember, early detection means quicker treatment and a better outcome. This is particularly true when facing a diagnosis of cancer.

Author Joan Liebmann-Smith, Ph.D., is a medical sociologist and award-winning medical writer. Her articles have appeared in American Health, Ms., Newsweek, Redbook, Self, and Vogue, and she has appeared on numerous television talk shows, including The Oprah Winfrey Show and The Today Show. She has a daughter, Rebecca, a cat, Fazelnut, and lives with her husband, Richard -- also a writer -- in New York City.
Jacqueline Nardi Egan is a medical journalist who specializes in developing and writing educational programs with and for physicians, allied health professionals, patients, and consumers. She is also a former medical editor of Family Health magazine. She has a daughter, Elizabeth, two dogs, Coco and Abby, and divides her time between Darien, Connecticut, and Sag Harbor, New York.
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