Could It Be Cancer?

You’ve probably heard that cancer is best caught early, when it’s most treatable. Still, many people don’t head to the doctor when they experience out-of-the-ordinary symptoms, instead attributing them to a less serious disease or other causes, such as age or diet.

“The fact is that many, perhaps most, cancers are diagnosed after patients report symptoms that cause concern to their primary care doctors,” says William Dale, M.D., Ph.D., an associate professor of medicine and section chief of geriatrics and palliative medicine at the University of Chicago Medicine. “That’s partly why it’s so important to talk with your doctor about any changes in your health.”

Symptoms to watch out for

A British survey of more than 1,700 adults ages 50 and older published in the December 2014 issue of PLOS One analyzed how people attribute symptoms experienced in everyday life.

Researchers sent a list of “alarm” symptoms (symptoms publicized by experts as being closely associated with cancer) and “nonalarm” symptoms (noncancerous symptoms unlikely to be associated with cancer, such as dizziness) to participants and asked them to mark symptoms they had experienced in the previous three months.

The researchers then had participants write down what they thought caused each symptom, how serious they thought the symptom was and whether they contacted a doctor about it. Alarm symptoms included an unexplained cough or hoarseness, a change in bowel or bladder habits, unexplained pain, a lump, a change in a mole’s appearance, a nonhealing sore, unexplained bleeding, unexplained weight loss, and difficulty swallowing.

Prevalence of alarm symptoms was high: More than half of the respondents (53 percent) reported experiencing at least one alarm symptom. However, only 2 percent cited cancer as a possible cause of the symptom. For example, respondents perceived changes in mole appearance as no more serious than feeling tired or having headaches, despite the fact that a change in the way a mole looks is a key sign of skin cancer.

Of those who experienced an alarm symptom, 59 percent talked with their doctors about it. Reassuringly, respondents attributed nonalarm symptoms to cancer less often than alarm symptoms and had lower perceived seriousness.

“Certainly, symptoms more closely associated with cancer don’t always indicate cancer; most of the time, they don’t,” Dale says. “And many cancer symptoms are also symptoms of other, less serious conditions, or result from other factors, such as dietary changes. But it’s important to have a knowledgeable provider determine this.”

The researchers hypothesize that this plausibility of other explanations, in addition to a perceived lack of personal relevance and cancer fear, may be why people so often don’t attribute alarm symptoms to cancer or seek further evaluation.

Err on the side of caution

Cancer symptoms vary, depending on the site of the cancer, a tumor’s size, the disease’s effect on organs and tissues, and whether the cancer has spread, or metastasized. Symptoms can range from general immune responses, like fever, to more widely recognized cancer signs, like a lump.

While general symptoms can also have other causes—and are more often caused by something other than cancer—it’s better to err on the side of caution and have them checked out.

“If it’s cancer, you’ll be more likely to catch it while it’s in an early, more treatable stage,” Dale says. “If it isn’t cancer, your doctor can diagnose the problem and treat it if needed, or reassure you that it’s not something that needs to be treated at all.”

Read more about symptoms that should be checked out, including bleeding after menopause and trouble breathing.