Let's Talk About the Signs and Symptoms of Cancer
A zillion symptoms look like cancer—but they don’t always, or even usually, mean you’ve actually got cancer. Learn the details so you can rest easy…or get yourself to the doctor if need be.by Erin L. Boyle Health Writer
You feel a lump where one shouldn’t be. Or this cough won’t go away, and you know it’s not leftover from a cold. Maybe you’ve been feeling tired, more tired than you’ve ever been before. Or you’ve lost weight but it happened far too quickly, and let’s be honest—you weren’t really trying. Are these signs or symptoms of cancer? Since it can be hard to know, here’s what to look for so you can take care of yourself without worrying needlessly.
Our Pro Panel
We went to some of the nation’s top experts in cancer to bring you the most up-to-date information possible.
Josephine (Joy) Feliciano, M.D.
Medical Oncologist, Assistant Professor of Oncology
The Johns Hopkins University School of Medicine
Swati Kulkarni, M.D.
Surgical Oncologist, Associate Professor of Surgery
Feinberg School of Medicine, Northwestern Medicine
Dale Shepard, M.D., Ph.D.
Medical Oncologist (specializing in 18 cancers)
Cleveland Clinic Hematology and Medical Oncology
With about 90% to 95% of cancers caused by genetic mutations that happen during our lifetimes, we can do things to help reduce our risk of cancer. The top suggestions are basic healthy-living advice: Stop smoking, maintain a healthy weight, reduce sun exposure (and wear sunscreen), and eat a well-balanced diet. Other ways to help prevent advanced stage cancer include having regular, age-appropriate cancer screenings to catch precancerous cells or cancer in early stages when it’s easiest to treat, so be sure to talk to your doctor about when and what those screenings are. And if you think you might have an inherited genetic link to cancer (about 5% to 10% of people of those with cancer), it’s a good idea to discuss genetic testing with your doctor, too.
Cancer = cells that don’t stop growing when they’re supposed to. They’re abnormal, unhealthy, and just keep going and going. These cells often form tumors (though in certain cancers, like leukemia, they’re in the blood stream instead) that invade key organs, including the lungs, brain, and liver, disrupting normal bodily functions. At the start, cancer cells make it difficult for those organs to do their jobs, and then as they increase in size and location, they can make it impossible for your organs to properly function. Symptoms increase and worsen. As your body systems shut down and these abnormal cells spread to more areas, they cause continued damage and destruction—and, unfortunately, this can lead to death.
Also called metastasis (or metastatic), stage IV cancer is advanced disease that has spread to multiple places in your body. It’s often not possible to be cured of cancer at this stage, but you can potentially live years with advanced stage cancer and have a good quality of life, thanks to treatments like targeted therapy.
The oldest description of cancer currently on record is from an ancient Egyptian textbook on trauma surgery from 3000 BC, called the Edwin Smith Papyrus. The word for cancer first showed up in medical literature after that, around 400 BC, as “karkinos,” meaning crab in Greek, named by Greek physician Hippocrates (for whom the Hippocratic Oath is named). He called it this because a tumor, which is surrounded by swollen blood vessels, reminded him of a crustacean in the sand, its legs forming a circle. Later, Roman physician Celsus (28-50 BC) translated the Greek term into cancer, the Latin word for crab. From that time on, other physicians and scientists sought to figure out what cancer is, and what causes it, with various theories along the way.
First, What Exactly Is Cancer?
Cancer is the abnormal growth of cells that can form malignant tumors or not (as in blood cancers). Just because a cell is abnormal doesn’t necessarily mean it’s cancerous. It could be benign (not cancer), or precancerous or premalignant (likely to become cancer). If it’s malignant, it’s already cancer. Doctors can test tissue to determine which it is.
Are Cancer Signs and Symptoms the Same Thing?
So we know what we’re talking about, let’s start here: What’s the difference between a “sign” and a “symptom” of cancer?
Signs are what your healthcare professional (or anyone else, really, outside of yourself) can examine and witness.
Symptoms are what you, the patient, experience.
In other words, signs are objective (so oftentimes, measurable), while symptoms are subjective (what you say, basically). An example in cancer might be this: You have redness, swelling, or a mass that your doctor can see, while you experience pain in your breast that you can’t show your doctor but you very much know is there.
What Are Some Common Signs and Symptoms of Cancer?
The first thing to know—and this is important: This list is not exhaustive. Even if you don’t have any of these signs or symptoms, you could still have cancer. On the other hand, you could have these symptoms and not have cancer. (For instance, a whopping 80% of lumps in the breast are not cancer!)
It’s vital to know your body and, most importantly, to listen to it. You—in conjunction with your healthcare professional, of course—are the best judge of your health. This list is just a starting point, to help you feel informed and in control.
Second: With cancer, your signs and symptoms can be different depending on whether it’s a solid tumor cancer (like breast or testicular cancers) or blood cancer (like leukemia and lymphoma). And signs and symptoms can indicate the stage of the cancer, too—for instance, blood cancers often have fevers as an early sign of cancer, while fever can indicate that solid tumors have spread and are more advanced.
If your cancer has gone elsewhere in your body, like to your lungs or brain or bones, you might have symptoms at the primary site (where the cancer started—so, say, nipple changes or discharge if you have breast cancer—but also, for example, shortness of breath or bone pain from where the cancer has spread (metastasized) to the lungs or bones.
Here are potential problems you might experience if you have cancer:
Pain. New pain that’s persistent could be a symptom of cancer. A key word here: persistent. Persistent, continuing neck pain could be a symptom of head and neck cancer, as could pain when chewing and swallowing food. Cancer that’s spread to the bones could cause pain in the long part of the limbs (and not the joints). Or it could be early stage bone cancer or testicular cancer. Back pain could be a symptom of spinal cord involvement of metastatic cancer originating from the primary cancer such as colon, rectal, or ovarian cancer.
Fatigue. This can be a tricky symptom because it can differ from individual to individual and be totally unrelated to cancer. But it can also be a common cancer symptom for many different cancer types, including stomach, colon, and leukemia. This fatigue is an intense exhaustion that doesn’t get better with rest.
Bleeding. You could be coughing and see blood (potentially lung cancer). Or you could have blood in your urine (potentially bladder or kidney cancer) or stool (potentially colon or rectal cancer) or if you’re a woman, your vagina (potentially cervix or uterine cancer). There can be non-cancerous reasons for these—urinary tract infection, hemorrhoids, vigorous sex—but still, if you see blood anywhere it shouldn’t be, tell your healthcare professional. Any change in your bowel movements or change in urination, as well as abnormal vaginal bleeding, could be cause for concern, so make sure to let your doctor know.
Unexplained weight change. Have you lost or gained weight suddenly, seemingly without trying? A good indicator of a problem can be losing 5% of your body weight or more, or 10 pounds or more, in six to 12 months, in an unexplained way. This loss can be common in pancreas, stomach, esophagus, and lung cancers. Unexplained weight gain can be a sign of an issue, too.
Cough. This one is a persistent cough that won’t go away. A cough with blood is also cause for concern and could mean lung cancer. Along with coughing, keep in mind that shortness of breath and/or chest pain could also indicate lung cancer.
Skin changes. Have a new mole that looks discolored? Or an older one that’s changed shape and is now an irregular mole? These moles, called dysplastic nevi, are a risk factor for melanoma, a type of skin cancer. Have new skin changes that concern you, like open sores that won’t heal, red patches or irritated areas on the face, chest, shoulder, arm, or leg that crust, itch, hurt, or cause discomfort? These (and more) could be signs of basal cell carcinoma, the most common type of skin cancer.
Neurological issues. Headaches that make no sense and you can’t explain—especially if they start coming more often, and with higher intensity: This type of new pattern, or suddenly having headaches when you didn’t before, could be an indication of a cancerous brain tumor like a glioblastoma. However, don’t think that headaches are your only tipoff of a brain tumor or even cancer metastasized to the brain, because they aren’t the main neurological signs and symptoms of cancer—more common ones include seizures, difficulty speaking, weakness on one side of the body, and vision changes.
Lumps and bumps. Cancerous tumors can sometimes be felt through the skin, and happen most commonly in the breast, testicles soft tissues, and lymph nodes (also known as glands). (They could also be non-cancerous masses, called benign tumors). A quick side note: If you have persistent swollen glands, it could be a sign of something beyond a simple infection, such as non-Hodgkin's lymphoma or chronic lymphocytic leukemia, especially if coupled with night sweats and (again with this sign) weight loss.
Are Cancer Signs Different in Men and Women?
They can be. Because men and women have several different types of cancer based on their physiology—as in (and this may seem obvious but …), men get prostate cancer but women can’t, and women get vaginal cancer, but men can’t—they can have signs and symptoms specific to those cancer types.
For example, cancer symptoms for prostate cancer that women wouldn’t experience include new onset of erectile dysfunction, blood in the seminal fluid, or discomfort or pain when sitting from an enlarged prostate. And cancer symptoms in women with vaginal cancer can include abnormal vaginal discharge and pain during sex.
Some cancers have differences between men and women that you might not expect—take lung cancer, for instance. Men and women have similar symptoms, like a persistent cough, hoarseness, coughing up blood, shortness of breath. What is different between the sexes is that in men, the most common type of lung cancer is squamous cell carcinoma; in women, it’s adenocarcinoma of the lung. And squamous cell carcinoma starts in the center of the lungs, while adenocarcinomas are tumors usually at the edges of the lungs.
Let’s look at another cancer, a common one that occurs in about 68,000 adults in the U.S. a year: bladder cancer. Signs and symptoms of this cancer type include blood in your urine, pain while urinating, and pelvic pain. These can happen in both men and women, but researchers have found that women often have more advanced disease when diagnosed, and a worse prognosis, than men.
Why might this be? Because women dismiss the most basic sign, blood in the urine, thinking it’s related to menstruation or menopause. Then, once they do tell their doctor, said doctor might think it’s a urinary tract infection, cystitis, or even post-menopausal bleeding, and not think bladder cancer. This delays diagnosis and treatment.
How Do I Know if I Have Cancer?
It turns out, you might not have any warning sign or symptom of cancer (this is called being asymptomatic) but you still have cancer. Or you might have a symptom that is so common (fatigue, we literally feel you), you mistake it for normal, everyday life—but it’s actually more insidious.
It’s wise not to try to explain away your symptoms if they don’t make sense, because early detection is huge. It can make a real difference in your cancer prognosis (meaning, the outlook for your cancer journey at diagnosis) and even how you respond to treatment, due to how strong your body and mind are before you start on taxing therapies. Research has also shown that early treatment leads to the best outcomes.
You want cancer to be caught as early as possible, and signs and symptoms can sometimes help. Alex Trebek, host of the game show Jeopardy, who has pancreatic cancer, says that he wishes he had “known sooner” that the persistent stomach pain he experienced was an early warning symptom of the cancer. By the time he was diagnosed, it had advanced to stage 4.
Even if you don’t have any of the classic cancer symptoms, some people still feel concerned they might have cancer (we get it; it’s scary). Maybe you’ve seen family members experience it, so you’re worried you’ll get it too. Or maybe Doctor Google has you freaked. In this case, will a yearly physical exam help? Sometimes, but those exams don’t always catch all—or any—cancers because there’s no one blood test that can find all cancers in all stages. If you have a physical sign or symptom, like a lump or new cough, your doctor can better zero in on tests that could check for, respectively, breast or lung cancer.
How do you know what is and isn’t a cancer sign or symptom? You don’t. At least, not on your own. This is when it’s time to see a healthcare professional. Which leads us to…
When Should I Go to a Doctor If I’m Worried About a Symptom?
Make an appointment with your doctor if you have a sign or symptom that is new, different, troubling you, continues to worsen, and/or is not going away. And stay up to date with age-appropriate cancer screenings, including for breast, colon, cervical, prostate, and even lung cancer.
You might be resistant about going to your doc, and we get it. But if any of these excuses sounds familiar to you, let us try to help you get past them.
You don’t want to bother your doctor. Guess what? Your doctors are in the rule-out-bad-things business. They are there for us. They are there because of us. So go. You won’t be bothering them. You’ll be giving them work.
You’re scared. We’ve been there, up at 2 a.m. Googling signs of breast cancer (or colon or lung or…). What if it is cancer? Well, what if it is? Then, at least, you’ll know. And there’s truth in the phrase “knowledge is power.” Because with knowledge, your anxiety can be eased. Even if you learn you have a problem, you can then develop a game plan, and you’re going to be more empowered knowing, rather than wondering and worrying and letting your fears spiral out of control.
You’re concerned it’ll be expensive. And yes, this is a real concern in this health insurance-happy world we live in, with costly co-pays and deductibles. But this is your life, and you must be your own advocate: If sometimes seems off, say something. Speak up, too, about finances if you need help, to your doctor, your nurse, your practice’s administrator, your pharmacist. They might be able to assist you in finding cheaper ways of doing things, or appeal to your insurance company about certain costs. Also ask them for recommendations on keeping costs as low as possible.
Remember: Knowing your own body is important—and if something seems wrong, say something. It’s far better to have something looked at than to explain it away in your own mind until it becomes a real problem.
Which Doctor Should I See If I Think I Have a Sign or Symptom of Cancer, and What Happens at the Appointment?
The doctor you see should be the one best to deal with your sign or symptom—start with your general practitioner if you don’t have a specialist, or a specialist like an ob/gyn if it’s a breast concern, a gastroenterologist if it’s a colon concern, and so on. If you don’t have a specialist in the area of your sign or symptom, start with your general practitioner.
After you’ve picked up the phone (or sent a message through your patient portal) and made that appointment to see your healthcare professional, it can help to write everything down beforehand, or even keep a symptom diary if you’re noticing recurring symptoms, so you can share precise information with your doc. Saying you experienced blood five out of six bowel movements a week can be more helpful (and make your case for further testing stronger) than “I’ve seen blood in the toilet.”
At your appointment, detail the symptom(s) that are concerning you, including when it/they happen, how often it/they happen, and any other info you want to share. You might have a sign your doctor can observe with a physical exam, like reddening, swelling, or a mass. Or not.
Your doctor will likely take a health history, doing what’s called a “work-up” of the sign or symptom. They’ll send you for blood work or imaging, depending on the type of sign or symptom. Then they’ll share results with you of any testing.
My Sign or Symptom WAS Cancer. Now What?
You’ll likely receive a treatment plan for your cancer, which could include several kinds of treatment, including surgery, chemotherapy, radiation therapy, targeted therapy, hormone therapy, immunotherapy, and/or stem cell transplant. Or it could just be one type of treatment. It all depends on the type of cancer you have, the stage your cancer is in, and if your cancer has spread.
My Sign or Symptom WASN’T Cancer. Now What?
In this case, your healthcare professional might want to follow up on your sign or symptom, to make sure it doesn’t become cancer. That might mean regular visits, say every three or six months. That might mean scans or imaging on a more regular basis, too, like every six months or yearly.
Or it could be that your sign or symptom is just that—a sign or symptom of something that has passed and is nothing to worry about. Make sure you feel secure with whatever “watch and wait” or “leave and let go” plan your doctor wants to follow—and then follow it. Keep in mind that seeking a second opinion is always OK, especially if you’re still concerned about something going on and feel that maybe you’re not being heard as loudly as you’d like at your doctor’s office.
Just remember: Honor your body and what it’s telling you through any and all signs and symptoms.
Cancer Signs vs. Symptoms: American Cancer Society. (2014). “Signs and Symptoms of Cancer.” cancer.org/cancer/cancer-basics/signs-and-symptoms-of-cancer.html
Signs and Symptoms of Cancer: Journal of Hospice & Palliative Nursing. (2012). “The Symptom Experience of Patients with Cancer.” ncbi.nlm.nih.gov/pmc/articles/PMC3358129/
Breast Lump Statistics: Cleveland Clinic. (2015). “Breast Lumps.” my.clevelandclinic.org/health/symptoms/6906-breast-lumps
Skin Cancer Symptoms: Skin Cancer Foundation. (2019). “Atypical Moles and Your Skin.” skincancer.org/risk-factors/atypical-moles/
Headache Symptom: Memorial Sloan Kettering Cancer Center. (2018). “When Is a Headache a Symptom of a Brain Tumor?” mskcc.org/blog/when-headache-symptom-brain-tumor
Prostate Cancer Symptoms: Cancer.Net. (2019). “Prostate Cancer: Symptoms and Signs.” cancer.net/cancer-types/prostate-cancer/symptoms-and-signs
Vaginal Cancer Symptoms: Cancer.Net. (2018). “Vaginal Cancer: Symptoms and Signs.” cancer.net/cancer-types/vaginal-cancer/symptoms-and-signs
Lung Cancer Differences Between Men and Women: Harvard Medical School. (2014). “Lung cancer in women.” health.harvard.edu/newsletter_article/Lung_cancer_in_women
Bladder Cancer in Women: Bladder Cancer Advocacy Network. (2017). “Women & Bladder Cancer.” bcan.org/women-bladder-cancer/
Diagnosing Cancer Earlier: British Journal of Cancer. (2015). “Diagnosing cancer earlier: reviewing the evidence for improving cancer survival.” ncbi.nlm.nih.gov/pmc/articles/PMC4385969/
When to See a Doctor: Preventing Chronic Disease. (2018). “Patterns and Trends in Cancer Screening in the United States.” ncbi.nlm.nih.gov/pmc/articles/PMC6093265/
Origin of Cancer: Siddhartha Mukherjee, M.D. (2010). The Emperor of All Maladies: A Biography of Cancer.