BREAST CANCER AND WHAT WOMEN SHOULD KNOW! By Agency
Surprising signs of cancer
If you were to find a lump in your breast, you’d have it looked at, wouldn’t you? Well, odd or unfamiliar symptoms like swelling in your neck, skin sores that won’t heal, or unrelenting pain deserve the same sort of vigilance.
There’s no need to leap to hair-raising conclusions—What if it’s cancer?—when it could easily be something else. But the sooner you get diagnosed, the quicker you and your doctor can take appropriate action.
“With all cancers, early diagnosis is key,” explains Stephen Rubin, MD, chief of the division of gynecologic oncology at Fox Chase Cancer Center in Philadelphia, “so women ought to feel free to see their physician to have these things checked out.”
Depending on your symptoms, medical history, and physical exam results, your doctor may order specific diagnostic tests or procedures to look for cancer and determine if and how far it has spread.
We asked physicians specializing in head-and-neck, gynecologic, breast, blood, lung, skin, and other malignancies to describe little-known cancer symptoms women ought to know about. Some of these indicators are surprising and others are more intuitive, but none of them should ever be ignored.
A pearly pimple
Heads up, tanners. The most commonly diagnosed cancer in the U.S. is actually skin cancer, specifically a type called basal cell carcinoma, which is linked to ultraviolet light exposure.
Marc Glashofer, MD, a board-certified, private-practice dermatologist specializing in skin cancer in Northern New Jersey, says basal cell carcinomas sometimes have a pearly translucent or waxy appearance. Other times these cancers look like sores, scaly patches, or cyst-like bumps.
“A lot of times people come in and say, ‘Hey, I’ve got this pimple on my cheek or my nose; it’s not going away.’” Usually these cancers are slow growing and highly treatable, Dr. Glashofer says, adding that any bump persisting for six to eight weeks ought to be checked out.
Foreign body sensation
An annoying lump-in-the-throat feeling often goes hand-in-hand with acid reflux. But sometimes that awkward sensation is telling you a tumor is present.
“It’s almost like, OK, did I swallow a chicken bone? Is there a hair back there?” says Bruce Davidson, MD, professor and chairman of otolaryngology-head and neck surgery at Georgetown University Medical Center in Washington, D.C. One patient bothered by this symptom saw multiple doctors over five years before seeing Dr. Davidson, who found a tiny back-of-the-tongue cancer using a scoping procedure.
Dr. Davidson says base-of-tongue and tonsil tumors are on the rise due to human papillomavirus infections, which are often acquired through oral sex. HPV can lay dormant in the body for years before producing symptoms, he adds, so people may not know they’re even at risk of oral head-and-neck cancer.
As strange as it sounds, unexplained itching can be a sign of lymphoma, according to Craig Moskowitz, MD, physician-in-chief for oncology at the University of Miami Health System’s Sylvester Comprehensive Cancer Center.
Itch is such a non-specific symptom, people often go from internist to dermatologist seeking relief, he says.
If you’ve seen the dermatologist or sought a second opinion and “nobody can really figure out why you’re having generalized itching, you really need to pursue a possible diagnosis of an underlying malignancy,” he says.
What does it mean when one ear constantly aches, but there’s no sign of infection? It may not be an ear problem at all. It might be “referred otalgia,” meaning pain that travels to the ear from nerves in the head or neck. Lots of conditions can trigger this sort of ear discomfort. One of them is oral cancer.
“An early cancer on the back of the tongue or tonsil might have pretty subtle symptoms,” explains Dr. Davidson. Someone can have ear pain without other symptoms for weeks or months before the oral cancer is uncovered, he says.
It could also be a sign of a later-stage mouth cancer that’s “burrowing down and starting to interfere with those nerves,” he explains.
Spotting or irregular periods may be due to a hormonal imbalance. It can also signal the presence of uterine fibroids or polyps. Sometimes, though, unusual bleeding is a sign of endometrial cancer (also known as uterine cancer).
Dr. Rubin says any abnormal bleeding ought to be promptly evaluated, especially after menopause (because bleeding in older women isn’t normal) or before menopause in women with risk factors for endometrial cancer, such as obesity.
Most endometrial cancers are diagnosed at stage 1, when they’re “highly curable,” he says.
A droopy eyelid
A droopy upper eyelid can be a sign of aging, injury, or disease (like stroke). It can also alert doctors to the presence of a so-called Pancoast tumor at the very top of your lung. Smokers and people exposed to secondhand smoke or asbestos are at higher risk of developing this type of lung cancer, typically a non-small cell carcinoma.
Cough is not an early symptom. One of the first signs can be severe shoulder pain. Some people develop Horner’s syndrome, a triad of symptoms including a droopy eyelid, constricted pupil, and loss of sweating on the same side of the face.
Because of its location in the tip, or apex, of the lung, a Pancoast tumor can irritate the nerve root to the eye and the face, explains Abirami Sivapiragasam, MD, a medical oncologist and assistant professor at State University of New York Upstate Medical University in Syracuse.
Scaly patches or warty lumps
What is that red, scaly patch of skin? If it’s on a sun-exposed area of your body and it’s still there eight weeks later, don’t assume it’s eczema, Dr. Glashofer cautions. It could be a sign of squamous cell carcinoma.
This type of skin cancer sometimes has a “warty-looking” or “dome-shaped” appearance, he says. It commonly shows up on the head, neck, and back of the hands. Women tend to find it on the front of their legs from years and years of sun exposure, he says.
The Skin Cancer Foundation says squamous cell carcinoma is almost always curable when caught early.
Blood in your stool (if it’s not caused by a hemorrhoid) is a classic sign of colorectal cancer, the third most commonly diagnosed cancer in the U.S. But according to the American Cancer Society (ACS), anemia, which can make you feel tired, lightheaded, and dizzy, can sometimes be the first sign of this cancer.
The reason? Colorectal cancers can bleed into the digestive tract, the ACS says. While you may not always detect rectal bleeding–“It tends to be microscopic bleeding,” Dr. Moskowitz explains–blood loss over time can lead to low red blood cell counts.
A hoarse voice
Some people temporarily lose their voice when they catch a bad cold. Hoarseness that persists is a different matter and should be evaluated promptly.
Laryngeal cancer attacks tissues in the part of the throat that houses your vocal cords. This type of cancer might also cause throat pain, ear pain, or a lump in the neck or throat. According to the National Cancer Institute (NCI), cancer of the larynx can also spread to the thyroid, trachea (wind pipe), or esophagus.
The ACS says rates of new cases of laryngeal cancer are declining, likely because fewer people are smoking.
Occasional abdominal pain or bloating is a common complaint not specific to cancer. You might have a GI problem, like irritable bowel syndrome. In rare cases, though, bloating and pelvic discomfort are signs of ovarian cancer.
Only 1.3% of women in the U.S. will be diagnosed with ovarian cancer during their lifetime, according to the NCI.
However, the ACS says ovarian cancer is the fifth-leading cause of cancer deaths in women (not counting non-melanoma skin cancers).
A lump in your neck
Not all lumps are cancer. You could have swollen lymph nodes due to a recent infection or a slow-growing cyst in your neck. Likewise, a nodule or swelling in the center of your neck where your thyroid is located is most likely benign but should be checked for cancer.
Women are three times more likely to develop thyroid cancerthan men. The good news: It’s usually slow growing and highly curable.
“The vast majority of these cancers are small and picked up because the primary care doctor felt a lump, or maybe the patient feels a lump,” Dr. Davidson says.
Breast swelling or dimpling
It should go without saying that any unusual breast changes (not just lumps!) require immediate attention. Breast pain, redness, and swelling are typical signs of mastitis, a common breast infection, particularly in breastfeeding moms. But did you know that inflammatory breast cancer can cause the same symptoms?
Women who develop this aggressive type of cancer may have thickening of the skin of the breast and dimpling, making the breast look like the peel of an orange.
“It can spread very quickly, so it’s managed very differently than routine breast cancer,” says Dr. Sivapiragasam.
Nipple crusting or discharge
Don’t confuse skin changes affecting your nipple and areola with eczema or dermatitis. Itching, tingling, flaking, crusting, or bloody or yellowish discharge may be signs of Paget disease, a rare cancer that’s often associated with an underlying tumor in the same breast.
According to the NCI, up to 4% of breast cancers involve Paget disease. The average age of diagnosis is 57, but it can affect anyone—from adolescents to octogenarians.
“Eventually, if you don’t address it, it can progress,” Dr. Sivapiragasam says.
Bone pain may be the result of an injury, infection, or osteoporosis. Or, it can be a sign of cancer.
Unexplained bone pain, especially in the spine, pelvis, and ribs, may be a symptom of multiple myeloma. This type of cancer affects plasma cells found in bone marrow. It’s more common in older adults and African Americans.
Bone or joint pain in people who have symptoms such as fever, fatigue, or weight loss can be a sign of leukemia, a type of blood and bone marrow cancer.
Pain after drinking alcohol
You can get a wicked hangover from imbibing too much. But, in rare cases, unexplained pain after consuming alcohol suggests a diagnosis of Hodgkin lymphoma.
A published case study describes a 31-year-old man who experienced severe pain moments after taking just two to three sips of alcohol. He’d had the same reaction for three months, with no pain after swallowing other liquids or food. A biopsy of a lymph node confirmed his diagnosis.
“Usually these patients can have some swollen lymph nodes in the neck or the chest,” Dr. Moskowitz says. Alcohol consumption seems to induce pain in these lumps.
This cancer of a type of white blood cells called lymphocytes is most common in early adulthood and after age 55, according to the ACS.
Feeling like you need to pee all the time? Or all of a sudden? Urinary symptoms are common in women with urinary tract infections, overactive bladder, or type 2 diabetes. Much less often, urgent or frequent urination suggests an ovarian mass is pressing on the bladder.
As for blood in the urine, it can signal a nasty urinary tract infection that’s traveled to the bladder. Or it can be a sign of a kidney stone. Less commonly, bloody urine is a symptom of bladder or kidney cancer.
Kidney cancer is one of the 10 most common cancers in the U.S. affecting both women and men.