About one in four of us will be diagnosed with cancer at some stage, or have a relative or friend diagnosed, notes the Cancer Association of South Africa (CANSA). And while many cancers are totally asymptomatic, there are some we can screen for. Most will have a cause other than cancer – but always have them checked out with a health professional to be safe. The earlier cancer (or other conditions) are diagnosed, the better the chance of successful treatment.
Unexplained blood
Blood in your urine (haematuria)
This is most likely from a urinary tract infection, kidney stones or other kidney disease. Hematuria could also indicate cancer of the kidney, bladder or prostate. Blood in your urine is however not always an ominous sign as it could also be due to dehydration and trauma such as prolonged endurance events (cycling and running), but should nonetheless be checked out without delay.
Blood in your stools (hematochezia)
Bright red blood in stool could indicate intestinal infection, haemorrhoids, colitis, intussusception and other colorectal conditions. Colorectal cancer should always be excluded especially if you have a change in bowel habits. Colorectal cancer is often asymptomatic and does not present with any pain. See your doctor if you present with bright red blood per rectum.
Melena stool (black stool which indicates old blood)
This is most likely due to and upper gastrointestinal bleed such as stomach and duodenal ulcers. See your doctor if you experience this.
Bloody discharge between periods or intermittent spotting
This could be the result of inflammation or thinning of your vaginal lining, or hormonal changes. But it could indicate cervical cancer (the most common cancer for black women in South Africa, and second-most common for white women, says Herbst), or endometrial cancer or cancer of the uterus. Consult your gynaecologist, especially if you also have pain during intercourse or an increased need to urinate.
Postmenopausal bleeding
Women who have been in menopause and suddenly start bleeding again, should see a gynaecologist without delay. Postmenopausal bleeding is cancer until proven otherwise.
A lump
In your breast
This is most likely a cyst or benign breast adenoma/fibroma, but it could be breast cancer (the most common cancer for white women in South Africa, second-most common for black women, says Herbst). Always have it checked out. Other concerning signs are dimpling, change in skin texture, rash, thickening, tenderness, breast lopsidedness or nipple discharge. Malignant breast lumps are very often not painful. They have irregular edges and are not mobile.
As a general rule of thumb: “pay day is breast day”, meaning that you should examine your breasts at least once a month by touching them with four flat fingers in all four the quadrants.
In your neck
It could be an infection – or, particularly if it’s painless, an early sign of cancer or the mouth, throat, vocal cords or thyroid. If it persists longer than a month, see your doctor.
Under your arm
An infection can cause axillary lymph nodes to swell, but so can breast cancer. A very common condition, hidradenitis supperativa cause painful, recurring axillary lymph nodes. Again, see your doctor if it hasn’t healed in one month.
In a testicle
A painless or uncomfortable lump or an enlarged testicle is a common sign of testicular cancer, although it may simply be due to an infection, hernia or fluid build-up. Have a check-up, urges Herbst.
A persistent cough
It may just be a lingering aftermath of flu, chronic infection such as tuberculosis, sarcoidosis, or side effect of certain blood pressure medication. A chronic cough is very often the only presenting sign in lung cancer and is not always accompanied by hoarseness, shortness of breath, bloody mucus, chest pain, weight loss and fatigue. Smoking of course is a very big risk factor for lung cancer, but not the only one. If you have a lingering cough, have it checked out by your GP.
Persistent fever
Running a temperature is the most common sign of your body fighting infection. It’s also a common sign of leukemia, lymphoma, and other cancers. If it lasts more than a few days and has no other obvious cause, get it checked out.
Appetite loss or anorexia
This could be caused by anything from flu to a gastric bug or depression. But, it’s also a common sign of a number of cancers so don’t ignore it.
Skin lesions and growths
Any growth bigger than a pencil eraser that changes colour has an oddly shaped edge, crusts or scabs and doesn’t heal, needs to be checked – it may be skin cancer.
A change in bowel habits
This is usually the result of a change in diet or fluid intake, infection, stress, constipation, side-effects of medication etc. Colorectal cancer can however present with a sudden change in bowel habit without any other contributing factor, and especially in the elderly population. Routine screening colonoscopies are now recommended from the age 50 onwards, unless 1st degree family history of colorectal cancer. Prostate cancer is the most common cancer for men in South Africa, says CANSA health specialist Professor Michael Herbst.
Sores that don't heal
These may be the result of poor circulation, but when they persist, especially in your mouth, on your gums or tonsils, they can sometimes be indicative of cancer.
Extreme tiredness or fatigue
This is not normal fatigue, but total exhaustion that doesn’t go away, and isn’t improved by changing your level of activity or sleeping more. Common culprits are pregnancy, anemia, exhaustion, hypothyroidism, and depression. See your medical professional.
Unexplained weight loss
If you’re losing weight for no obvious reason, get it checked out. It’s a common effect of many cancers, says Herbst.
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