1. Weight loss you did not plan
Losing more than about 5 to 10 percent of body weight without trying can be a warning sign. Cancers sometimes linked with this pattern include lung, stomach and pancreatic cancer. It is more concerning when appetite is also poor or fatigue is new. Infection, thyroid disease, depression and diabetes are among the many other explanations.
2. Fatigue that rest does not fix
Ordinary tiredness improves with sleep. Fatigue that is new, progressive and out of proportion to the day can be associated with blood cancers such as leukaemia, or with colon cancer, among other illnesses. It is a reason for a blood count and a clinical review, not for a self-diagnosis.
3. Acidity or difficulty swallowing that continues
Long-standing reflux is common and usually benign. If it persists despite treatment, or if food begins to stick, the oesophagus and stomach need a proper look. Those symptoms can, less often, be linked with oesophageal or stomach cancer. Do not keep changing antacids for months without an examination.
4. Bleeding or discharge that is unusual
Blood in the stool can be a sign of colorectal cancer, and of piles. Blood in the urine can come from infection, stones, or a cancer of the bladder or kidney. Bleeding after menopause, or between periods, needs a gynaecological assessment. Any of these should be seen promptly. None of them proves a diagnosis on its own.
Related: Colorectal cancer
5. A new lump or thickening
Most lumps are not cancer. A lump that is new, growing, hard, or unexplained still needs examination. That includes a breast lump, a neck node that does not settle, and swelling in a testicle.
Related: Breast cancer
6. A cough or hoarseness that lasts
A cough still present after about three weeks, coughing up blood, or a hoarse voice that does not recover should be assessed. Lung and throat cancers are among the possibilities, particularly in people who smoke or have another risk factor. Non-smokers are not exempt.
Related: Lung cancer
7. A change in bowel or bladder habit
Constipation or diarrhoea that becomes the new normal, narrower stools, or a persistent change in urination can be associated with colorectal or bladder cancer. They are also caused by diet, medicines and infection. Duration is the clue: a change that remains for weeks deserves investigation.
8. An ulcer or sore that does not heal
A sore in the mouth, on the tongue, or on the skin that remains for more than a couple of weeks should be examined. Oral and skin cancers sometimes present this way, especially in people who use tobacco or have significant sun exposure. A dental or skin check is the right first step.
9. A mole or patch of skin that is changing
Look for asymmetry, an irregular border, more than one colour, a diameter that is growing, or a mole that looks different from the others. Those features can be signs of melanoma. A changing lesion should be seen. It should not be watched across several months of photographs at home.
10. Pain without a clear cause
Cancer is not usually painful at the very start, but pain can be an early clue. Persistent bone pain, or abdominal pain without a diagnosis, needs evaluation. Possible associations include bone tumours and, in the abdomen, ovarian or pancreatic cancer. Pain also has many non-cancer causes. Unexplained pain that continues is the reason to book a visit, not a reason to decide the diagnosis in advance.
When to see a doctor
The practice website suggests a cancer specialist review when symptoms last beyond two or three weeks, when several of these changes are present together, or when there is a strong family history. A general physician is often the right first appointment. A medical oncologist becomes important once cancer is suspected or confirmed, or when a family wants advice on what the symptoms might mean.
This list is education. It is not a screening tool and it cannot tell you that you do, or do not, have cancer.
Related: How to request a consultation, About Dr. Rajit Rattan
Questions patients ask
Do these symptoms mean I have cancer?
No. Each of them has common non-cancer causes. The reason to act is that cancer is one of the causes, and it is easier to treat when it is found earlier.
How long should I wait?
A symptom that is severe, or includes bleeding, breathlessness or rapid weight loss, should be assessed promptly. A milder change that is still present after two or three weeks also deserves a clinical visit rather than another month of waiting.