7 SILENT CANCERS – AND HOW TO SPOT THEM

Vigilance is key against these symptomless or easily misdiagnosed diseases...

Silent cancer is a term that is sometimes used to describe cancers that either do not show any noticeable early symptoms, or whose early symptoms can be mild and overlap with other, less severe conditions, and so lead to individuals not seeking help soon enough.

As a result, silent cancers are often only caught at an advanced stage or incidentally, when the patient’s having investigations for another unrelated condition. They include bowel, cervical, liver, lung, ovarian, prostate and pancreatic cancer.

Here, Dr Ahmed El-modir, consultant oncologist at Spire Little Aston Hospital, talks through these seven silent cancers and the risk factors behind them.

1 Bowel

This refers to cancer of the large intestines (large bowel), which include your colon and rectum. Depending on where it starts, it’s also known as colon cancer or rectal cancer. Common symptoms include persistent abdominal pain, bloating, cramps and changes in your bowel habits – for example, constipation, diarrhoea or thinner stools. You may also notice blood in your stools, have the urge to open your bowels even after recently passing stools, and unintentionally be losing weight.

WHAT CAUSES A GREATER RISK?

The biggest risk factor for bowel cancer is age, with nine out of ten cases in those aged over 60. Your risk is also increased if you have a close family member (parent or sibling) who had bowel cancer before the age of 50. Lifestyle factors can increase your risk, too, including smoking, heavy drinking, a sedentary lifestyle, being overweight, and following a diet low in fibre and high in processed or red meat.

2 Cervical

Cervical cancer refers to cancer of the entrance to the womb (cervix). Almost all cases are caused by the human papillomavirus (HPV).

In the UK, all women over the age of 25 are offered regular cervical screening to test for HPV infection, and the HPV vaccine – available to girls and boys aged 12-13 as part of the NHS’ vaccination programme – reduces the risk of cervical cancer.

Common symptoms include vaginal bleeding in between your periods, during or after sex and after menopause, heavier periods, changes to your vaginal discharge, pain during sex and pain in your lower back, lower

Silent cancers are often only caught at an advanced stage

abdomen and pelvic area.

WHAT CAUSES A GREATER RISK? Cervical cancer is more common in those aged under 45 and those with a weakened immune system – for example, due to HIV or AIDS. Your risk of cervical cancer is also higher if you’ve given birth to children before the age of 17, had multiple births, have not been vaccinated against HPV or previously had bladder, kidney, vaginal or vulval cancer.

3 Liver

Liver cancer can affect any part of your liver, which is located above your stomach on the right-hand side of your body. Many symptoms of liver cancer relate to digestion issues, such as nausea, vomiting, paler stools, darker urine and feeling full after eating only a small amount of food. You may notice a lump on the top right side of your abdomen, feel pain in this area, and experience abdominal swelling that isn’t caused by eating. Other symptoms include jaundice, where the whites of your eyes become yellow, pain in your right shoulder, unintentional weight loss, loss of appetite, fatigue, fever and feeling unwell. WHAT CAUSES A GREATER RISK?

Your risk of liver cancer is higher if you are male, have a close relative (sibling or parent) who had liver cancer, or are aged over 60. Your risk is also raised if you have diabetes, gallstones, hepatitis, HIV, liver cirrhosis or are infected with liver flukes – parasites that can cause diseases of the liver and bile duct.

4 Lung

Lung cancer is the leading cause of cancer death in the UK and mainly affects those aged over 40. Symptoms include a persistent cough, breathlessness when performing activities that usually aren’t a strain, coughing up blood, fatigue, loss of appetite, pain in your chest or shoulders, repeated or persistent chest infections, and unintentional weight loss.

WHAT CAUSES A GREATER RISK? Seven out of ten cases of lung cancer are caused by smoking. Chronic obstructive pulmonary disease, which is more common among smokers, is also a major risk factor. Other risk factors include frequently breathing in diesel fumes and other toxic chemicals, such as arsenic, asbestos, coal fumes and silica. Exposure to high levels of radon gas, which is found in nature but can become concentrated in buildings, also increases your risk.

5 Ovarian

Ovarian cancer refers to cancer of the egg-producing organs in women (ovaries). Many of the symptoms of ovarian cancer overlap with period symptoms, which is why how often you experience these symptoms is important. Common symptoms include abdominal bloating, back pain, fatigue and persistent pain or tenderness in your pelvic area. Other symptoms include constipation, diarrhoea, loss of appetite, feeling full after eating only a small amount, unintentional weight loss, sudden urges to urinate and urinating more often. WHAT CAUSES A GREATER RISK? Women aged over 45 are most at risk, as well as women with diabetes or endometriosis, women carrying the faulty BRCA1 and BRCA2 genes, and those with a close female relative (mother or sister) who had ovarian cancer. Smoking and being overweight also increases your risk, as can taking hormone replacement therapy (HRT) to treat menopause.

6 Pancreatic

Pancreatic cancer can affect any part of your pancreas, which sits behind your stomach where your ribs meet at the bottom of your breastbone. Many symptoms of pancreatic cancer relate to digestion, such as bloating, changes in your stools, constipation, diarrhoea, nausea and vomiting. You may also experience back pain and pain in your upper abdomen, which feels better when you lean forward and worse when you lie down or eat. Other symptoms include jaundice, unintentional weight loss, loss of appetite, fever and fatigue.

WHAT CAUSES A GREATER RISK?

Your risk of pancreatic cancer is higher if you smoke, drink heavily, are overweight or aged over 75. Although most cases of pancreatic cancer do not run in families, you are at increased risk if a close relative (parent or sibling) had pancreatic cancer or if you carry a faulty BRCA2 gene. Certain medical conditions also increase your risk, including chronic (long-term) pancreatitis, diabetes, gallstones and metabolic syndrome.

7 Prostate

Prostate cancer refers to cancer of the prostate gland in men, which is a walnutsized gland that makes the f luid part of semen. It is located at the base of the bladder and surrounds the tube through which urine leaves your body (urethra). Symptoms of prostate cancer usually only occur once the tumour is large enough to press against the urethra. Symptoms include difficulty urinating, needing to urinate more often and the sensation that your bladder is not completely empty even after urinating.

WHAT CAUSES A GREATER RISK?

Your risk of prostate cancer increases with age and, consequently, is more common in men aged over 50, with most cases occurring in men aged between 75 and 79. You are also at greater risk if you are overweight or obese, or have a close relative (father or brother) who had prostate cancer. Men of Afro-caribbean descent have a higher risk than Caucasian men, while men of Asian descent have a lower risk than Caucasian men.

Lifestyle factors can increase your risk, such as smoking and drinking