What’s normal? What’s not? LIVE WELL
When it comes to cancer, too many of us are still unaware of red flag symptoms says Michele O’Connor. So when should you worry?
The NHS is “sleepwalking into a cancer crisis” that is setting survival rates back by up to 15 years, experts have warned. NHS data shows tens of thousands are missing a diagnosis due to disruption caused by the pandemic, which could slash their survival chances.
“Diagnosing cancer at an early stage saves lives. If you notice any changes that aren’t normal for you or aren’t going away, talk to your doctor,” advises Dr Angela Rai, of
The London General Practice (thelondon generalpractice.com).
So what should you be looking out for? Persistent heartburn
Normal: Many of us have experienced heartburn after eating a large, fatty or spicy meal and it’s common in pregnancy.
“Some people are prone to regular bouts of acid reflux triggered by caffeine, smoking and acidic foods relieved by over the counter medication,” adds Dr Rai.
Not: If you have heartburn or acid reflux most days, or if it is particularly painful, then you should get checked out. “There are many causes – from hiatus hernia to a stomach ulcer or gastro-oesophageal reflux disease – that can be treated,” explains Dr Rai. “But if you have a family history of gastric cancer and other symptoms, such as weight loss and loss of appetite, oesophageal cancer needs to be ruled out.”
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Always get medical advice if you start to shed pounds for no reason
Bowel changes
Normal: Our bowel patterns can vary depending on what we’ve eaten or if we’re stressed or anxious. Occasional tummy bugs can also trigger diarrhoea but settle down within days, while bowel issues can be a common problem for those with IBS, says Dr Rai.
Not: “See your GP if you notice a new change in your bowel movements lasting longer than a few weeks, such as alternating between diarrhoea and constipation,” advises Dr Rai. “This is very important if you have other symptoms, such as bloating, abdominal discomfort, weight loss or a family history of bowel cancer.”
Croaky voice
Normal: Hoarseness could be due to a cold, overuse of the vocal cords or acid reflux. “A common cause is laryngitis,” says Dr Rai. Not: “A croaky voice which lasts for more than three to four weeks should be investigated, particularly if accompanied by other symptoms, such as swollen glands in the neck, pain or discomfort when chewing and swallowing, a cough or breathlessness,” she explains.
Heavy night sweats
Normal: Sweating at night can be caused by an infection, a side effect of certain medications, and is a common symptom of the menopause.
Not: “Heavy, drenching night sweats could signal a more serious infection such as TB, an overactive thyroid or cancer, such as Hodgkin’s lymphoma,” explains Dr Rai. “All of these complaints will be accompanied by other symptoms but if you are also experiencing fatigue, itching and raised lymph nodes in the armpit or groin, seek
medical advice without delay.”
Difficulty swallowing
Normal: Some people find it difficult to swallow tablets and capsules, while those who suffer with acid reflux may experience a burning sensation in the throat. And most of us have experienced a sore, scratchy throat with a cold or an infection, or after scratching the food pipe after swallowing something sharp, such as a fragment of a tortilla chip.
Not: “Difficulties or discomfort swallowing or chewing, or a feeling that something is
stuck in your throat that doesn’t go away after a couple of weeks, should be checked out,” says Dr Rai. While a number of medical conditions could cause this, it could be a sign of oesophageal or throat cancer.
A sore that won’t heal
Normal: All of us get scrapes and abrasions from time to time and some of us heal faster than others. “Elderly people who bang their shins, for instance, will notice those wounds take a long time to heal because there is a limited blood supply to that area, in particular,” explains Dr Rai.
Not: When a sore doesn’t heal beyond two weeks, even if it’s painless, it should be checked out.
“If you have a sore in the mouth, there could be dental causes, and your dentist is also trained to spot signs of oral cancer,” adds Dr Rai.
An unusual lump or swelling
Normal: Most bumps are benign and are usually cysts or a fatty lump (lipoma), says Dr Rai.
Not: A lump or thickening of tissue can be an early sign of cancer. Lumps in the neck, armpit, stomach, groin, chest, breast or testicle should always be examined by a doctor, says Dr Rai.
A lingering cough
Normal: “It’s normal for a cough to last several weeks and it’s also a common symptom of a viral or bacterial chest infection, asthma, bronchitis and even acid reflux,” says Dr Rai.
Not: A new persistent cough is a key sign of
Covid-19 and if you’re experiencing this symptom then you should get a test and isolate. A cough that doesn’t go away and is accompanied by other symptoms, such as breathlessness, tiredness, loss of appetite and weight, and blood-stained sputum being coughed up, must be investigated,” warns Dr Rai. Smokers and ex-smokers need to be especially conscious of getting long-standing coughs checked out without delay.
Unexplained
weight loss
Normal: Small fluctuations in weight are normal but, if you haven’t cut back on your food or upped your exercise, weight loss can be caused by digestive problems, an infection or depression and anxiety.
Not: “Unexplained weight loss could be caused by an undiagnosed cancer, so always seek medical advice if you start to shed pounds unexpectedly,” says Dr Rai. (Scientists think that some cancers release chemicals into the blood that could contribute to the loss of fat and muscle).
Unusual bleeding
Normal: Vaginal bleeding between periods can often be the result of hormonal changes while fresh, bright-red blood when wiping after opening the bowels is usually piles (haemorrhoids), says Dr Rai.
Not: Bleeding after the menopause should be investigated – even if it is light – as it could signify cervical or endometrial cancer. Vomited or coughed-up blood should never be ignored, nor should darker blood mixed in with stools.