You’ve probably heard that some types of cancer are mysteriously rising in people under age 50. Right now, the list includes colon and rectal cancers, followed by uterine, blood, kidney and breast. And maybe you’ve also heard that when it comes to cancer, early signs can be vague. Think: Weight loss, fatigue and enlarged lymph nodes.
It can be tricky to tell if something is serious, but this list can help you know what not to just blow off. Especially if symptoms last longer than two weeks, oncologists would rather have you see a doc and err on the side of caution. “We don’t take any chances, and we investigate thoroughly to make sure that we’re taking the best care of people possible,” says Marla Lipsyc-Sharf, MD.
What are those symptoms an oncologist would want to investigate? They shared the top ones below. Keep in mind: Everything on this list can be explained by plenty of other conditions, many of which are benign. Having one of them doesn’t mean you have cancer – it just means that it’s worth getting an all-clear from your doctor.
12 Symptoms Cancer Doctors Would Never Ignore
1. Unusual Vaginal Discharge Or Bleeding
When it comes to symptoms below the belt, vaginal discharge that has a distinct odour, bleeding after sex and irregular bleeding between your menstrual cycles are three symptoms that could warrant a conversation with your doctor.
Your gynae can conduct a pelvic exam and run a few tests to first rule out if your symptoms are the result of a benign condition (of which there are a lot), such as vaginal dryness, an STI, or fibroids, says Premal H. Thaker. If all benign reasons are ruled out, the next step is to get a Pap test to screen for cervical cancer, she says.
READ MORE: 10 Things No One Ever Tells You About Your Pap Smear
2. A Change In Bowel Habits
Colorectal cancer is “on the rise in younger people for reasons that we don’t quite understand,” says Despina Siolas, so it’s important to take any changes in bowel habits seriously (and to remember to eat enough fibre).
Constipation, diarrhoea, or rectal bleeding that persists for more than two weeks are among potential warning signs. A change in bowel habits is also a possible sign of ovarian cancer. Unfortunately, the early signs and symptoms of ovarian cancer are incredibly vague (think bowel changes, bloating, changes in urination and feeling full quickly), Dr. Thaker says.
But changing bowel habits aren’t just indicative of cancer. Many women struggle with irritable bowel syndrome and other related illnesses – all of which warrant a visit to your doc. So no matter what, it’s important to bring those symptoms to someone to get checked out.
3. Unexplained Weight Loss
“[If] you’re losing more than four kilograms and you don’t understand why, that’s usually a sign that something is wrong,” says Dr. Siolas.
Whether you’re experiencing weight loss over the course of a few weeks or a longer period of time, if it’s unexplained, it’s a potential red flag. “Adults don’t lose weight without trying pretty hard to do so,” says Therese Bartholomew Bevers. “So, it could be a 4kg weight loss over a one month period or a six month period, but the individual was not trying to lose weight and had not changed their diet. Both are a concern to me.”
If weight loss is cancer-related, it could be because the tumour is taking up valuable vitamins and nutrients from the rest of the body, but weight loss could also be attributed to many benign conditions, like hyperthyroidism, which is caused by your body producing too much thyroid hormone. Having a gluten intolerance could lead to malabsorption, which could also cause weight loss, says Steve Lo.
4. Unexplained Weight Gain
On the flip side, “if you have unexplained weight gain in your abdomen accompanied by discomfort, that’s also a sign that maybe there’s something that needs to be checked out,” says Dr. Siolas.
If someone with cancer that originates in the abdomen is experiencing weight gain, it’s usually related to fluid retention, says Dr. Siolas. That’s because the early stages of a tumour can attract a lot of fluid and cause bloating, which is why it may appear you’re gaining weight in the abdomen, she says.
5. Persistent Pain In Your Abdomen Or Pelvis
If you have persistent pain around your pelvis or abdomen, your first step is to head to the gyno for a pelvic exam. It’s a symptom that could be indicative of a number of issues, including painful periods, pain after sex, endometriosis, or polycystic ovary syndrome, says Dr. Thaker.
“In rare cases though, pelvic pain could be a symptom of endometrial cancer. Screening for endometrial cancer typically involves a biopsy or dilation and curettage (D&C),” she says.
If you have PCOS, there’s good reason to pay close attention. “PCOS is associated with an increased risk of endometrial cancer, but it is unclear exactly how,” Dr. Thaker says. Some research suggests premenopausal women who have PCOS are around five times more at risk for endometrial cancer, according to a 2023 meta-analysis published in Oncology Letters.
6. Enlarged Lymph Nodes
Lymph nodes can be found all over the body – from the neck, to the underarms, to the groin area. When lymph nodes are enlarged, the most common cause is actually inflammation or a viral or bacterial infection, says Dr. Lo.
However, swollen lymph nodes – especially ones that persist for more than two weeks – should raise some red flags, says Dr. Thaker. They could be indicative of a variety of cancers, including lymphoma or carcinoma, says Dr. Lo. Though there are exceptions, “cancerous lymph nodes tend to be hard, [while] reactive lymph nodes tend to be soft and tender,” Dr. Lo describes.
7. Changes In The Skin Of Your Breasts
Redness, swelling, warmth and/or dimpled skin on your breasts (resembling the appearance of an orange peel), are symptoms of inflammatory breast cancer (IBC) – a condition that mimics the appearance of a breast infection, says Thomas Buchholz. “It’s a more aggressive form of breast cancer that is commonly diagnosed because the patient themselves notices a change,” he says.
Luckily, more often than not, colour changes on the breasts are actually caused by a rash. “Fungal infections are very common under the breast, especially in the summertime, when people are getting good, sweaty workouts in,” says Dr. Lipsyc-Sharf. At that point, a doctor can prescribe an anti-fungal cream or medication.
But if the area and colour change persist for more than a week and the root cause is determined not to be fungal, your doctor might recommend imaging for further evaluation.
READ MORE: 11 Symptoms Of Breast Cancer In Women That Aren’t Lumps
8. A New Lump That’s Not Going Away
A lump feels ominous and without the help of a biopsy, it’s often tricky to differentiate between a cancerous lump and something less serious (such as an enlarged lymph node), says Dr. Thaker. But some reassurance: “Oftentimes, the lumps that we find are benign,” says Dr. Lipsyc-Sharf. Still, that doesn’t mean that you shouldn’t head to your doctor to confirm.
“What I usually recommend to my patients, my friends and my family is when they first notice something, make a note in their calendar for two weeks from now,” says Dr. Lipsyc-Sharf. After two weeks, if the same lump is still there, contact your primary care doctor to schedule an appointment for a physical exam to determine if you need imaging of that area, she says.
If the lump is located in your breast, your provider can recommend the best breast screening plan for you, which likely includes a mammogram, or possibly an ultrasound, she says.
9. Persistent Breast Tenderness
The most common cause of breast tenderness in both breasts in pre-menopausal women is hormonal fluctuations (a.k.a. your period), says Dr. Lipsyc-Sharf. That’s why she always encourages patients to monitor their symptoms over the course of a couple of weeks to see if that tenderness persists.
It’s pretty common to experience breast tenderness during certain points of your menstrual cycle, especially if you’re experiencing it on both sides, says Dr. Thaker. But if the tenderness is still there after a few weeks, and doesn’t seem to be fluctuating in tune with your hormonal changes, bring it up with a provider.
READ MORE: What To Know About Breast Cancer As A Young Woman
10. Nipple Bleeding Or Discharge
Nipple bleeding and discharge can sometimes occur during pregnancy and breastfeeding, and could be as simple as a papilloma, which is a wart-like growth that develops within your milk ducts, per the ACS. But rarely, this symptom could be indicative of breast cancer, says Dr. Buchholz.
If you’re experiencing nipple bleeding or discharge, regardless of whether you’re pregnant, you should seek care. “Still, [patients] should know that more often than not, these are benign changes rather than cancerous changes,” says Dr. Lipsyc-Sharf.
11. Coughing Or Shortness Of Breath
A lingering cough or shortness of breath could arise from your run-of-the-mill cold, infection, allergies, environmental exposures, chronic obstructive pulmonary disease, or asthma. But they’re also two baseline symptoms of lung cancer, says Saiama N. Waqar. If these symptoms continue for more than two weeks and you’re unsure why, it’s time to see a doctor, she says.
“The biggest risk factor [for lung cancer] is cigarette smoking – and that still remains the case,” says Dr. Waqar. Still, between 10 and 20 percent of lung cancer cases occur in people who have never smoked or had fewer than 100 cigarettes in their lifetime, per the Centers for Disease Control.
If your cough reaches the point where you’re seeing blood, you’ll need to be seen more urgently, says Dr. Waqar. Coughing up blood isn’t a universal symptom of lung cancer, but a tumour sitting in your main airway could lead to it. This symptom could also be caused by something more benign (but still serious) like pneumonia or a pulmonary embolism, she says.
12. Being More Tired Than Usual
Feeling chronically fatigued could be caused by several things, including endocrine disorders, psychiatric issues (like depression), kidney concerns, and heart, lung and bowel absorption problems, Dr. Lo says. That said, “cancer can cause fatigue and again, that’s the challenge that the primary care physician has,” he adds.
Energy is a complicated biological process and everyone will have a different baseline as to what qualifies as fatigue, but if you’re having noticeable changes in your energy level or ability to do things, that’s a sign you need to talk to your doctor.
READ MORE: How Lizelle Knott Turned The Pain From Her Multiple Cancer Diagnoses Into Purpose
Even if you don’t have any of these symptoms, don’t skip your screenings.
With cancer, there might not be any signs at all – and that’s where screening comes in. “Screening is so important because it actually can detect cancer at a very early stage, such that it does not become a long term problem,” says Dr. Lipsyc-Sharf.
Catching cancer earlier via screening means that you’ve hopefully caught it at “a more curable stage of the disease,” says Dr. Buchholz. “Over 90 percent of people survive breast cancer and the survival is very dependent on the stage of the disease or detecting it early.”
And, if you’re someone with a family history of cancer, you might be recommended to get screenings even earlier than others. Doctors can actually estimate your risk of cancer using the health information you provide and then give you a more tailored screening plan. “Knowing your risk can help to find cancers even when there are no symptoms present,” says Dr. Lipsyc-Sharf.
Meet The Experts:
Marla Lipsyc-Sharf, MD, is a breast medical oncologist at UCLA Health. Despina Siolas, MD, is an oncologist at Weill Cornell Medicine and NewYork-Presbyterian. Thomas Buchholz, MD, is the medical director of Scripps Cancer Center in San Diego, California. Premal H. Thaker, MD, is the David and Lynn Mutch distinguished professor of obstetrics & gynaecology, chief of gynaecology oncology, director of gynaecologic oncology clinical research and professor in gynaecologic oncology at the WashU Medicine Siteman Cancer Center. Steve Lo, MD, is the director of medical oncology at the Bennett Cancer Center at Stamford Health. Saiama N. Waqar, MD, is a professor of medicine at WashU Medicine and medical oncologist at the WashU Medicine Siteman Cancer Center. Therese Bartholomew Bevers, MD, is the medical director of the Cancer Prevention Center at the University of Texas MD Anderson Cancer Center.
This article by Caroline Cliona Boyle was originally published on Women’s Health US.
