Beth Y. Karlan, MD, director of the Women’s Cancer Research Program at Cedars-Sinai’s Samuel Oschin Comprehensive Cancer Institute in Los Angeles, says warning signs do not mean cancer, even if you have all of them. But if your symptoms are “persistent and progressive, meaning you wake up every morning and feel something and it has you worried — even for two weeks in a row — it really is worth calling your physician and having it checked out.”
Regular checkups and screenings such as Pap smears and mammograms, as well as knowing your own body, are all crucial for good health.
Which changes are worth bringing to your doctor’s attention? Here are ten signs experts think you should keep on your radar screen.
1. Breast Changes
If you feel a lump, you shouldn’t ignore it, even if your mammogram is normal. If your nipple develops scaliness or flaking, that could indicate Paget’s disease of the nipple, which is associated with an underlying cancer in about 95% of cases. Any milky or bloody nipple discharge should also be checked out. Dimpling of the skin over the breast, particularly if it looks like the skin on an orange, is something to be worried about. Such dimpling is most often associated with inflammatory breast cancer, a rare, usually aggressive cancer characterized also by swollen, hot, red breasts.
2. Irregular Bleeding
Once you hit menopause (defined as 12 months without a period), any postmenopausal bleeding is a warning sign. Any bleeding, staining, little drops on your underwear, or big clots are abnormal and should be immediately investigated. Such bleeding could indicate something as benign as an endometrial polyp or something more serious like endometrial or cervical cancer.
Bleeding that is uncharacteristic for you — spotting outside of your normal menstrual cycle or heavier periods. Around menopause, abnormal bleeding is often attributed to hormonal shifts, though more serious problems could be the cause, which is why all abnormal vaginal bleeding should be evaluated. Expect to receive a transvaginal sonogram and perhaps a biopsy.
3. Rectal Bleeding
Colon cancer is the third most common cancer in women. One of the hallmarks is rectal bleeding, which many people attribute to hemorrhoids, the most common cause. But it’s not always that. Red or dark blood in your stool warrants a visit to your doctor. Your doctor will likely do a rectal exam and order a colonoscopy if you’re 50 or older and perhaps even if you’re younger.
A foul or smelly vaginal discharge could be a sign of cervical cancer. The discharge may contain blood and may occur between periods or after menopause. It’s best not to self-treat a discharge with over-the-counter medications. An exam is necessary to determine if the discharge is due to an infection or something more serious.
Ovarian cancer is the No. 1 killer of all the reproductive-organ cancers. The four most frequent symptoms are bloating; feeling that you’re getting full earlier than you typically would when eating; changing bowel or bladder habits, such as urinating more frequently; and low back or pelvic pain. Pay attention if you have two or more symptoms occurring daily for more than two weeks. If they’re persistent and progressive, call your physician. Expect a pelvic exam, transvaginal sonogram, and perhaps a CA-125 blood test to check for cancerous cells.
6. Unexplained Weight Gain or Loss
Gaining excess weight month to month — especially if you usually maintain a normal weight and watch what you eat — can be due to an accumulation of fluid in the belly related to ovarian cancer and warrants seeing your doctor. Unexplained weight loss of 10 pounds or more may be the first sign of cancer, according to the American Cancer Society, and is most often associated with pancreatic, stomach, esophagus, or lung cancer. But weight loss in women is often caused by a hyperactive thyroid. Expect your doctor to order a thyroid test first to check for this common disease.
7. Persistent Cough
Any persistent cough — one that lasts more than two or three weeks and is not due to an allergy or upper respiratory infection or one that produces blood in the sputum— needs to be checked by your doctor. If your cough may be caused by smoking or being exposed to second-hand smoke, get it checked out. Smoking is the number one cancer killer of women, but you don’t have to be a smoker to be at risk. Expect your doctor to order a chest X-ray and perhaps a CT scan.
8. Change in Lymph Nodes
If you feel hard lymph nodes in your neck or under your arm, you should be seen by a doctor. Swollen, firm lymph nodes are often the result of an infection. However, lymphoma or lung, breast, head, or neck cancer that has spread can also show up as an enlarged lymph node. Expect a physical exam and possibly a biopsy.
Although fatigue can be hard to quantify, the American Cancer Society defines it as “extreme tiredness that does not get better with rest.” If you’re persistently fatigued, see your doctor. Leukemia, colon, or stomach cancer — which can cause blood loss — can result in fatigue. Fatigue can be a serious problem and it’s easy to ignore. Your doctor will most likely do a physical exam and order blood tests to evaluate your thyroid and rule out a thyroid condition.
10. Skin Changes
Keep an eye on any changes you notice on your skin all over your body, and call your doctor right away if anything concerns you. Sores in the mouth that don’t heal — especially if you smoke or drink alcohol — may be a sign of oral cancer and should be examined by your physician. In particular, note any sores or irritated skin in the vaginal area. A nonhealing vulvar lesion could be a sign of vulvar cancer. Changes in moles or pigmented lesions on the vulva can also signify cancer. Vulvar melanoma can frequently be overlooked and can have a very aggressive course. A simple biopsy can be done in your doctor’s office if necessary.