Cancer: Is there a way to know if you have it?

Oct 21, 2018 Dr Zulfikar Bux, Features / Columnists

By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine

Cancer occurs when a part of the body malfunctions and produces more tissues than can be destroyed. After a while, there is excess tissue that forms a tumor which continues to grow and feed on the body. If left untreated, the cancerous tumor begins to overwhelm our body and spread to other organs. With cancer, early detection is key. Unfortunately, every type of cancer presents differently and can go unnoticed initially. There are some general symptoms and signs that may be evident from cancer. We will expand on them in today’s article.

HOW COMMON IS CANCER?
Cancer is a leading cause of death worldwide, and is responsible for an estimated 9.6 million deaths in 2018. Globally, about 1 in 6 deaths is due to cancer. Approximately 70% of deaths from cancer occur in low- and middle-income countries.
It is estimated that there will be 18.1 million new cancer cases and 9.6 million cancer deaths in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer and the leading cause of cancer death, closely followed by female breast cancer, prostate cancer, and colorectal cancer. In Guyana, cancer is a big burden. It is the third leading cause of death; giving us the highest rate of cancer-related death in the Caribbean. 21 out of every 100,000 persons die from cancer in Guyana. Cervical, breast and prostate cancer are the more common cancers in Guyana.

ARE THERE FACTORS THAT INCREASE MY RISKS FOR CANCER?
Yes! Around one third of deaths from cancer are due to the 5 leading behavioral and dietary risks:
• high body mass index (obesity)
• low fruit and vegetable intake
• lack of physical activity
• tobacco use
• alcohol use
Tobacco use is the most important risk factor for cancer and is responsible for approximately 22% of cancer deaths. Additionally, chronic infections such as Hepatitis and Human Papilloma virus (HPV), also contribute as causes of cancer. Having a family history of certain type of cancer e.g. breast cancer, increases your risk of acquiring that cancer.

WHAT ARE SOME SYMPTOMS THAT MAY SUGGEST THAT I HAVE CANCER?
Cancer symptoms will vary according to the type of cancer and how far the cancer has grown. There are some symptoms that are common to many cancers and are the result of the increased cell turnover. These include:
• Weight loss – in severe cases there can be both loss of fat and muscle, leading to a wasting condition called cachexia.
• Loss of appetite.
• Pale skin and paleness of the inside of the lower eyelid, a low blood count (anemia).
Other symptoms you may be asked about include:
• Any visible loss of blood.
• Any unexplained lumps or bumps.
You may also be asked about more specific features, depending on which underlying cancer is suspected such as:
• Breast cancer: breast lump, nipple discharge, change in skin.
• Bowel cancer: blood in stools or after passing stool, pain in rectum.
• Lung cancer: persistent cough, blood in sputum, chest pain.
• Brain cancer: unexplained headaches; headache present on waking, feeling upset, being sick (vomiting), abnormal sensations or weakness in the limbs.
CANCER FINDINGS ON EXAMINATION
Features on examination may also help determine if cancer is present and if so where it is. This may include the following:
• Features of excessive weight loss.
• Evidence of anemia – pale skin and pallor inside the lower eyelid.
• Any enlarged lymph nodes such as in the neck or under the armpits. The cancer cells will have a blood supply and toxins will pass into the veins and also the lymph channels. This toxic product can then build up and lead to enlargement of the lymph nodes.
• Raised temperature (fever) – some cancers can lead to high fever.
• Enlargement of the liver may be the result of cancer spreading to the liver (metastases).
• Lump of cancer – for example, in the breast in breast cancer or in the abdomen in bowel cancer.
It is important to note that often there may be nonspecific symptoms or even no symptoms.

IS THERE A SPECIFIC CANCER TEST?

This is a question that quite a few patients ask. Unfortunately, there is no specific test that can detect cancer. Each cancer has its own testing specific to the area of the body that is affected. There are screening tests that are done for various cancers. You and your doctor can work out if you need testing for any cancer based on your medical history, examination findings and risk factors. Pay attention to the general symptoms that cancer may cause.
When it comes to cancer, the earlier you detect it, the better your chances of survival.