Lesions that might signal oral cancer (more in tobacco chewers)

Two lesions that could be precursors to cancer are leukoplakia (white lesions) and erythroplakia (red lesions). Although less common than leukoplakia, erythroplakia and lesions with erythroplakic components have a much greater potential for becoming cancerous. Any white or red lesion that does not resolve itself in 2 weeks should be reevaluated and considered for biopsy to obtain a definitive diagnosis.

Possible signs and symptoms of oral cancer that your patients may report include: a lump or thickening in the oral soft tissues, soreness or a feeling that something is caught in the throat, difficulty chewing or swallowing, ear pain, difficulty moving the jaw or tongue, hoarseness, numbness of the tongue or other areas of the mouth, or swelling of the jaw that causes dentures to fit poorly or become uncomfortable.

If these problems persist for more than 2 weeks, a thorough clinical examination and laboratory tests, as necessary, should be performed to obtain a definitive diagnosis. If a diagnosis cannot be obtained, referral to the appropriate specialist is indicated.

These symptoms usually represent simple infections such as bronchitis or sinusitis. They could be symptoms of cancer of the lung, head, and neck. Anyone with a cough that lasts more than a month or with blood in the mucus that is coughed up should see a doctor.

Most changes in bowel habits are related to your diet and fluid intake. Doctors sometimes see pencil-thin stools with colon cancer. Occasionally, cancer exhibits continuous diarrhea. Some people with cancer feel as if they need to have a bowel movement and still feel that way after they have had a bowel movement. If any of these abnormal bowel complaints last more than a few days, they require evaluation.

A doctor always should investigate blood in your stool. Hemorrhoids frequently cause rectal bleeding, but because hemorrhoids are so common, they may exist with cancer. Therefore, even when you have hemorrhoids, you should have a doctor examine your entire intestinal tract when you have blood in your bowel movements. With some individuals, X-ray studies may be enough to clarify a diagnosis.Colonoscopy is usually recommended. Sometimes when the source of bleeding is entirely clear (for example, recurrent ulcers), these studies may not be needed.

Anemia is a condition in which people have fewer than the expected number of red blood cells in their blood. Anemia should be investigated. There are many kinds of anemia, but blood loss almost always causes iron deficiency anemia. Unless there is an obvious source of ongoing blood loss, this anemia needs to be explained. Many cancers can cause anemia, but bowel cancers most commonly cause iron deficiency anemia. Evaluation should include endoscopy or X-ray studies of your upper and lower intestinal tracts.

Most breast lumps are noncancerous tumors such as fibro adenomas or cysts. But all breast lumps need to be thoroughly investigated. A negative mammogram result is not usually sufficient to evaluate a breast lump. Your doctor needs to determine the appropriate X-ray study which might include an MRI or an ultrasound of the breast.

Generally, diagnosis requires a needle aspiration or biopsy (a small tissue sample).

Discharge from a breast is common, but some forms of discharge may be signs of cancer. If discharge is bloody or from only one nipple, further evaluation is recommended. Women are advised to conduct monthly breast self-examinations.

Most men (90%) with cancer of the testicle have a painless or uncomfortable lump on a testicle. Some men have an enlarged testicle. Other conditions, such as infections and swollen veins, can also cause changes in your testicles, but any lump should be evaluated. Men are advised to conduct monthly testicular self-examinations.

Urinary symptoms can include frequent urination, small amounts of urine, and slow urine flow. These symptoms can be caused by urinary infections (usually in women) or, in men, by an enlarged prostate gland. Most men will suffer from harmless prostate enlargement as they age and will often have these urinary symptoms. These symptoms may also signal prostate cancer. Men experiencing urinary symptoms need a bit of investigation, probably including a specific blood test called a PSA and a digital rectal exam. If cancer is suspected, a biopsy of the prostate may be needed. Cancer of the bladder and pelvic tumors can also cause irritation of the bladder and urinary frequency.

Hematuria or blood in the urine can be caused by urinary infection, kidney stones, or other causes. For some people, it is a symptom of cancer of the bladder or kidney. Any episode of blood in the urine should be investigated.

Hoarseness not caused by a respiratory infection or that lasts longer than three to four weeks should be evaluated. Hoarseness can be caused by simple allergy or by vocal cord polyps, but it could also be the first sign of cancer of the throat.

Lumps most frequently represent harmless conditions such as a benign cyst. A doctor should examine any new lump or a lump that won't go away. Lumps may represent cancer or a swollen lymph gland related to cancer. Lymph nodes swell from infection and other causes and may take weeks to shrink again. A lump or gland that remains swollen for three to four weeks should be evaluated.

Multicolored moles that have irregular edges or bleed may be cancerous. Larger moles are more worrisome and need to be evaluated, especially if they seem to be enlarging. Removing a mole is usually simple. You should have your doctor evaluate any suspicious mole for removal. The doctor will send it for examination under a microscope for skin cancer.

Most people with chronic heartburn usually do not have serious problems. People who suffer from chronic or lasting symptoms despite using over-the-counter antacids may need to have an upper GI endoscopy. A condition called Barrett esophagus, which can lead to cancer of the esophagus, can be treated with medication and then monitored by a doctor. Difficulty swallowing is a common problem, especially in elderly people, and has many causes. Swallowing problems need to be investigated, because nutrition is always important. Difficulty swallowing solids can be seen with cancer of the esophagus.