CAN THERE BE OTHER SYMPTOMS?
Yes, there can be. It pays to take note of non-specific symptoms, said Dr Ow, which can include persistent tiredness, headaches, giddiness, weight loss, shortness of breath, unusual bleeding or unexplained pain.
“Even if they are not due to an underlying cancer, they can still be due to other conditions that need to be dealt with such as anaemia from heavy menstrual bleeding or dietary insufficiency,” he said.
MANY OF THE NON-SPECIFIC SYMPTOMS SEEM HARMLESS. HOW DO YOU KNOW WHEN TO ACT?
Losing a few kilograms might seem like good news, especially if you’ve been working on your weight. However, losing 5 per cent or more of your body weight in six months, especially if unintended, is not normal and should be evaluated, cautioned Dr Ow.
“The weight loss is a general warning that may indicate a wide range of malignancies,” explained Dr Evelyn Wong, a consultant with National Cancer Centre Singapore’s Division of Medical Oncology. “It suggests that the cancer is using up the body’s energy or causing poor nutritional absorption.”
Extreme tiredness or fatigue that doesn’t improve with rest or recovery is another non-specific sign to look out for. “It is often due to anaemia, bone marrow suppression or the body’s inflammatory response to cancer,” said Dr Wong.
Another red flag is the shortness of breath, even when you’re not running or climbing the stairs. It could indicate the spreading of cancer to the lungs or the cancer causing the lungs to produce water, said Dr Ow.
Be wary, too, if you experience difficulty in swallowing or persistently feel full, cautioned Dr Ow. “This can be due to cancer in the swallowing tract. If the cancer has spread to the abdomen, it can cause water retention or liver enlargement that presses on the stomach. Advanced cancer can also result in significant reduction in appetite.”
HOW LONG SHOULD YOU OBSERVE THE SYMPTOMS FOR?
“A good rule of thumb is to see a doctor if a symptom persists for more than three to four weeks or if it gets worse over time,” said Dr Wong.
Similarly, go to a family doctor if you feel uncomfortable, advised Dr Ow, who can then take a detailed history and physical examination, and decide if further investigations are required. “Understanding your family history of cancer or other medical issues can also help decide if the suspicion of cancer is high,” he said.
For that matter, seeing a doctor is more urgent if you have a family history of cancer or a known genetic risk, such as Lynch syndrome or BRCA mutations, said Dr Wong. “Being proactive such as knowing your family history and not delaying care can make a difference.
IF THE SYMPTOMS ARE INTERMITTENT, ARE THEY LESS LIKELY TO POINT TO CANCER?
Persistent symptoms are generally more concerning but intermittent ones shouldn’t be ignored, especially with risk factors such as a family history of cancer or smoking, said Dr Tan. Intermittent symptoms should still be evaluated, especially if they “recur regularly or worsen over time”, he said.
