HEALTH TALK: Cancer symptoms women shouldn’t ignore

Dr. Victor Emanuel MD
Dr. Victor Emanuel MD

There are certain changes that a woman should really consider as worth bringing to her doctor’s attention. What follow are the signs and symptoms you most want to 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, especially if it looks like the skin on an orange (peau d’orange), is something to be worried about. Such discharge is most often associated with inflammatory breast cancer, a rare, usually aggressive cancer characterized also by swollen, hot, red breasts.

Expect your doctor to do a breast exam and medical history, followed by a mammogram or sonogram and perhaps a biopsy, depending on the results of both tests.

2. Irregular Bleeding

Once you’ve reached 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 – should be looked into. 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 among the top three most common cancers in women. One of the hallmarks is rectal bleeding, which many people attribute to hemorrhoids, the most common cause. But it’s not always hemorrhoids. Red or dark blood in your stool warrants a visit to your doctor.

Doc will likely do a rectal exam and order a colonoscopy if you’re 50 or older and perhaps even if you’re younger.

4. Discharge

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.

5. Bloating

Ovarian cancer is the number one killer of all the reproductive-organ cancers. For years it’s been known by the misnomer of the silent killer, and we really need to put that aside. Ovarian cancer clearly has symptoms. The four most frequent 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.

It’s not unusual to have one or two of these symptoms occasionally, particularly after a big meal. But pay attention if you have two or more symptoms occurring daily for more than two weeks. If they’re persistent and progressive, call the doc.

Expect a pelvic exam, transvaginal sonogram, and perhaps a CA-125 blood test to check for cancerous cells.

6. Unexplained Weight Gain or Loss

Don’t worry if you suddenly put on five pounds. But gaining excessive 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 abdomen related to ovarian cancer and warrants seeing the doctor. Unexpected weight loss of 10 pounds or more may be the first sign of cancer, 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 the 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 doctor. If your cough may be caused by smoking or being exposed to second-hand smoke, get it checked out. Smoking is a major cancer killer of women. Yet you don’t have to be a smoker to be at risk; the majority of lung cancers that occur in nonsmokers also occur in women. Expect the doctor to order a chest X-Ray or CT Scan.

8. Change in Lymph Nodes (Glands)

If you feel hard lymph nodes in your neck or under your arm, you should be seen by the doc. 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.

9. Fatigue

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 a 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. Doc will most likely do a physical exam and order blood tests to evaluate your thyroid and rule or a thyroid condition.

10. Skin Changes

Keep an eye on any changes you notice on your skin all over your body, and call doctor right away if anything really 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 doctor.

In particular, note any sores or irritated skin in the vaginal area. A non-healing vulvar (perivaginal) 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 doc’s office is necessary.

What’s the Bottom Line?

Watch for all these symptoms, but remember, while it’s important to be on the alert for physical changes, we don’t want to cause too much alarm.

Don’t be afraid. If you notice something different about your body, get it checked out. Most likely, it’s not cancer, but if it is, cancer is treatable, often it’s curable, and clearly having a diagnosis earlier will allow you to have the most benefit possible from current health care advances and live as full a life as prior to a diagnosis.

It’s all about early diagnosis.

3 Ways to Minimize Your Cancer Risk

Know thyself. Make a family health tree. Know your family history. Know what you’re at risk for, so you can focus on screening and preventions. Moreover, you’re just as likely to inherit your risk of breast and ovarian cancer from your father’s side of the family as from your mother’s.

Check your BMI. Make it a habit to know your body mass index, and keep it under 25 – the dividing line for being overweight. Regular exercise can lower blood estrogen levels, which helps cut your risk of breast cancer.

Schedule screenings. Make sure you get a colonoscopy if you’re 50 or older. And scheduled regular PAP Smears (starting three years after first intercourse or from age 21, whichever comes first), as well as mammograms after age 40.

See you next week.


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  1. ooppsss
    April 14, 2014

    i learned quit a bit from this short digest….looking forwards to the next ….kim kim

  2. Great article
    April 12, 2014

    Great article doc. It is time for people to take their health seriously by taking preventative actions such as watching their diet. Too many women are overweight for one which increases the risk factors.

  3. Carlyn
    April 11, 2014

    Great read!! Keep them coming Doc. :)

  4. anonymous
    April 11, 2014

    Very timely. I hope people go out there and support the Dominica Cancer Society’s fundraising drive. The centre helps both men and women in the fight against this disease.

  5. Anonymous
    April 11, 2014

    Thanks Doc. Very informative

  6. papa met
    April 11, 2014

    very well

  7. Kalinago
    April 11, 2014

    Thank you Doctor. The information you gave was very educational to me.

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