10 things to know about neuroendocrine tumors
14 Subtle Signs You Might Have Cancer, Including Feeling Full And Having A Pesky Cough
1. Fatigue Pay attention to persistent fatigue that you can't easily explain. Photographee.Eu/Shutterstock
Both Bonta and Meyers listed fatigue — tiredness that doesn't get better with rest — as a cancer symptom that's easy to miss.
This can include insomnia (feeling tired but being unable to sleep), sleeping more than usual without feeling rested, or a general sense of lethargy or lack of energy.
"When you have fatigue, my recommendation is do a little bit of analysis," Bonta said. There could be any easy explanation — maybe you've been sleeping poorly or recently started a new medication.
"But if all the other things are in order and this is a new symptom for you, then I'd be worried about it," Bonta said.
2. Skin bumps Skin cancer can look innocuous. IStock
"One thing that's often overlooked are skin cancers and skin lesions," Meyers said. "Skin cancers don't necessarily look ugly and scary. They sometimes can look like just little raised pink growths."
Melanomas — the most deadly type of skin cancer — aren't necessarily pigmented, she added. They can also occur in odd places in the body, including under your fingernails and toenails.
"For skin cancer we have to know our own skin and see if there's any change," Bonta added. Here's a simple guide to skin checks from the American Cancer Society.
A wound that won't heal is another potential sign of skin cancer, dermatologist Dr. Allison Arthur previously explained to Insider.
"A common story that my patients will tell me is, 'I have this sore, I thought it was a pimple, it bled, and then I thought it was going away but then it bled again,'" she said.
3. Feeling full really quickly Feeling full after just a few bites? It might be worth seeing your doctor if the feeling persists. Flickr/Rachel Hathaway
Ovarian cancer can be tough to catch in its early stages. One possible symptom might be early satiety, Bonta said. That's when you feel full after eating only small amounts of food.
The National Ovarian Cancer Coalition has a complete list of possible signs and symptoms women should know about.
And it's related to other symptoms such as ...
4. Poor appetite A decrease in appetite may sometimes be worrisome. TeoLazarev/Getty Images
Meyers said poor appetite can sometimes be a cancer symptom. It may signal colon cancer, ovarian cancer, stomach cancer, or pancreatic cancer, or even lung cancer, according to Cancer Treatment Centers of America.
This can be related to other symptoms such as pain, which can make it difficult to eat. But cancer also releases chemicals into the body that can mess with your metabolism.
5. Unexplained weight loss Watch out for dropping weight. Paul Velgos/Shutterstock
Bonta said that unexplained weight loss can be a symptom of cancer. If you drop 10 pounds or more without trying to, it's worth calling your doctor.
The ACS says unexplained weight loss happens most often pancreatic, stomach, esophageal, and lung cancers.
It can also be a symptom of several types of blood cancer, which are among the more difficult cancers to spot, according to a new UK campaign called "Make Blood Cancer Visible."
7. Bloating Bloating or a swollen stomach can be a warning sign, especially combined with other symptoms. Wavebreakmedia/Shutterstock
People with ovarian cancer may also experience bloating or a swelling stomach, Bonta said.
"If a woman reports pelvic or abdominal pain, increased abdominal size, bloating, difficulty eating, or feeling full quickly — and if the symptoms are new within the past year and if they occur more than 12 times per month — it's a red flag."
8. Fever It's not common, but fever may be an early sign of certain blood cancers. Marco Verch/Flickr
Bonta said that fever is sometimes a cancer symptom. Most often, it's a sign that a cancer has spread to a different part of the body than where it started, but it can be an early symptom of blood cancers leukemia or lymphoma, according to the ACS.
A temperature of more than 100.5 degrees Fahrenheit is concerning, especially if it persists for more than 24 hours or is accompanied by shaking or chills.
9. Night sweats Waking up soaked in sweat can be a red flag. Demaerre/Getty Images
Excessive sweating after bedtime can be a sign that something's going on with your health, especially if the weather doesn't warrant it.
Night sweats can indicate lymphoma, a cancer of the immune system. However, it's usually accompanied by other symptoms on this list like fever, fatigue, and weight loss.
10. Persistent hoarseness or coughing If your cough or sore throat lasts more than three to four weeks, check with a doctor. AaronAmat/ iStock
Plenty of common, noncancerous ailments can cause a cough or hoarseness, from allergies to respiratory infections.
But if you lose your voice for longer than three or four weeks, that may be an early symptom of throat cancer, according to Cancer Research UK. Other signs to watch out for include shortness of breath and difficulty swallowing.
11. Pain Mysterious, long-lasting pains could signal a problem. Koldunova Anna/Shutterstock
"Any pain that's out of proportion with your activity is a red flag," Bonta said. "If I go to the gym today and I pull a muscle, I have a reason for pain. But if I have leg pain, I don't remember injuring my leg, it doesn't go away, and three days later I still have to take pain medication, that's a problem."
Unexplained pain can be an early warning sign of a variety of cancers depending on where it is in the body, according to ACS. A persistent, untreatable headache could be a symptom of brain cancer. Back pain may indicate colon cancer, rectum cancer, or ovarian cancer. General pain, without an obvious cause, is sometimes a symptom of bone cancers or testicular cancer.
12. Anemia A low red blood cell count could indicate colorectal cancer. Joe Raedle/Getty Images
People with anemia don't have enough healthy, normal red blood cells. Iron-deficiency anemia — the most common type, according to the Mayo Clinic — can occur because of blood loss.
Bonta said some iron deficiency anemia is easily explained — it can happen to women with heavy periods, for example. But unexplained iron deficiency anemia may be a "red flag" for cancer in the colon or rectum, she added.
The ACS explains that some colorectal cancers, as they're often called, can bleed into the intestine. Over time that loss of blood may lead to anemia, and the blood may not always be visible or noticeable in the stool. In fact, the ACS says, a blood test that reveals a low red blood cell count is sometimes the first sign of a colorectal cancer.
13. Changes when you go to the bathroom Keep tabs on what's normal for your urinary and bowel habits. Buckeye Sailboat/Shutterstock
Changes in bowel movements or urine can be signs of a few different cancers.
Blood in the stool is never a good sign, especially if there's not an obvious cause. It signify stomach cancer or colorectal cancers. Other changes in bowel movements, like diarrhea or constipation that last more than a few days, can also be signs of colorectal cancer, the ACS explains.
Bonta said that in men, symptoms like blood in the urine, needing to pee freqeuntly at night, sudden urges to urinate, or a weak stream of urine could indicate prostate cancer.
In women, urinary frequency and urgency can be signs of ovarian cancer, according to the ACS.
And in all people, certain urinary changes may also be symptoms of kidney and bladder cancers, the ACS says. So it pays to be alert and notice when there's a long-lasting change in your normal bathroom habits.
14. Skin or eye yellowing MediaProduction/Getty Images
Jaundice — or the yellowing of your skin or eyes — is most commonly the first sign of pancreatic cancer, according to the American Cancer Society.
The yellowing of the skin is caused by a build-up of bilirubin, which is made in the liver and typically is released to the intestines from the pancreas through the common bile duct where it helps break down fats during digestion.
Pancreatic cancer can compromise the common bile duct and cause bilirubin to build up in the bloodstream, leading to the yellowing. Liver cancer can also cause jaundice.
Dark urine, light-colored stool, and itchy skin are other symptoms of jaundice to watch out for aside from the yellowing of skin.
Remember: Don't panic. Not every one of these symptoms is a surefire sign of cancer. Joe Raedel/Getty
Not every symptom indicates cancer, and not every symptom warrants a battery of tests. Both Meyers and Bonta stressed that unnecessary testing can actually be harmful.
"The financial costs and psychological costs can be very high," Bonta said. "Talk to any patient who ever had a biopsy about what you're going through psychologically while you're waiting for it and while you're having it."
Some testing and screening procedures have risks or complications, too. CT scans, for example, expose your body to radiation. A doctor will know when a scan, biopsy, or other test is truly going to be more helpful than harmful.
"I think, in general, we don't want people to panic," Meyers said. "Give [a symptom] a little time to see if it goes away. If it doesn't, then have it investigated."
Read more about the signs and symptoms of cancer at the American Cancer Society.
Many Older Men With Prostate Cancer And Limited Life Expectancy Are Overtreated
January 06, 2025
4 min read
Add topic to email alerts
Receive an email when new articles are posted on
Please provide your email address to receive an email when new articles are posted on . Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.Com.Back to Healio
Key takeaways:More men with limited life expectancy and certain localized prostate cancers have received definitive treatment over the past 2 decades despite shifts toward active surveillance, according to results of a retrospective study.
Clinicians treated veterans with limited life expectancy and low-risk disease at significantly lower rates in 2019 compared with 2000, but those with intermediate- or high-risk tumors received therapy more often.
"Physicians and patients should be aware that the risk for overtreatment is not just due to overly aggressive treatment of low-risk cancers, but also due to overly aggressive treatment of men who may not live long enough to benefit from treatment — even for higher-risk cancers," Timothy J. Daskivich, MD, MSHPM, associate professor and director of health services research in the surgery department at Cedars-Sinai Medical Center, told Healio.
Background and methodsMen with localized prostate cancer do not gain a mortality benefit from treatment for roughly 8 to10 years, Daskivich said.
Consequently, prostate cancer guidelines have recommended against definitive treatment for men who have intermediate-risk disease and a life expectancy of less than 10 years, as well as for those with high-risk cancer who have a life expectancy of less than 5 years, he added.
"However, these men often pursue local treatment to avoid potential risk of the cancer, even if the risks of the cancer are low or negligible over their projected longevity," Daskivich said. "We initially published on this topic 10 years ago and showed that roughly half of men with life expectancies of less than 10 years were treated with definitive local treatment in the early 2000s era. However, since that time, there has been a sea change in how men with low-risk cancers are managed — now favoring active surveillance as an upfront approach."
Daskivich and colleagues investigated whether the shift toward watchful waiting has led to a decrease in overtreatment.
Their analysis included men in the Veterans Affairs health system who had been diagnosed with localized prostate cancer between 2000 and 2019.
The cohort consisted of 243,928 men (mean age, 66.8 years; standard deviation, 8). Of those, 20.5% had a life expectancy of less than 10 years, and 4.7% had a life expectancy of less than 5 years.
Trends of definitive treatment, surgery or radiotherapy for men with limited life expectancy served as the primary endpoint.
Results and next stepsThe percentage of men with life expectancy of less than 10 years and low-risk disease who received definitive treatment declined from 2000 to 2019 (37.4% vs. 14.7%; absolute change = 22.7%; 95% CI, 30 to 15.4; P < .001).
However, the percentage of men with life expectancy of less than 10 years and intermediate-risk cancer who received definitive treatment increased from 2000 to 2019 (37.6% vs. 59.8%; absolute change = 22.1%; 95% CI, 14.8-29.4; P < .001). This trend persisted for those with favorable intermediate-risk disease (32.8% vs. 57.8%; P < .001) and unfavorable intermediate-risk disease (46.1% vs. 65.2%; P = .01).
Most men (78%) with life expectancy of less than 10 years who received definitive therapy underwent radiotherapy. Radiotherapy use increased among men with a life expectancy of less than 10 years and intermediate-risk cancer from 2000 to 2019 (31.3% vs. 44.9%; absolute change = 13.6%; 95% CI, 8.5-18.7; P < .001).
The percentage of veterans with a life expectancy of less than 5 years and high-risk disease who received definitive treatment increased from 2000 to 2019 (17.3% vs. 46.5%; absolute change = 29.3; 95% CI, 21.9-36.6; P < .001), as well.
Most of these men received radiotherapy (85%), and radiotherapy usage increased among this population from 2000 to 2019 (16.3% vs. 39%; absolute change = 22.6%; 95% CI, 16.5-28.8; P < .001).
"Physicians may fail to include average life expectancy when advising patients on treatments because they believe that the patients do not want to discuss this topic," Daskivich said. "In fact, recent research by our team found that providers often do not provide quantified information on average life expectancy when counseling patients with prostate cancer. Yet, in interviews with patients, we found that patients with prostate cancer reported they wanted this information. Efforts at solving this issue will no doubt require a multifaceted approach, including improving access to life expectancy data at the point of care for providers, educating providers on how to communicate this information, and improving data sources to predict longevity."
Researchers acknowledged study limitations, including the cohort consisting of only veterans and lack of data to determine the cause of these trends.
"We need more data on the drivers of this problem — whether it is primarily a patient-driven phenomenon or doctor-driven phenomenon," Daskivich said. "We are also doing work to help doctors improve their communication of key factors for decision making such as cancer risk and life expectancy."
The first step to stopping overtreating is the cessation of overscreening, Nancy Li Schoenborn, MD, associate professor of medicine at Johns Hopkins University School of Medicine, and Louise C. Walter, MD, professor of medicine at University of California, San Francisco, wrote in an accompanying editorial.
"We need to integrate existing tools into routine practice to help clinicians determine life expectancies at the time of decision-making, promote multifaceted messaging to patients about the nontrivial harms that may emanate from cancer screening and treatment, and help everyone remain focused on a patient's current life-limiting illnesses rather than distracting from this care by searching for asymptomatic localized prostate cancer," they wrote.
References: For more information:Timothy J. Daskivich, MD, MSHPM, can be reached at timothy.Daskivich@cshs.Org.
Reference:Fox Chase Cancer Center. Cancer prediction tools. Available at: https://cancernomograms.Com/nomograms.
Perspective Back to Top J. Ryan Mark, MD, FACS Prostate cancer treatment can significantly impact a man's urinary and sexual function. These risks are justified when the aim is to cure a life-threatening condition or prevent future metastatic symptoms. However, when prostate cancer is unlikely to cause symptoms or lead to death, the potential disadvantages of treatment may surpass its benefits. For indolent, low-risk prostate cancer, active surveillance is endorsed by all major treatment guidelines and widely recognized and accepted by the public, but the aggressiveness of the cancer is not the sole consideration. The likelihood of prostate cancer progressing to symptomatic disease or death also depends on the life expectancy of the man diagnosed. Discussing these issues with my patients can be difficult, but I have found the tools available from Fox Chase Cancer Center at www.Cancernomograms.Com to be very helpful. These resources include life expectancy calculators that factor in a man's risk for prostate cancer progression, age and other health considerations, offering men and their families the essential context needed to make informed decisions regarding prostate cancer treatment. J. Ryan Mark, MD, FACS Fox Chase Cancer CenterDisclosures: Mark reports no relevant financial disclosures.
Sources/DisclosuresCollapse Disclosures: Daskivich reports personal fees from EDAP, Medical Education Speakers Network and RAND, as well as research support from Janssen and Lantheus. The other authors report no relevant financial disclosures. Schoenborn reports grants from National Institute on Aging. Walter reports no relevant financial disclosures.Add topic to email alerts
Receive an email when new articles are posted on
Please provide your email address to receive an email when new articles are posted on . Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.Com.Back to Healio
Study Unveils Key Mechanism Behind Prostate Cancer's Uncontrolled Growth
Prostate cancer hijacks the normal prostate's growth regulation program to release the brakes and grow freely, according to Weill Cornell Medicine researchers. The discovery, published Dec. 13 in Nature Communications, paves the way for new diagnostic tests to guide treatment and could also help drug developers identify novel ways to stop the disease.
A protein called the androgen receptor normally functions to guide the development of the prostate—signaling the cells to stop growing, act as normal prostate cells and maintain a healthy state. The receptor is activated by androgens or sex hormones like testosterone, which triggers the receptor to bind to DNA, causing the expression of some genes and suppression of others. But in cancer, the androgen receptor is reprogrammed to tell the cells to continue growing, driving tumor development.
It's pretty well known in the field that the androgen receptor gets hijacked in a variety of ways and starts taking on new functions to drive prostate cancer cell growth."
Dr. Christopher Barbieri, senior author, the Peter M. Sacerdote Distinguished Associate Professor in Urologic Oncology, associate professor of urology and member of the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine
This study showed that androgen receptors in prostate cells can work as either an accelerator speeding cell growth or a brake inhibiting it. Tumors redirect the receptors' normal activity to press the accelerator and release the brake.
Uncovering genes that halt cell growthMuch of the research on prostate cancer has focused on how the androgen receptor activates genes that promote cell growth. However, Dr. Barbieri's team noticed that the protein also loses functions, binding less to some of its normal DNA sites. The researchers hypothesized that those normal binding sites might suppress cell growth, so when the androgen receptor abandons them, the tumor cells can multiply uncontrollably.
To test that, co-first author Dr. Michael Augello, who was a postdoctoral fellow at the time of the study, created a panel of artificial proteins, each containing a DNA-binding section of the androgen receptor and either an activating or suppressing module. "This approach allowed us to examine the genes involved in the normal cell program that remains embedded but hijacked in cancer cells," said co-first author Dr. Xuanrong Chen, a postdoctoral associate in urology at Weill Cornell Medicine.
Using these artificial transcription factors, the team then tested all the androgen receptor binding sites in cultured cells, cataloging what each site did in both normal and cancerous cells. That experiment revealed a family of genes that can stop the growth of prostate cancer cells.
"When we turn on the genes controlled by these androgen receptor regulatory elements, the cell's growth is shut down," Dr. Barbieri said. In contrast, turning on the same genes in healthy prostate cells had no effect. "It really suggests that these elements are there for normal cells to differentiate and be happy, and the cancer has to rewire them in order to grow," said Dr. Barbieri, who is also a urologic surgeon at NewYork-Presbyterian/Weill Cornell Medical Center.
Findings may lead to new diagnosticsBased on their initial results, the investigators screened tissue samples from prostate cancer patients. "We found that the more the tumors express the normal cells' androgen receptor program, the better the patient's prognosis, the better their response to therapies and the better the patient outcome," said Dr. Barbieri. His lab is already developing diagnostic tests based on these results, which could be used to tailor patient treatment regimens.
"The findings also open up the possibility of developing a therapeutic that reactivates the normal regulatory program in prostate cancer cells to restrain their growth," said Dr. Chen.
Source:
Journal reference:
Chen, X., et al. (2024). Canonical androgen response element motifs are tumor suppressive regulatory elements in the prostate. Nature Communications. Doi.Org/10.1038/s41467-024-53734-z.
Comments
Post a Comment