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Patophysiology Cancer

Genetic changes
In normal cells, genes regulate growth, maturity and death of the cells. Genetic
changes can occur at many levels. There could be a gain or loss of
entire chromosomes or a single point mutation affecting a single DNA nucleotide.
There are two broad categories of genes which are affected by these change:

Oncogenes these are cancer causing genes. They may be normal genes
which are expressed at inappropriately high levels in patients with cancers or
they may be altered or changed normal genes due to mutation. In both cases
these genes lead to cancerous changes in the tissues.

Tumor suppressor genes these genes normally inhibit cell division and
prevent survival of cells that have damaged DNA. In patients with cancer
these tumor suppressor genes are often disabled. This is caused by cancerpromoting genetic changes. Typically, changes in many genes are required to
transform a normal cell into a cancer cell.

Genomic amplification
Sometimes there may be genomic amplification. Here a cell gains many copies
(often 20 or more) of a small chromosomal locus, usually containing one or more
oncogenes and adjacent genetic material.
Point mutations
Point mutations occur at single nucleotides. There may be deletions, and insertions
especially at the promoter region of the gene. This changes the protein coded for by
the particular gene. Disruption of a single gene may also result from integration of
genomic material from a DNA virus or retrovirus. This may lead to formation of
Oncogenes.
Translocation
Translocation is yet another process when two separate chromosomal regions
become abnormally fused, often at a characteristic location. A common example is
Philadelphia chromosome, or translocation of chromosomes 9 and 22, which occurs
in chronic myelogenous leukaemia, and results in production of the BCR-abl fusion
protein, an oncogenic tyrosine kinase.
Tumors
A tumor in latin means a swelling but not all swellings are tumors in the modern
sense of the term. Some of them may be caused due to inflammation, infections,

cysts or fluid filled lesions or due to benign growths. A cancerous tumor has the
capacity to grow rapidly and to metastasize or spread to other tissues. Some tumors
like leukemias grow as cell suspensions but most grow as solid masses of tissue.
Solid tumor parts
Solid tumors have two distinct parts. One of them is the parenchyma that contains
cancer tissues and cells and the other is the stroma that the neoplastic cells induce
and in which they are dispersed.
Tumors that originate from epithelial cells have a basal lamina that separates
clumps of tumor cells from stroma. However, the basal lamina is often incomplete,
especially at points of tumor invasion. The stroma is juxtaposed between malignant
cells and normal host tissues and is essential for tumor growth. The stroma contains
nonmalignant supporting tissue and includes connective tissue, blood vessels, and,
very often, inflammatory cells. All solid tumors require stroma if they are to grow
beyond a minimal size of 1 to 2 mm.
In addition, tumors that are cancerous also have the property of new blood vessel
formation. Blood vessels are only one component of tumor stroma. In fact, in many
tumors, the bulk of stroma comprises interstitial connective tissue, and blood
vessels are only a minor component of the stromal mass. The stroma also contains
tissues and cells from blood including water and plasma proteins, together with
various types and numbers of inflammatory cells. There are in addition
proteoglycans and glycosaminoglycans, interstitial collagens (types I, III, and, to a
lesser extent, type V), fibrin, fibronectin, fibroblasts etc.

Perubahan genetik
Pada sel normal, gen mengalami pertumbuhan, kematangan dan kematian sel.
perubahan genetik dapat terjadi pada berbagai tingkatan. Mungkin ada
penambahan atau kehilangan dari keseluruhan kromosom atau mutasi titik tunggal
yang mempengaruhi nukleotida DNA tunggal.

Ada dua kategori besar gen yang dipengaruhi oleh perubahan ini:
Onkogen - ini adalah gen penyebab kanker. Mereka mungkin saja gen yang normal
yang tidak di expresikan sempurna pada pasien dengan kanker atau mereka dapat
diubah atau diubah gen normal karena mutasi. Dalam kedua kasus gen ini
menyebabkan perubahan kanker dalam jaringan.
gen supresor tumor - gen ini fungsinya menghambat pembelahan sel dan
mencegah kelangsungan hidup sel-sel yang telah rusak DNAnya. Pada pasien
dengan kanker gen supresor tumor ini sering tidak berfungsi. Hal ini disebabkan
oleh perubahan genetik kanker. Biasanya, perubahan banyak gen diperlukan untuk
mengubah sel normal menjadi sel kanker.

amplifikasi genom
Kadang-kadang mungkin ada amplifikasi genom. Pada proses ini sel mendapat
banyak copy (sering 20 atau lebih) dari lokus kromosom kecil, biasanya
mengandung satu atau lebih onkogen dan materi genetik yang berdekatan.

mutasi titik
Point mutations occur at single nucleotides. There may be deletions, and insertions
especially at the promoter region of the gene. This changes the protein coded for by
the particular gene. Disruption of a single gene may also result from integration of
genomic material from a DNA virus or retrovirus. This may lead to formation of
Oncogenes.

mutasi titik terjadi pada nukleotida tunggal. Mungkin terjadi penghapusan, dan
penambahan terutama pada daerah promotor gen. Hal ini akan mengubah kode
protein oleh gen tertentu. Gangguan gen tunggal mungkin juga hasil dari integrasi
bahan genom dari virus DNA atau retrovirus. Hal ini dapat menyebabkan
pembentukan Onkogen.

pemindahan
Translocation is yet another process when two separate chromosomal regions
become abnormally fused, often at a characteristic location. A common example is
Philadelphia chromosome, or translocation of chromosomes 9 and 22, which occurs
in chronic myelogenous leukaemia, and results in production of the BCR-abl fusion
protein, an oncogenic tyrosine kinase.

Translokasi adalah proses yang terjadi ketika dua kromosom yang terpisah belum
menyatu, sering di lokasi yang khas. Sebuah contoh umum adalah kromosom
Philadelphia, atau translokasi kromosom 9 dan 22, yang terjadi pada leukemia
myelogenous kronis, dan menghasilkan produksi protein fusi BCR-ABL, sebuah
tyrosine kinase onkogenik.

tumor
A tumor in latin means a swelling but not all swellings are tumors in the modern
sense of the term. Some of them may be caused due to inflammation, infections,
cysts or fluid filled lesions or due to benign growths. A cancerous tumor has the
capacity to grow rapidly and to metastasize or spread to other tissues. Some tumors
like leukemias grow as cell suspensions but most grow as solid masses of tissue.

Tumor dalam bahsa latin berarti pembengkakan tetapi tidak semua pembengkakan
adalah tumor dalam pengertian modern istilah. Beberapa dari mereka mungkin
disebabkan karena peradangan, infeksi, kista atau lesi berisi cairan atau karena
pertumbuhan jinak. Sebuah tumor kanker memiliki kemampuan untuk tumbuh
dengan cepat dan untuk bermetastasis atau menyebar ke jaringan lain. Beberapa
tumor dapat berupa pembelahan sel yang abnormal seperti pada leukemia tetapi
kebanyakan tumor berupa massa padat jaringan.

bagian tumor padat


tumor padat memiliki dua bagian yang berbeda. Salah satunya adalah parenkim
yang berisi jaringan kanker dan sel-sel dan yang lainnya adalah stroma bahwa selsel neoplastik menginduksi dan di mana mereka tersebar.

Tumor yang berasal dari sel epitel memiliki lamina basal yang memisahkan
gumpalan sel tumor dari stroma. Namun, lamina basal sering tidak lengkap,
terutama pada titik-titik invasi tumor. stroma disandingkan antara sel-sel ganas dan
jaringan host biasa dan sangat penting untuk pertumbuhan tumor. stroma
mengandung jaringan pendukung nonmalignant dan termasuk jaringan ikat,
pembuluh darah, dan, sangat sering, sel-sel inflamasi. Semua tumor padat
membutuhkan stroma jika mereka ingin tumbuh melampaui ukuran minimal 1
sampai 2 mm.

Selain itu, tumor yang bersifat kanker juga memiliki sifat pembentukan pembuluh
darah baru. pembuluh darah hanya salah satu komponen dari stroma tumor.
Bahkan, dalam banyak tumor, sebagian besar stroma terdiri jaringan ikat
interstitial, dan pembuluh darah hanya komponen kecil dari massa stroma. stroma
juga mengandung jaringan dan sel dari darah termasuk air dan plasma protein,
bersama-sama dengan berbagai jenis dan jumlah sel inflamasi. Ada di proteoglikan
penambahan dan glikosaminoglikan, kolagen interstitial (tipe I, III, dan, pada tingkat
lebih rendah, tipe V), fibrin, fibronektin, fibroblas dll

Classification by site of origin


By primary site of origin, cancers may be of specific types like breast cancer, lung cancer,
prostate cancer, liver cancer renal cell carcinoma (kidney cancer), oral cancer, brain cancer
etc.

Classification by tissue types

The international standard for the classification and nomenclature of histologies is the
International Classification of Diseases for Oncology, Third Edition (ICD-O-3). This
classification is based on the ICD-O-3.
Based on tissue types cancers may be classified into six major categories:

1. Carcinoma
This type of cancer originates from the epithelial layer of cells that form the lining of
external parts of the body or the internal linings of organs within the body.
Carcinomas, malignancies of epithelial tissue, account for 80 to 90 percent of all cancer
cases since epithelial tissues are most abundantly found in the body from being present in
the skin to the covering and lining of organs and internal passageways, such as the
gastrointestinal tract.
Carcinomas usually affect organs or glands capable of secretion including breast, lungs,
bladder, colon and prostate.
Carcinomas are of two types adenocarcinoma and squamous cell carcinoma.
Adenocarcinoma develops in an organ or gland and squamous cell carcinoma originates in
squamous epithelium. Adenocarcinomas may affect mucus membranes and are first seen as
a thickened plaque-like white mucosa. These are rapidly spreading cancers.

Kanker jenis ini berasal dari lapisan epitel sel yang membentuk lapisan bagian luar tubuh
atau lapisan internal organ dalam tubuh.
Karsinoma, keganasan dari jaringan epitel, memperhitungkan 80 sampai 90 persen dari
semua kasus kanker sejak jaringan epitel yang paling berlimpah ditemukan dalam tubuh
dari yang hadir di kulit untuk menutupi dan lapisan organ dan lorong-lorong internal, seperti
saluran pencernaan.
Karsinoma biasanya mempengaruhi organ atau kelenjar mampu sekresi termasuk payudara,
paru-paru, kandung kemih, usus besar dan prostat.
Karsinoma terdiri dari dua jenis - adenokarsinoma dan karsinoma sel skuamosa.
Adenokarsinoma berkembang di organ atau kelenjar dan karsinoma sel skuamosa berasal di
epitel skuamosa. Adenokarsinoma dapat mempengaruhi selaput lendir dan pertama kali
terlihat sebagai plak-seperti mukosa putih menebal. Ini dengan cepat menyebar kanker.

2. Sarcoma
These cancers originate in connective and supportive tissues including muscles, bones,
cartilage and fat. Bone cancer is one of the sarcomas termed osteosarcoma. It affects the
young most commonly. Sarcomas appear like the tissue in which they grow.

Other examples include chondrosarcoma (of the cartilage), leiomyosarcoma (smooth


muscles), rhabdomyosarcoma (skeletal muscles), Mesothelial sarcoma or mesothelioma
(membranous lining of body cavities), Fibrosarcoma (fibrous tissue), Angiosarcoma or
hemangioendothelioma (blood vessels), Liposarcoma (adipose or fatty tissue), Glioma or
astrocytoma (neurogenic connective tissue found in the brain), Myxosarcoma (primitive
embryonic connective tissue) and Mesenchymous or mixed mesodermal tumor (mixed
connective tissue types).
Kanker ini berasal jaringan ikat dan suportif termasuk otot, tulang, tulang rawan dan lemak.
kanker tulang adalah salah satu sarkoma disebut osteosarcoma. Ini mempengaruhi anak
paling umum. Sarkoma muncul seperti jaringan di mana mereka tumbuh.
Contoh lain termasuk chondrosarcoma (tulang rawan), leiomyosarcoma (otot-otot halus),
rhabdomyosarcoma (otot rangka), sarkoma Mesothelial atau mesothelioma (lapisan
membran rongga tubuh), Fibrosarcoma (jaringan fibrosa), angiosarkoma atau
hemangioendothelioma (pembuluh darah), Liposarkoma ( adipose atau jaringan lemak),
Glioma atau astrocytoma (jaringan neurogenik ikat ditemukan di otak), Myxosarcoma
(primitif jaringan ikat embrio) dan Mesenchymous atau tumor mesoderm campuran (mixed
ikat jenis jaringan).

3. Myeloma
These originate in the plasma cells of bone marrow. Plasma cells are capable of producing
various antibodies in response to infections. Myeloma is a type of blood cancer.
Ini berasal dari sel plasma sumsum tulang. sel plasma mampu memproduksi berbagai
antibodi dalam menanggapi infeksi. Myeloma adalah jenis kanker darah.

4. Leukemia
This a group of cancers that are grouped within blood cancers. These cancers affect the
bone marrow which is the site for blood cell production. When cancerous, the bone marrow
begins to produce excessive immature white blood cells that fail to perform their usual
actions and the patient is often prone to infection.
Types of leukemia include:

Acute myelocytic leukemia (AML) these are malignancy of the myeloid and
granulocytic white blood cell series seen in childhood.

Chronic myelocytic leukemia (CML) this is seen in adulthood.

Acute Lymphatic, lymphocytic, or lymphoblastic leukemia (ALL) these are


malignancy of the lymphoid and lymphocytic blood cell series seen in childhood and
young adults.

Chronic Lymphatic, lymphocytic, or lymphoblastic leukemia (CLL) this is seen in the


elderly.

Polycythemia vera or erythremia this is cancer of various blood cell products with a
predominance of red blood cells.

Ini kelompok kanker yang dikelompokkan dalam kanker darah. Kanker ini mempengaruhi
sumsum tulang yang merupakan situs untuk produksi sel darah. Ketika kanker, sumsum
tulang mulai memproduksi sel-sel darah yang berlebihan yang belum matang putih yang
gagal melakukan tindakan biasa mereka dan pasien sering rentan terhadap infeksi.
Jenis leukemia meliputi:
leukemia mielositik akut (AML) - ini adalah keganasan dari myeloid dan seri sel
darah putih granulocytic terlihat di masa kanak-kanak.
kronis leukemia mielositik (CML) - ini terlihat di masa dewasa.
akut limfatik, limfositik, atau lymphoblastic leukemia (ALL) - ini adalah keganasan
dari seri limfoid dan limfositik sel darah terlihat pada anak-anak dan dewasa muda.
kronis limfatik, limfositik, atau lymphoblastic leukemia (CLL) - ini terlihat pada
orang tua.
Polycythemia vera atau erythremia - ini adalah kanker dari berbagai produk sel
darah dengan dominasi sel darah merah.

5. Lymphoma
These are cancers of the lymphatic system. Unlike the leukemias, which affect the blood and
are called liquid cancers, lymphomas are solid cancers. These may affect lymph nodes at
specific sites like stomach, brain, intestines etc. These lymphomas are referred to as
extranodal lymphomas.
Lymphomas may be of two types Hodgkins lymphoma and Non-Hodgkins lymphomas. In
Hodgkin lymphoma there is characteristic presence of Reed-Sternberg cells in the tissue
samples which are not present in Non-Hodgkin lymphoma.
Ini adalah kanker dari sistem limfatik. Tidak seperti leukemia, yang mempengaruhi darah
dan disebut "kanker cair", limfoma adalah "kanker padat". Ini dapat mempengaruhi kelenjar
getah bening di lokasi tertentu seperti perut, otak, usus dll limfoma ini disebut limfoma
sebagai ekstranodal.
Limfoma mungkin dari dua jenis - limfoma Hodgkin dan limfoma non-Hodgkin. Dalam
limfoma Hodgkin ada kehadiran karakteristik sel Reed-Sternberg dalam sampel jaringan
yang tidak hadir pada limfoma Non-Hodgkin.

6. Mixed types
These have two or more components of the cancer. Some of the examples include mixed
mesodermal tumor, carcinosarcoma, adenosquamous carcinoma and teratocarcinoma.
Blastomas are another type that involves embryonic tissues.
Ini memiliki dua atau lebih komponen dari kanker. Beberapa contoh termasuk tumor
campuran mesoderm, carcinosarcoma, karsinoma adenosquamous dan teratokarsinoma.
Blastomas adalah jenis lain yang melibatkan jaringan embrio.

Classification by grade
Cancers can also be classified according to grade. The abnormality of the cells with respect
to surrounding normal tissues determines the grade of the cancer. Increasing abnormality
increases the grade, from 14.
Cells that are well differentiated closely resemble normal specialized cells and belong to low
grade tumors. Cells that are undifferentiated are highly abnormal with respect to
surrounding tissues. These are high grade tumors.

Grade 1 well differentiated cells with slight abnormality

Grade 2 cells are moderately differentiated and slightly more abnormal

Grade 3 cells are poorly differentiated and very abnormal

Grade 4 cells are immature and primitive and undifferentiated

Kanker juga dapat diklasifikasikan menurut kelas. Kelainan sel sehubungan dengan jaringan
normal sekitarnya menentukan kelas dari kanker. Peningkatan kelainan meningkatkan kelas,
1-4.
Sel yang baik dibedakan mirip sel khusus normal dan milik tumor kelas rendah. Sel-sel yang
berdiferensiasi sangat normal sehubungan dengan jaringan sekitarnya. Ini adalah tumor
kelas tinggi.
Kelas 1 - baik sel diferensiasi dengan sedikit kelainan
Kelas 2 - sel cukup diferensiasi dan sedikit lebih normal
kelas 3 - sel yang berdiferensiasi buruk dan sangat tidak normal
kelas 4 - sel yang belum matang dan primitif dan tidak dibedakan

Classification by stage

Cancers are also classified individually according to their stage. There are several types of
staging methods. The most commonly used method uses classification in terms of tumor
size (T), the degree of regional spread or node involvement (N), and distant metastasis (M).
This is called the TNM staging.
For example, T0 signifies no evidence of tumor, T 1 to 4 signifies increasing tumor size and
involvement and Tis signifies carcinoma in situ or limited to surface cells. Similarly N0
signifies no nodal involvement and N 1 to 4 signifies increasing degrees of lymph node
involvement. Nx signifies that node involvement cannot be assessed. Metastasis is further
classified into two M0 signifies no evidence of distant spread while M1 signifies evidence of
distant spread.
Stages may be divided according to the TNM staging classification. Stage 0 indicates cancer
being in situ or limited to surface cells while stage I indicates cancer being limited to the
tissue of origin. Stage II indicates limited local spread, Stage II indicates extensive local and
regional spread while stage IV is advanced cancer with distant spread and metastasis.
Kanker juga diklasifikasikan secara individual sesuai dengan tingkatan mereka. Ada
beberapa jenis metode penentuan stadium. Metode yang paling umum digunakan
menggunakan klasifikasi dalam hal ukuran tumor (T), tingkat penyebaran atau regional
node keterlibatan (N), dan metastasis jauh (M). Ini disebut stadium TNM.
Misalnya, T0 menandakan tidak ada bukti tumor, T 1 sampai 4 menandakan peningkatan
ukuran tumor dan keterlibatan dan Tis menandakan karsinoma in situ atau terbatas pada
sel permukaan. Demikian pula N0 menandakan ada keterlibatan nodal dan N 1 sampai 4
menandakan peningkatan derajat keterlibatan kelenjar getah bening. Nx menandakan
bahwa keterlibatan kelenjar tidak dapat dinilai. Metastasis selanjutnya diklasifikasikan
menjadi dua - M0 menandakan tidak ada bukti penyebaran jauh sementara M1 menandakan
bukti penyebaran jauh.

Tahapan dapat dibagi menurut klasifikasi TNM penentuan stadium. Tahap 0


menunjukkan kanker berada di situ atau terbatas pada sel-sel permukaan
sementara tahap I menunjukkan kanker yang terbatas pada jaringan asal. Tahap II
menunjukkan penyebaran lokal yang terbatas, tahap II menunjukkan penyebaran
lokal dan regional yang luas sementara stadium IV adalah kanker stadium lanjut
dengan penyebaran jauh dan metastasis.

Demografi dan Relevansi untuk rehabilitasi


Kanker merupakan penyebab kedua kematian di Amerika Serikat, terhitung sekitar
satu dari setiap empat kematian di antara anak-anak dan orang dewasa
Hampir 60% dari semua kanker terjadi pada usia individu 65 dan kejadian
disesuaikan menurut umur adalah 10x lebih besar pada individu> 65 dari kelompok
usia muda

Karena kanker paling umum pada kelompok usia yang lebih tua, dampak dari
kanker dalam populasi geriatri perhatian.
Secara umum, kanker pada orang tua mungkin tidak lebih mematikan dari kondisi
medis umum lainnya seperti diabetes atau CHF, tetapi gejala yang lebih berat atau
pengobatan yang luas terkait dengan kerugian yang lebih besar dari fungsi

Karnofsky dan Eastern Cooperative Oncology Group (ECOG) skala telah digunakan
oleh ahli onkologi sebagai ukuran status kinerja, kurang begitu untuk hasil
fungsional; karenanya, langkah-langkah ini dari nilai pasti dalam rehabilitasi.
36-Item Pendek Survey Form Kesehatan (SF-36), instrumen status kesehatan, juga
telah diterapkan pada populasi kanker

Membantu pasien dan orang yang mereka cintai membuat keputusan mengenai
kemungkinan modalitas pengobatan, perawatan paliatif, dan hal-hal pribadi, seperti
masalah keuangan dan warisan.

Karena pasien memasuki tahap akhir kanker, tujuan rehabilitatif menjadi paliatif
dan fokus pada memaksimalkan kenyamanan pasien, psikologis kesejahteraan dan
kemandirian dalam mobilitas dan kinerja ADL

Diagnosis
If you have a symptom or your screening test result suggests cancer, the
doctor must find out whether it is due to cancer or some other cause. The
doctor may ask about your personal and family medical history and do a
physical exam. The doctor also may order lab tests, scans, or other tests or
procedures.

Lab Tests
High or low levels of certain substances in your body can be a sign of cancer.
So, lab tests of the blood, urine, or other body fluids that measure these
substances can help doctors make a diagnosis. However, abnormal lab
results are not a sure sign of cancer. Lab tests are an important tool, but
doctors cannot rely on them alone to diagnose cancer.

Imaging Procedures
Imaging procedures create pictures of areas inside your body that help the
doctor see whether a tumor is present. These pictures can be made in
several ways:

CT Scan:
An x-ray machine linked to a computer takes a series of detailed pictures of your
organs. You may receive a dye or other contrast material to highlight areas
inside the body. Contrast material helps make these pictures easier to read.
Nuclear scan:
For this scan, you receive an injection of a small amount of radioactive material,
which is sometimes called a tracer. It flows through your bloodstream and
collects in certain bones or organs. A machine called a scanner detects and
measures the radioactivity. The scanner creates pictures of bones or organs on a
computer screen or on film. Your body gets rid of the radioactive substance
quickly. This type of scan may also be called radionuclide scan.
Ultrasound:
An ultrasound device sends out sound waves that people cannot hear. The
waves bounce off tissues inside your body like an echo. A computer uses these
echoes to create a picture of areas inside your body. This picture is called
a sonogram.
MRI:
A strong magnet linked to a computer is used to make detailed pictures of areas
in your body. Your doctor can view these pictures on a monitor and print them
on film.
PET scan:
For this scan, you receive an injection of a tracer. Then, a machine makes 3-D
pictures that show where the tracer collects in the body. These scans show how
organs and tissues are working.
X-rays:
X-rays use low doses of radiation to create pictures of the inside of your body.

Biopsy
In most cases, doctors need to do a biopsy to make a diagnosis of cancer. A
biopsy is a procedure in which the doctor removes a sample of tissue.
A pathologist then looks at the tissue under a microscope to see if it is
cancer. The sample may be removed in several ways:

With a needle: The doctor uses a needle to withdraw tissue or fluid.


With an endoscope: The doctor looks at areas inside the body using a thin,
lighted tube called an endoscope. The scope is inserted through a natural
opening, such as the mouth. Then, the doctor uses a special tool to remove
tissue or cells through the tube.
With surgery: Surgery may be excisional or incisional.

o
o

In an excisional biopsy, the surgeon removes the entire tumor. Often


some of the normal tissue around the tumor also is removed.
In an incisional biopsy, the surgeon removes just part of the tumor.

Sympoms of Cancer

Symptoms of cancer are masters of deception. On several occasions, cancer symptoms are
attributed to other diseases, for example, stomach pain is associated with gas or digestion problem.
Hence we highlight the symptoms of cancer and throw some light on the symptoms of cervical, lung
cancer, breast cancer in men and women, ovarian cancer and ways to prevent cancer.
Cancer Symptoms: Unexplained weight loss:Significant weight loss over a few months without
any apparent cause, i.e. unexplained weight loss, can be one of the main warning signs that you
might be suffering from cancer. This happens most often with cancers of the pancreas, stomach,
esophagus, or lungs.
Cancer Symptoms: Fever: Fever may be associated with some cancers, too. Almost all patients
with cancer will have fever at some time or the other, especially if the cancer or its treatment affects
the immune system. One can also find constitutional symptoms of fatigue with some kind of cancers.
Cancer Symptoms: Pain: Pain usually occurs late, as early cancer stages are usually painless.
Most often pain due to cancer is a symptom of cancer that has already spread. It can be felt early
with cancers like bone or testicular cancer.
Cancer Symptoms: Changes in the skin: One can witness changes in his/her appearance,
boundary or colour in a pre-existing mole or appearance of new lesions. Skin cancer may be
developing in some. Especially in people who often chew tobacco, smoke or drink alcohol, their skin
sores might not heal.
Cancer Symptoms: Changes in bowel habits or bladder function: Constipation, diahorea
frequency, bleeding in urine. Pain when passing urine, blood in the urine, or a change in bladder
function.
Cancer Symptoms: White patches inside the mouth or white spots on the tongue: It is also
known as lenkoplakia, which may progress to oral cavity cancer later. Leukoplakia is a precancerous area that is caused by frequent irritation. If it is not treated, leukoplakia can become oral
cancer.
Cancer Symptoms: Unusual bleeding or discharge: It can happen in early or advanced cancer.
Blood in the sputum (phlegm) may be a sign of lung cancer. Blood in the stool could be a sign of
colon or rectal cancer. Cancer of the cervix or the endometrium (lining of the uterus) can cause

abnormal vaginal bleeding. Blood in the urine may be a sign of bladder or kidney cancer. A bloody
discharge from the nipple may be a sign of breast cancer.
Cancer Symptoms: Thickening or lump in the breast or other parts of the body: These
symptoms can be caused by many other reasons, other than cancer, and a doctor is the best person
to identify the reason after necessary investigations. Instead of waiting for symptoms to surface, it
would be better to opt for periodic health checkups.
Cancer Symptoms: Indigestion or trouble swallowing: It is usually associated with stomach or
esophagus (food pipe) cancer. Getting it checked and treated as soon as it occurs will prevent
further developments.
Cancer Symptoms: Nagging cough or hoarsenes: This can be one of the main symptoms of
throat cancer. If the cough remains for a long time, then it may be a sign of lung or vocal cord
cancer.
Cancer Symptoms: Itching, crusting or bleeding:These are less common signs but should not be
ignored. It is important to see your doctor if you have any unusual marks on the skin that last more
than a few weeks, or an existing mole which shows any of the above signs. If necessary they will
arrange for you to see a doctor who specialises in skin conditions (a dermatologist) or a surgeon.
General symptoms of Lung cancer: Pain is experienced in the chest, back and shoulders; this is
generally different from the pain experienced during coughing, the colour and the volume of the
sputum changes, shortness of breath; Coughing blood with consistent lung problems like bronchitis
or pneumonia; loss of appetite and the patient experiences constant fatigue; bone and joint pain,
facial and neck swelling.
Less common symptoms of lung cancer:Problem in swallowing, finger clubbing, which means
changes in the shape of your finger and nails, blockage of blood vessels in the face area, and
swelling in the neck area because of lymph nodes.
Cancer Symptoms: Hormone related symptoms:Weakness in the muscles, needles and
numbness in the fingers, drowsiness, dizziness and confusion, swelling of chest in men and blood
clots.
Ovarian Cancer symptoms: Pain in the abdomen, pelvis or legs, swollen abdomen, nausea,
diarrhea or constipation, feeling tired all the time, difficulty in eating, weight loss or weight gain,
fatigue, pain during intercourse and frequent urination.

Cancer can cause many different symptoms. These are some of them:

Skin changes, such as:

A new mole or a change in an existing mole

A sore that does not heal


Breast changes, such as:

Change in size or shape of the breast or nipple

Change in texture of breast skin

A thickening or lump on or under the skin

Hoarseness or cough that does not go away

Changes in bowel habits

Difficult or painful urination

Problems with eating, such as:


o

Discomfort after eating

A hard time swallowing

Changes in appetite

Weight gain or loss with no known reason

Abdominal pain

Unexplained night sweats

Unusual bleeding or discharge, including:

Blood in the urine

Vaginal bleeding

Blood in the stool


Feeling weak or very tired

Most often, these symptoms are not due to cancer. They may also be caused by benign
tumors or other problems. If you have symptoms that last for a couple of weeks, it is
important to see a doctor so that problems can be diagnosed and treated as early as
possible.
Usually, early cancer does not cause pain. If you have symptoms, do not wait to feel
pain before seeing a doctor.
To learn more about symptoms for a specific cancer, see the PDQ cancer treatment
summaries for adult and childhood cancers. These summaries include information
about symptoms.

Knowing how your body normally looks and feels can help you be aware of
any changes that could be caused by cancer. If you have any symptoms that
are ongoing, unexplained or unusual for you its important to see your doctor.
There are certain symptoms you should always have checked. Dont be
scared about getting symptoms checked by your doctor. The earlier cancer is
found, the more likely it is to be cured. You wont be wasting their time.
Common symptoms of cancer include:

Unexplained bleeding

Unexplained weight loss

A lump or swelling

Unexplained pain.
These symptoms can be caused by something other than cancer. However,
its always best to have them checked by your GP, as soon as possible. You
are not wasting your doctors time by getting your symptoms checked.
If youve already been to your doctor with symptoms but they havent gone
away, it is important to see your doctor again.