Director, Emergency Services, Bikur Cholim Hospital
Warning signs of cancer. First the principles: Not all cases
of these signs are cancer and chances are that they are not.
But in all cases the earlier you catch it the better the
chances of a full recovery. Some cancers are curable, but
denial or excuses ("I hate doctors", "It will go away") can
turn a survivable situation into a lethal one.
What is something that needs further investigation? Lumps
that grow, are fixed and not movable, are hard, and irregular
shaped need to be investigated. Unexplained weight loss is
also a possible symptom as are fatigue and sores that do not
heal.
Now individual cancers. We will not speak on breast and teste
cancer here since we have discussed them in the past.
Skin: Sun exposure in light-skinned people is the
danger here. People with lots of moles and spots need to be
regularly checked by a dermatologist. Black spots are more
worrisome. Sores that do not heal in nondiabetics can be
easier to treat cancers.
Mouth: Smokers beware. These are disfiguring cancers
with high mortality rates. Change of voice, festering sores,
are risks
Brain: Deep boring headaches that persist and new
seizure are possible signs. Brain is often secondary to other
areas in the body.
Esophageal: Problems with swallowing. Heartburn. Those
who suffer from heartburn regularly are at risk. Blood test
Ca 9-19 is elevated. Smokers at risk.
Lung: Cough with blood. Shortness of breath that is
unexplained. Smoking is a risk, as is exposure to other air
pollution.
Stomach: Ulcer sufferers are at risk. Pain, bleeding.
There is a higher risk in fish eaters, but fish is very
healthy and this may be related to fish that has high mercury
levels which mostly are fish not eaten by Jews. Smokers are
at risk.
Liver: Usually secondary to other cancers, like colon
and ovary. Yellowing of the skin, confusion. Perhaps pain.
Pancreas: Yellowing, weight loss. A bad cancer that is
often picked up too late.
Kidney: Another bad one picked up too late. Weight
loss, blood in urine.
Colon: Black stool, occult blood in stool. Very common
cancer in fat eaters and in Western Cultures. Stool should be
checked for occult blood yearly from age 40. Alpha Feto
Protein elevated in Blood. CA 9-19 as well.
Rectal cancer: Fullness in rectum. A routine rectal
exam can pick this up, as well as occult blood in stool and
prostate lumps.
Ovarian Cancer: Another bad one. Routine gynecological
exam yearly. Blood levels of Ca 125 rise.
Hematological cancers: That is leukemia, MDS. Symptoms
are easy bruising, unexplained anemia, fatigue and
weakness.
Lymphoma: Lumps. If they are in the chest or abdomen
cavity they may not be detected without a CT. Hodgkin's
Lymphoma is curable.
Bladder: Blood in urine. Much more common in Israel
than in USA. I'm not sure why.
Thyroid: Lump in neck, weakness or excitability. Very
common in women. Often curable if caught early.
*
Answering another question: How do you relate to a person
coming home from a psychiatric hospital? First respect their
privacy and dignity. Often the drugs given to control
schizophrenia and, to a lesser point, depression make the
person look "strange" and perhaps have slurred speech. Do not
stare. Be supportive. Understand that getting back into
society requires time, just like any other illness. Be on the
lookout for a relapse. Often these folks feel much better and
think there is no need to keep taking their pills. Be
available to talk to. Be firm about treatment plans. Hiding
can put much pressure on the family. Good luck.
Write me in care of the Yated.
