THE SILENT TYPE

A number of cancers — including ovarian, breast, colorectal, cervical, pancreatic and lung — are known as “silent” cancers because they don’t necessarily trigger any initial symptoms and/or their warning signs are similar to those of less serious conditions. Because these cancers can remain under the radar in earlier stages, screening tools have never been more important for those at high risk.
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WARNING SIGNS
Dr. Devika Rao, medical site director at Memorial Sloan Kettering, Basking Ridge, explained that the word cancer originated from the Greek karkinos, or crab. “There are various theories regarding the etymology of that word, but one that explains why cancer is so difficult to identify is that the disease courses through one’s body as a crab would burrow into the sand, leaving no trace of its presence on the surface above,” Dr. Rao said. “Similarly, the abnormal growth of tissue can take root in almost any organ with no clinical symptoms until it either reaches a certain size or invades a surrounding structure.”
While ovarian, breast, colorectal, cervical, pancreatic, and lung cancers can develop without symptoms, “Red flags may include persistent abdominal pain, bloating, blood in the bowels, shortness of breath, coughing up blood, unexplained weight loss, loss of appetite, postmenopausal bleeding and bone pain,” said Dr. May Abdo-Matkiwsky, hematologist/oncologist at Regional Cancer Care Associates (RCCA) in Sparta.
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While many cancers can be silent, “I would call ovarian and pancreatic cancers truly silent and difficult to diagnose in early stages because, anatomically, both of those organs have free space around them where a tumor could grow undetected before it causes symptoms,” Dr. Rao said. “At the same time, ovarian and pancreatic cancers are two types that have no screening program to detect precancerous or early-stage disease; as a result, we often end up catching these diseases in advanced stages, which can be more challenging to treat or eradicate.
“By contrast, colorectal, breast, cervical and lung cancers do have robust screening programs designed to catch precancerous and/or earlystage disease,” Dr. Rao said. Among those cancers, “symptoms of progressive colorectal cancer include anemia in individuals over age 50, a change in bowel habits and blood with stool; while symptoms of progressive breast cancer can include a palpable mass or lump in the breast or lymph nodes in the armpit, an abnormal swelling or rash over the breast, nipple discharge and/or bleeding in non-pregnant women, and asymmetry of breasts compared to the norm for that individual,” she said. Symptoms of progressive cervical cancer include post-coital bleeding and spotting/bleeding between menstrual periods, while symptoms of progressive lung cancer include coughing, chest pain, shortness of breath, coughing up blood and hoarseness of voice. Finally, pain in the upper abdomen, malabsorption of food (reflected by floating and oily stools, bloating and diarrhea), jaundice (which can appear as dark urine and pale stools), and a sudden loss of blood sugar control (in diabetics) can all be symptoms of early-stage pancreatic cancer.
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“Other overarching symptoms which could indicate an underlying malignancy include the sudden and unexplainable loss of over 10% of your body weight, loss of appetite, extreme letha...