| Roughly, cancer symptoms can be divided | | | | cervical cytology testing (using the Pap |
| into three groups: | | | | smear) leads to the identification and |
| Local symptoms: unusual lumps or | | | | excision of precancerous lesions. Over |
| swelling (tumor), hemorrhage (bleeding), | | | | time, such testing has been followed by |
| pain and/or ulceration. Compression of | | | | a dramatic reduction of cervical cancer |
| surrounding tissues may cause symptoms | | | | incidence and mortality. Testicular |
| such as jaundice. | | | | self-examination is recommended for men |
| Symptoms of metastasis (spreading): | | | | beginning at the age of 15 years to |
| enlarged lymph nodes, cough and | | | | detect testicular cancer. Prostate |
| hemoptysis, hepatomegaly (enlarged | | | | cancer can be screened for by a digital |
| liver), bone pain, fracture of affected | | | | rectal exam along with prostate specific |
| bones and neurological symptoms. | | | | antigen (PSA) blood testing. |
| Although advanced cancer may cause pain, | | | | Screening for cancer is controversial in |
| it is often not the first symptom. | | | | cases when it is not yet known if the |
| Systemic symptoms: weight loss, poor | | | | test actually saves lives. The |
| appetite and cachexia (wasting), | | | | controversy arises when it is not clear |
| excessive sweating (night sweats), | | | | if the benefits of screening outweigh |
| anemia and specific araneoplastic | | | | the risks of follow-up diagnostic tests |
| phenomena, i.e. specific conditions that | | | | and cancer treatments. For example: when |
| are due to an active cancer, such as | | | | screening for prostate cancer, the PSA |
| thrombosis or hormonal changes. | | | | test may detect small cancers that would |
| Every single item in the above list can | | | | never become life threatening, but once |
| be caused by a variety of conditions (a | | | | detected will lead to treatment. This |
| list of which is referred to as the | | | | situation, called overdiagnosis, puts |
| differential diagnosis). Cancer may be a | | | | men at risk for complications from |
| common or uncommon cause of each item. | | | | unnecessary treatment such as surgery or |
| Biopsy | | | | radiation. Follow up procedures used to |
| A cancer may be suspected for a variety | | | | diagnose prostate cancer (prostate |
| of reasons, but the definitive diagnosis | | | | biopsy) may cause side effects, |
| of most malignancies must be confirmed | | | | including bleeding and infection. |
| by histological examination of the | | | | Prostate cancer treatment may cause |
| cancerous cells by a pathologist. Tissue | | | | incontinence (inability to control urine |
| can be obtained from a biopsy or | | | | flow) and erectile dysfunction |
| surgery. Many biopsies (such as those of | | | | (erections inadequate for intercourse). |
| the skin, breast or liver) can be done | | | | Similarly, for breast cancer, there have |
| in a doctor's office. Biopsies of other | | | | recently been criticisms that breast |
| organs are performed under anesthesia | | | | screening programs in some countries |
| and require surgery in an operating | | | | cause more problems than they solve. |
| room. | | | | This is because screening of women in |
| The tissue diagnosis indicates the type | | | | the general population will result in a |
| of cell that is proliferating, its | | | | large number of women with false |
| histological grade and other features of | | | | positive results which require extensive |
| the tumor. Together, this information is | | | | follow-up investigations to exclude |
| useful to evaluate the prognosis of this | | | | cancer, leading to having a high |
| patient and choose the best treatment. | | | | number-to-treat (or number-to-screen) to |
| Cytogenetics and immunohistochemistry | | | | prevent or catch a single case of breast |
| may provide information about future | | | | cancer early. |
| behavior of the cancer (prognosis) and | | | | Cervical cancer screening via the Pap |
| best treatment. | | | | smear has the best cost-benefit profile |
| Screening | | | | of all the forms of cancer screening |
| Cancer screening is an attempt to detect | | | | from a public health perspective as, |
| unsuspected cancers in the population. | | | | being a cancer, it has clear risk |
| Screening tests suitable for large | | | | factors (sexual contact), and the |
| numbers of healthy people must be | | | | natural progression of cervical cancer |
| relatively affordable, safe, noninvasive | | | | is that it normally spreads slowly over |
| procedures with acceptably low rates of | | | | a number of years therefore giving more |
| false positive results. If signs of | | | | time for the screening program to catch |
| cancer are detected, more definitive and | | | | it early. Moreover, the test itself is |
| invasive follow up tests are performed | | | | easy to perform and relatively cheap. |
| to confirm the diagnosis. | | | | For these reasons, it is important that |
| Screening for cancer can lead to earlier | | | | the benefits and risks of diagnostic |
| diagnosis. Early diagnosis may lead to | | | | procedures and treatment be taken into |
| extended life. A number of different | | | | account when considering whether to |
| screening tests have been developed. | | | | undertake cancer screening. |
| Breast cancer screening can be done by | | | | Use of medical imaging to search for |
| breast self-examination. Screening by | | | | cancer in people without clear symptoms |
| regular mammograms detects tumors even | | | | is similarly marred with problems. There |
| earlier than self-examination, and many | | | | is a significant risk of detection of |
| countries use it to systematically | | | | what has been recently called an |
| screen all middle-aged women. Colorectal | | | | incidentaloma - a benign lesion that may |
| cancer can be detected through fecal | | | | be interpreted as a malignancy and be |
| occult blood testing and colonoscopy, | | | | subjected to potentially dangerous |
| which reduces both colon cancer | | | | investigations. |
| incidence and mortality, presumably | | | | Canine cancer detection has shown |
| through the detection and removal of | | | | promise, but is still in the early |
| pre-malignant polyps. Similarly, | | | | stages of research. |