World Cancer Day is celebrated on February 4 every year. The word “cancer” seems to be both strange and familiar. Sometimes the Internet will explode that a celebrity has died of cancer, as if it is far away from us, but it is all around us. Cancer makes many people feel horrible, but it is not completely impossible to escape from its clutches. It takes about 10 years for a cancer cell to develop into an obvious cancer, from the initial cancer (also called “a little cancer”) that has just formed. During this period of time, it is difficult to detect the signs of cancer without careful examination of the body. Before cancer cells attack your body unscrupulously, there must be some signals that alert you in advance, but they are not noticed at that time. On the occasion of “World Cancer Day”, we would like to remind you to pay attention to some early signs of cancer for early detection and prevention. 1. Alarm signal of lung cancer [Example] Lihua is 45 years old and works in a foreign bank. Last winter, she suspected rheumatoid arthritis disease because of swollen and painful joints, hypertrophy at the end of the limbs, as well as distension and numbness, but the test for rheumatoid factor was negative, and there were no symptoms such as early morning stiffness, and the use of various anti-inflammatory and analgesic agents failed to relieve the condition. She was very uneasy and felt that she should have a comprehensive medical checkup, which resulted in the discovery of an abnormal lung shadow in the chest radiograph, which was later confirmed to be lung cancer, fortunately in its early stage. When the lung lesion was removed, the joint pain was quickly relieved, and the swelling and numbness of the extremity completely disappeared 2 months after the surgery. Lihua’s bone and joint lesions were all caused by lung cancer, which is medically known as lung cancer osteoarthropathy. Expert comment: About 1/3 of early stage lung cancers lack lung symptoms, but may show certain extra-pulmonary manifestations, such as endocrine and metabolic abnormalities, skin and connective tissue changes, neuromuscular lesions, cardiovascular and hematologic abnormalities. Osteoarthropathy is a common extra-pulmonary manifestation. Bone and joint lesions of lung cancer are characterized by enlarged or hypertrophied bone joints, mainly large joints, painful periosteal hyperplasia in the distal ends of long bones of the limbs; pestle-like fingers and toes; pain, swelling and numbness in the extremities; and redness of the skin around the nails. In addition to bone and joint lesions, the following symptoms may also indicate whether lung cancer has found you: (1) Cough. Cough is usually the first symptom and early stage signal of lung cancer. Especially for people with chronic cough, when the nature of cough changes, irritating dry cough or severe cough does not heal, they should pay high attention and be alert to the possibility of lung cancer. (2) Blood in sputum. This is also a common first symptom of lung cancer, which is often caused by ulceration of cancer foci and manifests as blood in sputum or blood clots, while massive hemoptysis is rare. Therefore, men and women over 40 years old with no previous history of hemoptysis should first think of the possibility of lung cancer when unexplained bloody sputum suddenly appears. (3) Chest pain. For people over 40 years of age, once they feel chest pain, they should be examined before it is too late. (4) Fever. After the lung cancer lesion obstructs the larger bronchus or invades the bronchial wall and causes bronchial narrowing, the secretions in the distal bronchus can accumulate and cannot be emptied, which can cause generalized fever due to infection. Therefore, those who have fever accompanied by intrapulmonary shadow should not be let off easily and the real cause should be searched carefully. Therefore, for people who are at high risk of lung cancer, they should learn some knowledge about tumors and learn some early signs of lung cancer and other cancers. If you find any “hint”, you should seize it and seek medical treatment in time to trace it to the end. 2. Alarm signal of stomach cancer [Example] Xiao Ning is 39 years old, a civil servant in government office and in good health. Not long ago, she had occasional upper abdominal pain because of weakness. She was very uneasy and thought she should have a comprehensive medical checkup, the result showed: stomach cancer with extensive metastasis to liver and bone. Expert comment: The five-year survival rate of patients with early gastric cancer can reach 90-95% after surgery. If gastric cancer develops to advanced stage, the treatment effect is not so satisfactory. Therefore, early detection of gastric cancer is an important part of gastric cancer prevention and treatment. So, what are the early signs of stomach cancer? (1) Discomfort and vague pain in upper abdomen. This is the most common symptom in the early stage of stomach cancer. The discomfort of fullness refers to an indefinable vague and stuffy feeling, which often has no obvious cause and appears mostly when it is quiet and disappears when it is active or mentally distracted, and the effect of diet regulation is poor. The pain starts as intermittent vague pain, and then gradually increases and lasts. Although the pain is tolerable, it is not easily relieved or reappears after a short period of relief. (2) Loss of appetite, acid reflux, belching, and indigestion. Usually no cause can be found, and the symptoms are poor appetite, followed by lack of interest in one’s favorite food, especially aversion to meat or greasy food, and poor results even after changing the menu, or poor appetite again despite improvement, sometimes accompanied by acid reflux, belching, or indigestion, accounting for about 68% of these manifestations. It is easy to be ignored because of similar symptoms with gastritis and ulcer disease. (3) Unexplained weakness, emaciation or progressive anemia. Patients often feel general weakness and gradually lose weight, which can be 3 to 5 pounds in 2 to 3 months. (4) Positive fecal occult blood or black stool. Positive fecal occult blood is one of the more common symptoms of gastric cancer. It accounts for 50% to 65% in early gastric cancer. (5) Paraneoplastic syndrome. Paraneoplastic syndrome can appear before gastric cancer, mainly including: (1) recurrent thrombophlebitis; (2) acanthosis nigricans, skin pigmentation, especially in the two axils; (3) dermatomyositis, etc. Although these signs are not typical and specific, for people over 40 years old, if they have no history of gastric disease and the above symptoms appear in the near future, they should not be easily considered as general gastric disease, but should pay high attention to it and strive for more detailed examination. For those who have previous stomach diseases, if their original symptoms change or worsen, they should also pay high attention and go to hospital for examination in time. 3. Alarm signal of liver cancer Mr. Huang has been engaged in media work for a long time and is a senior editor. At the beginning of this year, due to diarrhea, he initially suspected that it was caused by improper diet and went to the community hospital, but he could not stop. A few days later, he went to a local hospital and was finally found to have advanced liver cancer, which was like a thunderstorm when his family was informed. Expert Comment: Liver is an important detoxification organ of human body, which is responsible for detoxification of toxins in the body. However, some liver cancer patients can show some “signals” in the early stage, and if attention is paid, early liver cancer can be detected. Some people have diarrhea as the first symptom of liver cancer, which is usually not serious and chronic, with no abnormalities in stool test and bacterial culture, and antibiotic treatment is ineffective. In addition to persistent diarrhea as the first symptom, the following symptoms may also indicate the early signs of liver cancer. (1) Pain in the right upper abdomen. Finding persistent dull pain in the right upper abdominal liver area area is the most common symptom of primary liver cancer. Due to the rapid enlargement of the liver, it makes the pericyte membrane of the liver tense, which manifests as persistent dull pain or swelling pain. When the tumor invades the muscle area, the pain will spread to the right shoulder or right back. (2) Skin changes. Yellowish eyes or skin, medically called liver disease face, is likely to have liver cancer. 1/4 of people with abnormal liver function will have dull and dark skin changes, and such skin changes are still very easy to be detected. (3) Indigestion. About 40% of liver cancer patients will think they have stomach disease in the early stage because they usually feel indigestion, poor appetite and fullness in upper abdomen after eating, in fact, indigestion is also a typical sign of early stage liver cancer, which is easy to be ignored. (4) Abnormal weight. Due to the impaired liver function and reduced digestion and absorption function of patients with early stage liver cancer, they suffer from unexplained weight loss, which is also a typical symptom of early stage liver cancer. This is a typical symptom of early stage liver cancer. However, when the symptom of serious weight abnormality is found, it is usually in the middle and late stage, which is caused by the change of biochemical metabolism of the body caused by tumor metabolites and the reduction of food intake, resulting in a thin body. Early detection can slow down the development of the disease and will not be life-threatening for a while, but if we find it late, it will be much more difficult to treat. 4.Alarm signal of colorectal cancer 【Example】 Xiaoliu of accounting firm, 41 years old, is a very capable staff. At the end of last year, he was found to have positive occult blood in his stool during his physical examination, and his doctor suggested him to have a colonoscopy, which revealed multiple polyps and cancerous lesions in the large intestine. A simple stool occult blood test led to the early detection of colorectal cancer. Expert commentary: In recent years, the incidence of colorectal cancer presents three new features: rising incidence rate, early age of onset, and high misdiagnosis rate. As the early symptoms of colorectal cancer are not obvious, its misdiagnosis rate reaches 50% to 80%, and is often misdiagnosed as constipation, hemorrhoids, diarrhea, etc. A positive occult blood test, which actually refers to minor gastrointestinal bleeding not visible to the naked eye, is of great significance for early diagnosis of gastrointestinal cancer. Occult blood test should be done promptly when darkening or blackening of stool is detected. In addition to positive occult blood test, the following symptoms may also indicate the danger signs of colorectal cancer (1) Abdominal pain and discomfort. If the abdominal pain is accompanied by abdominal distension and little exhaustion from the anus, you should be alert to intestinal obstruction. (2) Abdominal mass. The mass is hard, of different sizes, with a nodular surface, which can generally be pushed, but at a later stage it is fixed and does not move, and there may be pressure pain when combined with secondary infection. The abdominal mass indicates a large polyp type cancer or metastasis to the organs around the intestine. (3) Blood in stool. Blood in stool is the most common early sign of colorectal cancer, the main reason is tumor enlargement and bleeding, but generally the amount of blood in stool is not much, some are bright red, some are dark red or sauce color. (4) Change of stool shape. Normal stool is cylindrical and discharged vertically from the anus. If the cancer protrudes in the rectal cavity and compresses the stool, the discharged stool often becomes thinner and the shape may be flat, and sometimes there is a trace of blood attached to the deformed stool strip. (5) Change in stool habits. Change in stool habits, including changes in stool time, frequency and constipation or unexplained diarrhea. In general, people need to stool 1 to 2 times a day, and more regular. If there is a change in the original pattern, especially if it is difficult to pass stool, from the regular 1 to 2 times a day to 4 to 5 times a day or 2 to 3 days to pass stool once, it should be noted. (6) Systemic symptoms such as anemia, emaciation and weakness. Due to the chronic bleeding of the tumor and the consumption of nutrients in the body, people will have symptoms such as anemia, emaciation, weakness and even inexplicable fever after a long time. 5. Alarm signal of pancreatic cancer [Example] Xiao Wei is 45 years old, an employee of a company. In the past month, he lost a lot of weight and was diagnosed with diabetes mellitus after he noticed a significant increase in blood glucose when he went to the doctor. After treatment, his blood sugar level decreased, but he was still losing weight. He was very uneasy and went to several hospitals for treatment, but later he was found to have pancreatic cancer. Expert comment: In recent years, the incidence of pancreatic cancer is on the rise, and it is mostly found in middle-aged and elderly people. The location of the pancreas is deep, and pancreatic cancer lacks typical symptoms at the early stage, so it is not easy to detect it at the early stage. Pancreatic cancer develops diabetic symptoms, elevated blood sugar and positive urine sugar before various related symptoms appear. However, this type of diabetes has its special manifestation of weight loss and continues to decline even after blood glucose is obtained under control. In addition to sudden diabetes, there are some early signs of pancreatic cancer as follows: (1) Jaundice. In general, jaundice is more common in pancreatic head cancer and appears earlier, but there is no jaundice when the cancer is confined to the body and tail. Jaundice is mostly obstructive, progressive and deepening, accompanied by skin itching, urine color like strong tea, and feces of clay color. Most of them are caused by the compression of the common bile duct by the cancer of the head of the pancreas, and a few are caused by the metastasis of the cancer of the body and tail of the pancreas into the liver or the lymph nodes of the liver/general bile duct. (2) Abdominal pain. Recent unexplained pain in the upper abdomen or lower back, with less clear localization, is vague or dull in nature. The pain is worse when lying down, but decreases when bending, sitting, standing or walking. The abdominal pain is not associated with eating. Therefore, although the pain is mainly in the upper abdomen, it is not quite similar to the symptoms of “stomach pain”. (3) Wasting. This is an important feature of pancreatic cancer. In addition to the consumption of the cancer, it is also related to the lack of pancreatic fluid secretion. (4) Diarrhea. Some cases may have steatorrhea, which is not like fatty dishes, and also steatorrhea, which is a symptom of dysentery in which fat is not digested, but mixed with feces and excreted. Early diagnosis of pancreatic cancer is difficult, and when typical symptoms appear, the cancer has often developed to an advanced stage. Therefore, middle-aged and elderly people, especially middle-aged and elderly men, should pay attention to examine the pancreas in time if they find that they have these early symptoms of pancreatic cancer, such as repeated upper abdominal discomfort, fullness, nausea and vomiting, when treatment according to stomach disease is ineffective, or when there is abdominal pain radiating to the back. 6. Alarm signal of kidney cancer [Example] Jian Fang is 52 years old, a university professor who has been suffering from hypertension for many years and his condition is quite stubborn. After a CT abdomen by chance, it was found that there was a small shadow in the kidney, which was later diagnosed as kidney cancer through several examinations. After the kidney cancer was removed surgically, the hypertension was also cured. Expert Comment: The kidney is located in the retroperitoneum, which is relatively deep, and the early symptoms of kidney cancer are not obvious. The early signs of kidney cancer can also be manifested in two aspects: symptoms outside the urinary tract and intrarenal symptoms. In addition to the most typical triad of kidney cancer symptoms (painless hematuria, back pain and abdominal mass), about 9-28% of kidney cancer patients have hypertension. Therefore, in addition to hypertension, symptomatic hypertension caused by other diseases should also be considered when there is an increase in blood pressure in a short period of time, especially the hypertension caused by kidney cancer. The three major symptoms of early kidney cancer are: (1) Hematuria. It is mostly sudden hematuria with no pain or other symptoms. About 70% of kidney cancer patients will have hematuria. This kind of hematuria is often intermittent and can stop on its own, but it will recur many times. Early diagnosis can be obtained if attention is drawn at the first hematuria and early medical attention is sought. (2) Low back pain. About 50% of patients will have low back pain. It is the result of the enlargement of the cancer foci pulling the kidney peritoneum or pressing the surrounding nerves and muscle tissues. It is mostly a dull pain in the lower back or upper abdomen. Occasionally, severe colic occurs when blood clots are discharged downward, which may be easily mistaken for kidney and ureteral stones. (3) Lumbar mass. Kidney cancer lesions can be felt (or seen) from the lumbar region or upper abdomen when they have grown to a considerable extent. About 20% to 30% of patients will have this symptom. The mass is easier to be felt when lying on the side, and sometimes it can be seen to move up and down with breathing. If the mass adheres to the surrounding tissues, the mass is fixed and cannot be pushed, then it is in the advanced stage. Once patients have hematuria, masses and back pain in daily life, they must seek medical consultation quickly. If kidney cancer is treated timely in early stage, it has a very high cure rate and can protect the health and life of patients to the greatest extent. In addition, there are some other early signs of cancer that need attention, such as: blood in the nose is a warning for nasopharyngeal cancer; choking sensation is a sign of esophageal cancer; nipple overflow and/or breast lump is a warning for breast cancer; abnormal vaginal bleeding is a warning for cervical cancer; sudden enlargement of nevus with itching, breaking and painful bleeding is a warning for malignant melanoma; white spots appear on oral mucosa, female vulva or male penis, and All cancers do not occur overnight, nor do they become unmanageable overnight, and they will inevitably show some traces during the “development” process. If we can pay attention to these signs and do a good job in cancer prevention screening, we can successfully nip this health killer in the bud.