In many cases, the recognition that there is something amiss earlier rather than later is the key to survival when the diagnosis is cancer. Lately I have met a number of people who have been diagnosed with cancer themselves or who have had a loved one diagnosed that have been very alarmed that the signs and symptoms of cancer were there for a long time, but that they went unrecognized. So I promised to put the warning signs on my webpage so that maybe other people who glance through might be prompted to stay alert for the signs. Not all of these signs and symptoms will be present. If there is even one of the following signs, CONSULT YOUR PHYSICIAN. Conditions other than cancer may cause some of the following symptoms, but if you are not satisfied that your suspicion has been appropriately addressed, seek a second opinion.

• Fatigue
  Cancer is an accelerated metabolic process. Growth of anything takes energy (take your average teenager as an example and an exception: they are often asleep because of the huge metabolic demand to put on a few inches in all directions!).
• Weight loss
  There may be a loss of body weight and a lack of appetite with cancer.
• Night sweats
  This is not just sweating that occurs if you have too many covers and a radiator for a spouse. This is when you are soaking the sheets on a nightly basis or off and on over a few months. (Night sweating can also occur during menopause and with infectious disease, but unless it is associated with either of these two circumstances, it should be checked out.)
• Sores that don't heal
  In particular these would be sores from bumps and bruises that don't appear to be getting better, and that are getting bigger or more painful, and perhaps are starting to bleed.
• An obvious change in a wart or mole
  We use the "ABCD" rule which stands for:
  A - asymmetry - any growth with an irregular shape, particularly when it appears to become more irregular in surface characteristics or consistency.
  B - border - any growth which blurs the otherwise normally distinct border of a mole or wart.
  C - color - especially spread of red, white and blue pigmentation to the surrounding normal skin. However, you may also see a pale ulcer with red blood vessels apparent on it.
  D - diameter - is the mole bigger than a pencil eraser? Increase in size also increases concern.
• Unusual bleeding or discharge
  Particularly blood in the urine or stool that you can readily see, or discharge from any part of the body such as the nipples or penis.
• Thickening or lump
  There may be a change in breast or testicular tissue which feels different than surrounding tissue.
• Swollen lymph node
  Lymph nodes may be palpable in the armpit, just over the clavicle or along the side of the neck, in the groin. Cancerous lymph nodes may be painless enlargements. Normally we cannot feel lymph nodes unless we are sick with an infection, at which point they may be tender and palpable. Cancerous lymph nodes tend to be painless and rubbery.
• Changes in bowel or bladder habits
  A change in the frequency of bowel or bladder eliminations particularly accompanied by changes in color, consistency (diarrhea or constipation), size or shape of stools, or blood.
• Indigestion or difficulty swallowing
  A feeling of pressure in the throat or chest which makes swallowing uncomfortable may be a sign of cancer. Pressure or feeling full without food or with a small amount of food.
• Nagging cough or hoarseness
  A change in the voice or hoarseness, or a cough that does not go away and is accompanied by blood in the sputum should always be checked out.