Symptoms, screening, markers: Everything you need to know about India’s top 5 major cancers

Cervix uteri cancer reported 1,27,526 cases and 79,906 deaths, while there were 81,748 cases of lung cancer and 75,031 deaths. Oesophageal cancer registered 70,637 cases with 66,410 reported deaths in the same period.

These statistics underscore the significant health challenges posed by these prevalent cancers in the country.

As the incidence of these cancers continues to rise in the country, it is crucial to examine how these trends directly affect individuals and communities.

Also Read: Poonam Pandey’s ‘death’ to cervical cancer highlights importance of screening at a younger age

Symptoms of various cancers

The symptoms of different types of cancer can vary widely, and it’s important to note that having one or more symptoms does not necessarily mean you have cancer.

Many symptoms are nonspecific and can be caused by various conditions. However, if you experience persistent or worsening symptoms, it’s crucial to consult with a healthcare professional for a proper evaluation.

Here are some common symptoms associated with breast, lip and oral cavity, cervix uteri, lung, and oesophageal cancers:

1. Breast Cancer

Speaking to South First, Dr L Rohit Reddy, Consultant Medical Oncologist & Hemato-oncologist at Yashoda Hospitals in Hyderabad, said that if a patient has symptoms of breast cancer, it means that “it’s already there”.

“There are no pre-clinical symptoms which will show up before cancer. If these symptoms are showing up, the patient is already suffering from breast cancer,” he reiterated.

• Changes in breast size or shape
• Unexplained pain in the breast or nipple
• Skin changes, such as redness, dimpling, or puckering
• Nipple discharge, other than breast milk
• A lump or thickening in the breast or underarm

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2. Lip and Oral Cavity Cancer

• Persistent mouth sores or ulcers
• Red or white patches in the mouth
• Swelling, lumps, or thickening in the lips or oral cavity
• Difficulty swallowing or persistent sore throat
• Changes in voice

3. Cervix Uteri Cancer (Cervical Cancer)

• Abnormal vaginal bleeding between periods, after menopause, or after sex
• Pelvic pain or pain during sexual intercourse
• Unexplained weight loss
• Changes in bowel or bladder habits

“When there is bleeding after intercourse, abnormal white discharges or even bleeding after menopause, many women ignore it. These should not be ignored; women should get screened for it,” Gynaecologist, Obstetrician and Laparoscopic Surgeon at Yashoda Hospitals in Hyderabad, Dr Sarada M, told South First.

4. Lung Cancer

• Persistent cough that worsens over time
• Coughing up blood or bloody sputum
• Chest pain that may be sharp and worsens with deep breathing or coughing
• Shortness of breath or wheezing
• Unexplained weight loss

5. Oesophageal Cancer

• Difficulty swallowing (dysphagia)
• Persistent or worsening indigestion or heartburn
• Chest pain or discomfort, particularly behind the breastbone
• Unexplained weight loss
• Coughing or hoarseness

Early detection and timely medical intervention significantly improve the chances of successful cancer treatment. Regular health check-ups and screenings, especially for individuals with known risk factors, are also crucial for cancer prevention and early detection.

Also Read: This doctor urges HPV vaccination for both genders, sets record straight on screening age

Pre-Screening and Screening

Pre-screening for various cancers typically involves assessing risk factors, recognising early warning signs, and employing specific screening tests when applicable. It’s crucial to note that pre-screening is a term often used for identifying individuals who may be at higher risk for a particular cancer and who may benefit from more frequent or targeted screening.

Here are pre-screening and screening considerations for the top 5 cancers:

1. Breast Cancer

Pre-screening:

• Family history of breast cancer, certain malignancies, undergo screening early, by age 25.
• Understanding family history, especially any history of breast or ovarian cancers.
• Identifying personal risk factors, including age, reproductive history, and hormone replacement therapy.

Screening:

• Genetic counselling and testing for individuals with a strong family history or known genetic mutations (e.g., BRCA1, BRCA2).
• Mammography is the primary screening tool for women aged 40 and older, with frequency based on individual risk factors.

“It should be done annually, as right now one out of 15 females are suffering from breast cancer. Screening is the most optimal way to know about it,” said Dr Rohit Reddy.

“Women come with pain and lumps in their breasts, we check and examine them. This can happen to any age group now, even 25-year-old women can have it. We send them for a mammogram and if there is something suspicious, we see if there are markers. We ask for a biopsy. If the biopsy confirms malignancy, then we refer to an oncologist. If the lump or cyst is benign, we observe the patient regularly and ask them to get tests done every six months,” explained Dr Sarada.

2. Lip and Oral Cavity Cancer

Pre-screening:

• Regular dental check-ups for oral health assessments

Screening:

• Visual examination by a dentist or healthcare professional
• Biopsy for suspicious lesions or ulcers

“High risk behaviour such as chewing smokeless tobacco is the cause of oral cancer. For such individuals, annual oral assessment of the entire mouth, which includes teeth, tongue, and inner surface of cheeks, should be done,” Dr Reddy said.

3. Cervix Uteri Cancer (Cervical Cancer)

Pre-screening:

• HPV vaccination for prevention, typically administered in adolescence
• Regular gynaecological check-ups

Screening:

• Pap smear (Pap test) for women starting at age 25, or married earlier with frequency based on individual risk factors

“HPV DNA testing should also be done in conjunction with Pap smears tests,” said Dr Reddy.

“There is a myth that only women who lives unhygienic condition can have cervical cancer. It’s not true at all. It can happen to anyone. The other issue is that women don’t want to get a Pap smear test, either because they are shy or have societal biases as it requires physical examination. A Pap smear test will help in early detection,” said Dr Sarada.

4. Lung Cancer

Pre-screening:

• Identification of risk factors, particularly a history of smoking or exposure to environmental carcinogens

Screening:

• Low-Dose Computed Tomography (LDCT) scans for high-risk individuals, such as current or former smokers aged 55 to 80 with a significant smoking history

5. Oesophageal Cancer

Pre-screening:

• Identification of risk factors, including a history of Barrett’s oesophagus

Screening:

• Endoscopy for high-risk individuals, especially those with Barrett’s oesophagus

It’s essential to consult with healthcare professionals for personalised risk assessments and screening plans.

Dr Reddy recommends two more screenings. “A person above the age of 45 years should get a colonoscopy done every 10 years to look into the colorectal diseases, including cancer. A person above the age of 55 years should get prostate specific antigen (PSA) tests done annually to check for prostate cancer, and a long-term heavy smoker should get a CT scan of their chest done to look at the health of the lungs,” said Dr Reddy.

Also Read: Karnataka’s door-to-door cancer screening initiative in 8 districts puts spotlight on early detection

The cancer markers

The term “markers” generally refers to substances or indicators that can be measured objectively and used to assess various physiological or pathological conditions. These markers can be found in blood, urine, tissues, or other bodily fluids. Markers are valuable tools for diagnosing, monitoring, and predicting the progression of diseases, including cancer. There are genetic markers, protein tumour markers, biomarkers, and screening markers.

The markers for various types of cancers, including breast, lip and oral cavity, cervical, lung, and oesophageal cancers, can vary.

Here are some common markers:

1. Breast Cancer

• BRCA1 and BRCA2 gene mutations: Genetic markers associated with increased breast cancer risk
• HER2/Neu status: Overexpression of this protein can indicate aggressive forms of breast cancer

2. Lip and Oral Cavity Cancer

• Human Papillomavirus (HPV): Certain strains of HPV are associated with oral cancers

3. Cervical Cancer

• Presence of high-risk HPV types
• Abnormalities in Pap smear results

4. Lung Cancer

• Blood markers like carcinoembryonic antigen (CEA) or cytokeratin fragments

Oesophageal Cancer

• Presence of Barrett’s oesophagus, a precancerous condition
• Changes in specific genes associated with esophageal cancer

It’s important to note that markers are not always definitive, and a confirmed diagnosis often requires further diagnostic tests, such as biopsies or imaging studies.

Also Read: Union Health Ministry yet to take decision on rollout of HPV vaccination against cervical cancer

Consulting a doctor

Consulting a doctor is essential if you experience persistent or unusual symptoms, or if you have specific risk factors that increase your likelihood of developing certain types of cancer. Here are general guidelines for when to consult a doctor:

1. Breast Cancer

• Consult a doctor if you notice any changes in your breasts, such as lumps, changes in size or shape, nipple discharge (other than breast milk), or skin changes.
• Women should also undergo regular breast cancer screenings as recommended by healthcare guidelines, including mammograms.

2. Lip and Oral Cavity Cancer

• Seek medical attention if you have persistent mouth sores, red or white patches in the mouth, swelling, or difficulty swallowing.
• Regular dental check-ups may also help in early detection.

3. Cervix Uteri Cancer (Cervical Cancer)

• Schedule a doctor’s appointment if you experience abnormal vaginal bleeding, pelvic pain, pain during intercourse, or other concerning symptoms.
• Women should undergo regular Pap smears and HPV testing as recommended by healthcare guidelines.

4. Lung Cancer

• Consult a doctor if you have a persistent cough, coughing up blood, chest pain, shortness of breath, or unexplained weight loss.
• If you are a current or former smoker, or if you have other risk factors, discuss lung cancer screening options with your healthcare provider.

5. Oesophageal Cancer

• Seek medical attention if you experience difficulty swallowing, persistent indigestion, chest pain, unexplained weight loss, or other concerning symptoms.
• Individuals with risk factors such as a history of Barrett’s oesophagus should have regular check-ups.