By Lynne Eldridge, MD
Updated on May 21, 2022
Medically reviewed by Doru Paul, MD
Causes and Risk Factors of Cancer
Reviewing cancer symptoms can be surprising—and worrying. While there are several common symptoms of cancer, there are few that are specific to this group of diseases. Aside from those you may immediately associate with cancer (e.g., a breast lump or skin changes), symptoms such as bloating, persistent cough, and others can also occur. Of course, these vague symptoms may also indicate something else entirely.
Symptoms of cancer vary widely depending on the type of disease. For instance, a tumor can invade nearby structures and affect their function, or press on nerves (e.g., ovarian cancer may cause constipation by pressing on the colon; lung cancer may cause hoarseness by pressing on a nerve as it travels through the chest). In addition, cancer often causes metabolic changes that result in generalized symptoms such as fatigue, weight loss, and an overall sense of being unwell.
Recognizing the early symptoms of cancer can help you have the best chance for early detection and effective treatment.
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Frequent Symptoms
While it's important to remember that each of the most common symptoms of cancer can have other causes, it's best to talk to your healthcare provider about any that you experience.
These are the 14 most common symptoms of cancer:
Unintentional or unexplained weight loss
Lumps, bumps, or enlarged lymph nodes
Night sweats
Abnormal vaginal bleeding
Changes in your bowel movements
Blood in your stool or rectal bleeding
Persistent cough
Shortness of breath
Pain occurring anywhere in your body, especially a pain felt as a deep ache
Persistent, severe fatigue
Skin changes
Abdominal swelling or bloating
Blood in your urine
Difficulty swallowing
Your gut feeling can be an important "early symptom" of cancer. Upon learning of their diagnosis of cancer, many people state that they knew something was wrong. A large 2016 study confirmed this finding, at least with colorectal cancer. The third most commonly reported symptom prior to diagnosis was "feeling different."
Some of these symptoms are specific to certain types of cancer, while others may occur in several types.
Unexplained Weight Loss
Unintentional weight loss is defined as the loss of 5% of body weight over a six- to 12-month period without trying. This is equivalent to a 130-pound woman losing 6 or 7 pounds, or a 200-pound man losing roughly 10 pounds of weight. Though many people may welcome dropping a few pounds, it's important to see your healthcare provider if you do unexpectedly lose weight.
Cancer is the cause of unintentional weight loss at least 25% of the time.1 While weight loss is more likely to occur in advanced cancers, it can occur in early-stage cancers as well.
Cancer can cause weight loss in several ways:
Changes in the metabolic activity of the body caused by cancer may increase daily calorie needs.
Cancers such as colon cancer can cause people to become full faster when eating, reducing their overall consumption.2
Other cancers may interfere with eating by causing nausea or difficulty swallowing.
Sometimes people with cancer may simply not feel well enough to eat as they normally would.
The syndrome of cancer cachexia, which includes weight loss as well as muscle wasting, is not only a symptom of cancer but is considered the direct cause of death in up to 20% of people with cancer.3
Why Unexplained Weight Loss Is Concerning
Lumps and Bumps
A lump or thickening anywhere on your body that does not have an explanation is an important first symptom of cancer.
Breast lumps could be cancer but could also easily be benign breast cysts or fibroadenomas. There are less common signs of breast cancer as well, and symptoms such as redness, thickening, or an orange-peel appearance to the breast should be addressed.
It's important to see your healthcare provider if you have any changes in your breast tissue, even if you've had a normal mammogram. Mammograms miss around 20% of breast cancers.4
Testicular lumps may be a symptom of testicular cancer, and just as women are encouraged to do monthly self-breast exams, men are encouraged to do monthly testicular self-exams.
Enlarged lymph nodes may be the first sign of cancer—especially lymphomas—and can occur in many regions of the body. In fact, enlarged lymph nodes are one of the key warning signs of lymphoma.5
Enlarged lymph nodes may be a sign of many solid tumors as well.6 Lymph nodes function as “dumpsters” in some ways. The first cancer cells to escape a tumor tend to be caught in the lymph nodes closest to a tumor, and many cancers spread to nearby lymph nodes before spreading further in the body.
Other bumps, thickenings, or even bruises out of proportion to an injury should be evaluated by your healthcare provider.
Night Sweats
Night sweats are a common symptom of cancer, especially leukemias and lymphomas.7 Night sweats that occur with cancer are not simply "hot flashes." They are often drenching to the point that people need to get out of bed and change their pajamas, sometimes repeatedly. Unlike hot flashes, which may occur at any time of the day or night, night sweats are more common when sleeping.
Night sweats in men should always be evaluated by a healthcare provider. While this can be an important symptom of cancer in women as well, it can be hard to differentiate what is "normal" or not in women, especially those who are in the early stages of menopause.
Night Sweats and Cancer
Abnormal Vaginal Bleeding
Abnormal vaginal bleeding can be a sign of cancer but certainly has many benign causes as well. Abnormal bleeding can take many forms, including:
Bleeding between periods
Periods that are heavier or lighter than usual
Bleeding after sex
Bleeding after you have completed menopause
Cancers of the uterus, cervix, and vagina may cause bleeding directly related to a tumor.8 Hormonal changes due to cancers, such as ovarian cancer, may also cause changes in your menstrual cycle.
Every woman is different, and the most important symptoms are those that represent a change in what is normal for you.
Changes in Bowel Habits
If you experience changes in your bowel movements, whether in color, consistency, or frequency, talk to your healthcare provider. Symptoms of colon cancer can range from diarrhea to constipation, but what is most concerning is something that is out of the norm for you.
Rectal Bleeding
If you see blood in your stool you will likely be worried, but as with other possible cancer symptoms, there are many benign causes as well.
The color of the blood is sometimes useful in determining the origin of the blood (but not the cause). Bleeding from the lower colon (left colon) and rectum is often bright red. That from the upper colon (right colon) and small intestine is often dark red, brown, or black. And blood from higher up, for example, the esophagus or stomach, is very dark and often resembles coffee grounds.
Other causes of rectal bleeding include hemorrhoids, anal fissures, and colitis, but an important point to note is that—even if you have these other conditions—it does not mean that you don't also have colon cancer. In fact, some types of colitis are a risk factor for colon cancer.9
If you have this symptom, make sure to see your healthcare provider even if you think there is a reasonable cause.
Persistent Cough
A persistent cough may be a symptom of lung cancer; roughly half of people with the disease have a chronic cough at the time of diagnosis.10 It could also be a sign of a cancer that has spread to the lungs, such as breast cancer, colon cancer, kidney cancer, or prostate cancer.
A cough can be caused by a narrowing of the airways caused by a tumor, or as the result of infections that arise as a result of tumors in the lungs. Of course, respiratory conditions such as chronic obstructive pulmonary disease (COPD) must also be considered.
Shortness of Breath
Shortness of breath is one of the leading early symptoms of lung cancer.11 While you may associate lung cancer with a chronic cough, the most common symptoms of lung cancer have changed over time.
A few decades ago the most common types of the disease tended to grow near the large airways in the lungs; a location that frequently caused a cough and coughing up blood. Today, the most common form of lung cancer—lung adenocarcinoma—tends to grow in the outer regions of the lungs. These tumors can grow quite large before they are detected, and often cause shortness of breath with activity as their first symptom.
Other Possible Causes of Shortness of Breath
Chest, Abdominal, Pelvic, Back, or Head Pain
Pain occurring anywhere in your body could be a possible symptom of cancer. If you have any unexplained pain that persists, especially pain you would describe as a deep ache, talk to your healthcare provider.
Head Pain
Headaches are the most common symptom of brain cancer or tumors that have spread (metastasized) to the brain, but certainly most headaches are not due to cancer.12
The classic headache due to a brain tumor is severe, at its worst in the morning, and progresses over time. These headaches may worsen with activities such as coughing or bearing down for a bowel movement, and may occur on one side only. People with a headache related to a brain tumor frequently have other symptoms, such as nausea and vomiting, weakness of one side of the body, or new-onset seizures. However, brain tumors can also cause headaches that are indistinguishable from a tension headache, and may be the only sign that a tumor is present.
Cancer spread to the brain (brain metastases) are seven times more common than primary brain tumors and cause similar symptoms. Cancers most likely to spread to the brain include breast cancer, lung cancer, bladder cancer, and melanoma.13 It's not uncommon for people with brain metastases, especially those with small cell lung cancer, to have symptoms related to a tumor in the brain before they have symptoms due to the primary cancer.
Back Pain
The most common cause of back pain is a back strain, but back pain that persists and doesn't have an obvious cause could be a symptom of cancer as well. Back pain related to cancer is often (but not always) worse at night, does not improve when you lie down, and may worsen with a deep breath or during bowel movements.
Back pain can be caused by tumors in the chest, abdomen, or pelvis, or by metastases to the spine from other cancers.14
Shoulder Pain
Pain that is felt in the shoulders or shoulder blades can easily be due to a muscle strain, but it can also be an important early symptom of cancer. Referred pain from lung cancer, breast cancer, and lymphomas, as well as metastases from other cancers, may cause aching in the shoulders or shoulder blade pain.
Chest Pain
There are many causes of chest pain, with heart disease often being a prime suspect. Unexplained chest pain can be a symptom of cancer as well.11 Though the lung does not have nerve endings, pain that feels like "lung pain" is present in a large number of people who are diagnosed with lung cancer.
Abdominal or Pelvic Pain
As with pain in other regions of the body, abdominal pain and pelvic pain are most often associated with conditions other than cancer. One of the difficulties with pain in the abdomen and pelvis, however, is that it's often hard to determine where the pain begins.
What to Know About Breakthrough Pain
Fatigue
Unlike ordinary tiredness, cancer fatigue is often much more persistent and disabling. Some people describe this tiredness as “total body tiredness” or exhaustion. It's not something you can push through with a good night of rest or a strong cup of coffee. The hallmark of this kind of fatigue is that it significantly interferes with your life.15
There are many ways in which cancer can cause fatigue. The growth of a tumor, in general, can be taxing for your body. Other symptoms of cancer such as shortness of breath, anemia, pain, or a decreased level of oxygen in your blood (hypoxia) can cause fatigue as well.
If you find that fatigue is disrupting your normal activities, make sure to talk to your healthcare provider.
Skin Changes
There are many types of "skin changes" that could be a symptom of skin cancer. Some of these include new spots on your skin (no matter the color), a sore that does not heal, or a change in a mole or freckle.
While skin cancers such as basal cell carcinoma and squamous cell carcinoma are more common, melanoma is responsible for the majority of deaths from skin cancer.16
Familiarize yourself with the ABCDEs of melanoma, which cover aspects of skin changes (asymmetry, borders, diameter, and more) that may indicate skin cancer. Though a less-than-clinical distinction, many experts note that even something you consider "funny looking" could be a sign of skin cancer.
It's worth noting that melanomas are often first noticed by someone else. If your loved one has a suspicious looking skin spot, don't be afraid to say something.
ABCDEs of Melanoma
Bloating (Abdominal Distension)
Abdominal swelling or bloating may be a first symptom of several cancers, including ovarian cancer, pancreatic cancer, and colon cancer.
You may feel a fullness in your abdomen, or may note that your clothes are tighter around the middle even though you haven't gained weight.
Ovarian cancer has been coined the "silent killer" as symptoms often occur late in the disease, and then are frequently dismissed as due to something else.
It's been found that bloating is a common symptom of ovarian cancer, but women often attribute this symptom to weight gain or other causes. Likewise, constipation, pain with intercourse, constipation, and frequent urination can be symptoms of ovarian cancer, but are often first attributed to other causes.17
If you notice any of these symptoms, talk to your healthcare provider. Ovarian cancer can be treatable when caught early.
Blood in Urine
Blood in your urine can be a symptom of bladder cancer. Even a slight pink tinge to your urine warrants a visit to your healthcare provider. This is extra important if you have a history of smoking, as the habit is responsible for at least half of bladder cancer cases.18
Difficulty Swallowing
Difficulty swallowing, also known as dysphagia, can be a symptom of cancer. It is often the first symptom of esophageal cancer due to narrowing of the esophagus.19
Since the esophagus travels through the area between the lungs (called the mediastinum), tumors in this region such as lung cancer and lymphomas often cause this symptom as well.
Why Swallowing Difficulties Can Occur
Rare Symptoms
There are several less common, but no less important symptoms that may alert you to the presence of a cancer. Some of these include:
Blood clots: There are many risk factors for blood clots in the legs known as deep vein thrombosis (DVT). In recent years, it's been noted that one of these factors can be a previously undiagnosed cancer.20 It is important to know the symptoms of DVTs not just because of this, however, but because they often break off and travel to the lungs, something known as a pulmonary embolus.
Urinary changes: Changes in urination such as frequency or difficulty starting your stream can be an early symptom of cancer.
Heartburn or indigestion: Chronic heartburn due to gastroesophageal reflux disease (GERD) is an important cause of esophageal cancer. If you have long-standing heartburn, talk to your healthcare provider about screening.
Shingles: Shingles, a condition caused by reactivation of the chickenpox virus, can be a symptom of underlying cancer.
Depression: New-onset depression is a fairly common early symptom of cancer.21
Fractures with minimal trauma: When cancers spread to bones they can weaken them so that fractures occur with minimal trauma. A fracture that occurs in a bone weakened by cancer is called a pathologic fracture.
Easy bruising: Cancers that infiltrate the bone marrow can reduce the number of platelets in your blood. Decreased platelets, in turn, can result in easy bruising.
White patches in your mouth: White patches on the gums or tongue (called leukoplakia) could be an early symptom of oral cancers, and many healthcare providers now routinely screen for this during regular dental exams. Whereas smoking and drinking were the prime culprits causing these cancers in the past, many are now believed to be caused by infections with the human papillomavirus (HPV).22
Finally, some cancers cause unique symptoms based on compounds they produce and secrete. These symptoms—referred to as paraneoplastic syndromes—may present with symptoms caused by the actions of those compounds.
For example, some lung cancers produce a hormone-like substance that raises the calcium level in the blood. Symptoms of hypercalcemia (high blood calcium), such as muscle aches, may, therefore, be the first symptom of cancer.23
Sub-Groups and Complications
It's important not to dismiss symptoms due to a lack of risk factors. For example, breast cancer does occur in men, as well as many women without a family history of the disease. Lung cancer does occur in people who have never smoked. And colon cancer does occur in young men and women.
If you have any symptoms, don't ignore them, even if you have no risk factors or family history of cancer and have lived a healthy lifestyle.
People with existing conditions such as diabetes, cardiovascular diseases, chronic pulmonary diseases, psychiatric disorders, and dementia often have a different course of cancer detection and treatment, as well as more postoperative complications and a higher mortality. In some conditions, there is earlier detection because you are visiting your healthcare provider frequently. In others, especially psychiatric conditions, people may delay getting a diagnosis.
Various conditions may mean that healthcare providers are reluctant to do aggressive cancer treatment because your health is already fragile and you might not tolerate surgery, radiation, or chemotherapy. The cancer drugs might interact with the medications you are taking for your other condition. Your other condition might become worse, and this can make it difficult to complete cancer treatment.
For example, if you have lung disease, chemotherapy can result in lung inflammation and worsen your symptoms. Steroids and side effects of cancer treatment can affect blood glucose control in diabetes.24 In addition, with many conditions, you will have a slower recovery if you receive cancer treatment.
Cancer treatment is also difficult during pregnancy as the fetus would be affected by chemotherapy or radiation.
When to See a Healthcare Provider
There are very few symptoms that specifically mean cancer, so it's hard to know when you should be concerned. Any symptom that is new to you; that you have been living with, but is unexplained; and any change in bowel, bladder, or menstrual habits that is out of the ordinary for you is worth discussing with your healthcare provider.
Oftentimes, these symptoms turn out to be related to conditions other than cancer. But confirming that is essential to avoiding missing an early diagnosis.
Despite the importance of addressing cancer symptoms, many people delay talking to their healthcare providers. For example, a 2016 study found that the median time between noting symptoms of lung cancer and the eventual diagnosis was 12 months.25 People delay going to their healthcare providers for several reasons, including denial, fear of the diagnosis, or fear of being labeled a "complainer" or "hypochondriac."
If you note any symptoms, make sure to consciously admit the symptom to yourself and share your concern with a loved one you trust. Your healthcare provider wants you to bring up any unusual symptoms, and it can make a difference if cancer is found early.
Finding cancer early may increase survival rates and can minimize the extent of treatment needed. Even when cancers have progressed to a point in which they are no longer treatable, they can often be managed. People are living longer than ever with cancer, as the 18 million cancer survivors in the United States alone show.
A Word From Verywell
If you have any of the cancer symptoms noted above—or any symptoms not listed for that matter—talk to your healthcare provider. At times it may be hard to determine the precise cause of a symptom. Be persistent. Symptoms are your body's way of telling you that something is wrong. If you aren't getting answers, ask for a referral or get a second opinion. Nobody knows your body or what is normal for you better than you do, and nobody else is as motivated to make sure it stays healthy.
FREQUENTLY ASKED QUESTIONS
Is it possible to have cancer without having symptoms?
Absolutely—especially early on before the disease has progressed enough to cause noticeable symptoms like pain or a lump. This is why screening is an important aspect of health care. Many cancers, such colon, breast, or cervical cancer, can be detected by testing long before they cause symptoms and, often, in plenty of time for effective treatment and a positive prognosis.26
What are some symptoms of cancer?
While symptoms differ depending on the type of cancer, there are some symptoms commonly shared by most types of cancer, particularly early on, including:27
Weight loss
Fatigue
Fever
Pain
Skin changes
What conditions have symptoms similar to cancer?
Any number of conditions can cause tumors, growths, and masses in soft tissue or bone that resemble cancer. Among the most common are:28
Abscesses
Cysts in joints caused by injury or degeneration
Rheumatoid arthritis and other inflammatory conditions
Hyperlipidemia
Osteomyelitis (an infection of bone)
Hyperparathyroidism
Paget's disease
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