The standard wisdom about colon cancer is that most people don't experience any symptoms in the early stages of the disease. That's true, in part; it's best to take advantage of all the available methods of colon cancer testing, including having regular colonoscopies after age 50 (earlier if you have extra risk factors, such as a family history of the disease). But according to research -- and to those who've been diagnosed with colon cancer -- there are also some surprising early signs of colon cancer to be aware of.
Colon cancer symptom #1: Bathroom troubles
People diagnosed with colon cancer often look back and realize they'd been struggling with mysterious digestive problems for some time. These issues are embarrassing to talk about, but it's important not to keep this early sign of colorectal cancer to yourself.
How it feels: Like chronic diarrhea, gas, or constipation, or a combination of all three. (Of particular concern are alternating bouts of diarrhea and constipation.) You may also notice that it feels like your bowels aren't emptying completely or notice "pencil stools" that are thinner than usual. Many colorectal cancer patients say they received a prior diagnosis of colitis, irritable bowel syndrome, or another bowel condition before they were tested and diagnosed with cancer.
What causes it: Polyps and tumors in the colon and rectum can irritate or narrow the lining of the intestine.
What to do: Any time serious digestive symptoms persist for a week or more, discuss them with your doctor. Diarrhea is particularly concerning because it can lead to severe dehydration and drain your body of nutrients. One rule of thumb: If you have six or more bowel movements a day for several days, it's time to report it.
Weakness and Fatigue
One of the few signs of colorectal cancer that appears early in the progression of the disease is fatigue, weakness, and general malaise.
How it feels: You might feel more tired or weak, or notice that exercise or exertion takes more out of you. You may feel like sleeping more than usual or find it difficult to get out of bed. Some people notice dizziness with exertion, such as when climbing stairs or when they stand up suddenly. You might also notice that you look pale or feel cold easily. In extreme cases, intestinal bleeding can lead to shortness of breath.
What causes it: Large polyps or tumors can bleed into the digestive tract. Over time, the blood loss can lead to iron deficiency anemia and can lower oxygen levels in the blood. Lower sodium levels in the blood due to dehydration can also contribute to fatigue.
What to do: Pay attention to stools for any change of color or sign of blood. (Tip: Look at toilet paper closely after you wipe.) Darkened purplish or black stools can indicate the presence of blood. However, blood loss can occur without any blood being visible. Ask your doctor to perform a fecal occult blood test, which can detect blood that's not visible to the naked eye.
Weight Loss or Poor Appetite
Weight loss that can't be explained by other factors is probably the most common early sign of colon and other digestive cancers.
How it feels: You might not feel like eating as much as you normally do, or you might feel full or "stuffed" more quickly than usual. Rich food may seem less appetizing because you don't feel as hungry. Women: This symptom might feel something like the inability to eat you experienced in late pregnancy. Because you're not trying to lose weight, you might not notice weight loss until you get on a scale or your pants suddenly feel loose.
What causes it: As your intestines become affected by the developing tumor, digestion can slow or back up. When colon cancer spreads to the liver, your body's ability to rid itself of wastes is compromised, leading to severe loss of appetite.
What to do: Because weight loss and loss of appetite can be caused by many other conditions, keep watch on these symptoms for a week or more to see if they go away or if you can detect an underlying cause. If not, ask your doctor about colon cancer testing.
One bout of upset stomach is nothing to worry about. Ongoing or repeated bouts of cramping, indigestion, nausea, and vomiting, however, are cause for concern.
How it feels: The upset stomach caused by colon cancer can feel like gas, bloating, and aching, or like sharp stabbing cramps and pain that causes you to double over. "I thought I had ulcers" is a common comment of those diagnosed with colon cancer. Some people experience chronic heartburn or acid stomach.
What causes it: An obstruction in the intestines may lead to indigestion, nausea, and vomiting. Inflammation can lead to cramping and pain. When impaired digestion causes food to back up, the result can be acid indigestion.
What to do: Be careful if your doctor diagnoses acid indigestion or heartburn and sends you home with a prescription for heartburn medication. It's fine to take it for a while, but if symptoms persist, return and ask for additional testing.
Tender Abdomen or Abdominal Pain
Pay attention if it hurts or feels tender when someone touches your abdomen, stomach, or groin; this can be an early sign of a growth in your digestive tract.
How it feels: You might find yourself protesting if someone puts his or her head on your stomach or accidentally bumps you during a sport or activity. The difference between this type of pain and digestive issues is that the pain comes from the outside.
What causes it: Typically, abdominal pain occurs when a tumor has begun to obstruct bowel flow or there's a perforation of the intestine. Abdominal tenderness can also be a sign that the cancer has begun to spread to other organs.
What to do: Wait a few days to see if the pain goes away, as it would when caused by something you ate or by food poisoning. This symptom can also occur with parasites, which the doctor can test for with a stool sample. If the pain or tenderness persists, call your doctor and ask for a full workup.