Most Common Cancers

This article discusses how the most common cancers might cause symptoms based upon their location.

According to the centers for disease control and prevention (CDC), cancer is the second most common cause of death after heart disease.  There are different ways to consider what constitutes the commonest cancers.  What cancers occur most frequently?  What cancers are you most likely to die from?  Of those cancers occurring frequently, which ones are potentially curable? And so on.  There are multiple angles to evaluate this generic question.  While breast cancer receives a lot of media attention and public awareness campaigns, lung cancer is the leading cause of cancer death in woman and a woman with colon cancer is more likely to die from that cancer than a breast cancer.  This is not to say that breast cancer is not important, this is to emphasize the different ways that the frequency of cancer can be described.

The most common types of cancer are given:

  • Bladder Cancer
  • Breast Cancer
  • Colon and Rectal Cancer
  • Endometrial Cancer
  • Kidney Cancer
  • Leukemia
  • Lung Cancer
  • Melanoma
  • Non-Hodgkin Lymphoma
  • Pancreatic Cancer
  • Prostate Cancer
  • Thyroid Cancer

Symptoms from any of the above tumors will be related to their effects at the area of the tumor as well as effects on the entire body.  There are several ways a tumor can affect others areas of the body.  First, most tumors cause the secretion of stress hormones and chemical messengers such as cortisol and TNF-alpha.  The effect of these tumors can also be to increase the metabolism and calories burned even at rest.  These stress hormones and chemical messengers (such as the cytokines TNF-alpha, interleukins, etc.) can take away appetite.  The loss of appetite with weight loss is referred to as anorexia.

Second, tumors can secrete hormones or make abnormal antibodies that can cause a wide variety of effects on the body.  For example, a tumor of the adrenal gland might over-secrete adrenaline (also known as epinephrine).  A tumor that secretes high levels of adrenaline will cause racing of the heart, high blood pressure and feeling of nervousness.  A tumor of the thyroid gland that secretes too much thyroid hormone can cause similar symptoms as well as fever.  These are all examples of how a tumor can affect the entire body and other organ systems.  There are many other more complex examples such as paraneoplastic syndromes.  Paraneoplastic syndrome occurs when a tumor secretes antibodies or hormones that cause effects in other body systems.  A complex example of this would be antibody secretion by small cell lung cancer causing myasthenia gravis syndrome (also known as Lambert-Eaton syndrome).

Local or regional effects of a tumor can cause symptoms in that area.  Almost all cancers that involve an organ with a lining such as the lung, intestine or bladder will result in some type of bleeding because cancer grows in a disorderly fashion and injures or disrupts the normal smooth lining.  A bladder cancer will usually cause blood in the urine and may be the initial symptom that prompts investigation as to the cause.  A tumor of the bladder might also block the flow of urine if it grows near the entrance of the ureters or near the exit by the urethra.

Tumors also can cause fistulas or abnormal connections between different organs or structures.  In the case of the bladder, a tumor of the bladder might grow into the colon or more commonly a tumor or inflammation of the colon might create a connection to the bladder.  A fistula between the bladder and colon is termed a colovesical fistula.  The symptoms of this abnormal connection are related to passage of bacteria, stool and air from the colon into the normally clean bladder.  A person with a colovesical fistula will complain of bladder pain, burning, passage of air or stool particles in the urine.  They may even develop multiple severe kidney infections from the constant flow of bacteria into the normally sterile urinary tract.  Other types of fistulas are possible such as connections between the lung, chest, esophagus and major blood vessels.

Blockage of some type of flow of fluid or secretion is a common theme among cancer symptoms.  For example, cancers of the liver, bile ducts, gallbladder, duodenum, ampulla or pancreas can all cause blockage of the bile secretion resulting in jaundice.  Normally bile is made in the liver and empties periodically into the intestine to assist in fat digestion.  Bile is responsible for the brown color of stool and is made in part by broken down byproducts of old red blood cells.  A buildup of bile in the blood or liver will cause a yellow or orange coloration to the skin and eyes.  The failure of bile to empty into the intestines will cause whitish and pasty stool with a high fat content that tend to float.  Digestion will also be altered as well.  There are many different causes of jaundice that do not involve tumors however it is easy to see the complexity of evaluating a tumor that causes jaundice as there are many possible causes of blockage along the way.

Another very common type of blockage that can occur with almost any cancer is intestinal blockage.  Many cancers that occur in the intestines or those that can spread to the intestine have the ability to block the passage of food or wastes thus causing bowel blockage.  Blockage or bowel obstruction is fatal unless relieved because a blocked intestine will quickly swell, have poor blood flow and burst.  The leakage of dirty intestinal contents as well as other enzymes and acid causes severe abdominal pain and if left untreated a fatal infection.

Sometimes the symptoms of a cancer are misinterpreted and require careful evaluation by the treating physician.  An example of this might be an older man that gets appendicitis and has his appendix removed.  Normally, this is considered a cure of a serious disease but if the physician treating him fails to consider the possibility of a tumor blocking the appendix such as a colon cancer then an opportunity to potentially cure it may be overlooked.

Another common example of blockage of fluid flow would be enlargement of the prostate.  The prostate gland is found in men near the exit of the bladder.  If the prostate enlarges it may cause blockage of the bladder or difficulty in emptying the bladder.  Some enlargement of the bladder might be due to a cancer of the prostate whereas some enlarged prostates are due to over activity of the gland referred to as BPH (benign prostate hypertrophy).  Importantly, the initial symptoms will be similar from the man’s point of view – difficulty with passing urine.  This emphasizes the importance of investigating symptoms of any type of blockage in the body in order to exclude the possibility of a cancer causing these.

REFERENCES:

  1. www.cdc.gov/nchs/fastats/deaths.htm
  2. www.cancer.gov/cancertopics/types/commoncancers
  3. This article was originally published on September 3, 2012 and last revision and update was 9/4/2015.