What Happens if You Ignore Symptoms

This article emphasizes the importance of not ignoring cancer symptoms.  We will also provide some examples and possible outcomes from ignoring symptoms.  The examples given are real people with real cancers but the information and details have been changed to help protect the privacy and rights of the people involved.  In reality, these examples could point to hundreds of people because doctors in the United States see patients that neglect symptoms all the time.  There are several reasons for neglecting an obvious problem.  Even with little or no medical education, the average person could say that someone with an open bleeding wound or severe weight loss and weakness needs to see a doctor.  Reasons for ignoring glaring or even subtle symptoms are primarily due to:

  • Lack of education or knowledge about the importance of a symptom
  • A feeling that help is not available even if sought
  • Fear of financial burdens imposed by treatment
  • Superstition that acknowledging the symptom will cause it to happen or may invoke a curse.  This type of belief is common in many parts of the world and different sub-cultures.
  • Voluntarily wanting to ignore the symptom in the child-like hope that it will go away.  This is also known more commonly as denial.

There are thousands of types of cancers and similarly many possible symptoms of cancer.  Based upon statistics, the most common symptoms of cancer for the most common cancers in the United States could be roughly listed as follows:

  • Any blood passed with bowel movement or from the rectum
  • Unexplained weight loss
  • Difficulty urinating and or blood in the urine
  • Unexplained pain in the stomach or chest that does not go away
  • Yellow or orange discoloration of the skin
  • A new “lump” or bump found on the body
  • A change in a skin mole or spot
  • Persistent cough or bloody cough
  • Post-menopausal vaginal bleeding

These nine concerning symptoms or signs occur in part or together with most human cancer.  It is important to note that these symptoms are not specific to cancer and can occur with many conditions that are NOT cancer.  Nevertheless, it is still important to note these as they are considered “red flag” symptoms that demand some type of investigation.

Example # 1 “Oh, it’s just my hemorrhoids acting up.”

Attributing the passage of any blood with the stool to “hemorrhoids” is extremely common.  Hemorrhoids are extremely common.  Passage of blood from the rectum is common with colon cancer.  Colon cancer is also a common cancer in the United States.  This leads to a problem.  The average person has no clue what a hemorrhoid actually is or that almost every human alive has hemorrhoid tissue.  Collections of veins in the lower rectal canal help with continence and are normal.  Sometimes they can become enlarged, bleed or even fall out of the rectum and this is when people refer to the problem as “hemorrhoids.”

The problem is with a limited knowledge about them and no way to reliably diagnose yourself.   You could mistake a serious symptom for something minor and ignore it.  A 55 year old man finally sees the doctor after a few years of ignoring some bleeding with bowel movements.  He mentioned it to his wife once and she has nagged him ever since to get it “checked out.”  The man thought his wife worried too much and he was a bit nervous about what it meant to get “checked out.”  He was worried that there would be embarrassment or discomfort with having the rectum examined.

When he finally went to see his physician it was another 10 weeks because he was embarrassed to tell the scheduling nurse the real reason for his visit and told her he needed “just a checkup.”  When he saw his doctor and mentioned the problem, the doctor mentioned that he had lost 22 pounds since his last visit two years ago.  The man didn’t think much of it and told his doctor he had been trying to eat healthier.  The doctor’s physical examination didn’t detect anything abnormal but a test of his stool showed trace amounts of blood.  The doctor recommended a colonoscopy and he had this test the following week.  The gastroenterologist who performed the study found a tumor in the sigmoid colon and took several samples of the tumor which proved to be cancer a few days later.  The man had a CAT scan a few days later of the abdomen and pelvis which showed evidence of tumor in the right lobe of the liver.  A biopsy done that same day revealed evidence of colon cancer that had spread to liver.

So after months of ignoring the problem, 10 weeks of waiting for an appointment and 3 weeks of testing; the man is informed he has stage IV colon cancer.  Stage IV colon cancer has an average 5 year survival rate of about 5% or less.  Now the man is faced with a very bleak outlook and although treatment might help the rare person exceed statistics it is still a grim situation.  Earlier attention to a “red flag” symptom such as blood in the stool might have allowed treatment of the cancer before it spread to the liver.

Example #2 “I can’t get rid of this cough, I should really stop smoking.”

Cough is a symptom of lung cancer but it is also very non-specific as we all get a cough from time to time and it is not lung cancer the vast majority of the time.  A 72 year old, that has smoked a pack of cigarettes a day for more than 40 years, develops a nagging cough that does not seem to go away.  He had realized for many years that he should stop smoking but figured it was not worth the hassle of trying to quit and he had already smoked for so long what difference would it make?

This kind of lackadaisical attitude is common among people who ignore cancer symptoms, and more common in men.  Only when the man starts coughing up some blood with his cough does he begin to get concerned about it.  A lung tumor eventually might block part of the smaller airways and can irritate the lining of the lung as well.  These will produce the sensation of needing to cough.  Of course, the cancer cannot be “coughed up” and the cough will continue.  As the tumor grows, it will erode through the inner lining of the lung and cause some bleeding into the airways which then manifests as bloody cough.  By the time this man sees a doctor he experiences a similar situation as the one prior with a battery of testing and biopsies only to find out he has far advanced lung cancer that is not amenable to surgical curative treatment.

We are not advocating someone to become a hypochondriac, however – attention to certain cardinal symptoms as listed above should facilitate earlier detection of some of the most common cancers.  With most cancers, early detection generally allows more treatment options and better outcomes.

REFERENCES:

  1. Diagnosing cancer in the symptomatic patient. Salzman BE, Lamb K, Olszewski RF, Tully A, Studdiford J. Prim Care. 2009 Dec;36(4):651-70; table of contents. Review. PMID:  19913180
  2. What factors do cancer patients believe contribute to the development of their cancer? (New South Wales, Australia). Willcox SJ, Stewart BW, Sitas F. Cancer Causes Control. 2011 Aug 12. PMID: 21837407
  3. www.womenshealth.gov/
  4. www.cancer.gov
  5. This article was originally published on September 3, 2012 and last revision and update was 9/4/2015.