We wait for pain, but cancer often starts without it

One of the most dangerous misconceptions of modern medicine is the belief that serious illnesses must hurt BEFORE they matter. Many people believe that if it does not hurt, there is no illness. Unfortunately, cancer does not work that way.

A few of the most aggressive cancers can develop WITHOUT pain, lack of dramatic symptoms, and don't alter the usual course of life until the disease has already progressed. Therefore, by the time the cancer has shown any signs of discomfort, it has often progressed BEYOND its earliest stage and most treatable stage.

Pain is the body's alarm system. Unfortunately cancer is biologically intelligent. During the earlier stages of development, it usually grows quietly, adapting to the body instead of immediately attacking it.

Consider cervical cancer as an example: early stages of the disease, it may show few or no symptoms. Women often do not recognize the early warning signs of cervical cancer, including irregular bleeding, light discharge, or bleeding after intercourse, because they appear minor or unrelated to something serious.

Ovarian cancer is often referred to as a "silent cancer" for similar reasons. The symptoms closely resemble common digestive issues or IBS like complaints such as bloating, abdominal fullness, acidity, pelvic heaviness, or a change in their bowel habits. Many women self-treat these symptoms for several months, before seeking medical attention.

Even colorectal cancer presents women with similar symptoms, like constipation, fatigue, changes in bowel habits, or mild pain in the abdomen, that can easily be attributed to lifestyle changes.

Pancreatic cancer is another example where early symptoms are often not serious such as loss of appetite, unintentional weight loss, or mild indigestion. By the time jaundice or severe pain develops the disease may already have advanced.

As a surgical oncologist, one of my greatest dilemmas is not merely dealing with the treatment of cancer, but working to alter the way individuals consider the development of their symptoms; i.e., "I ignored it because it did not hurt." That sentence is more common than most people realise.

The problem becomes even more significant in India. A large percentage still proceed with health-seeking behaviour based on the presence of symptoms. Most will place off obtaining a screening or seeking professional assistance until such time as their symptoms significantly interfere with their daily lives. Cancer biology has no concept of "timing" and will not wait until it is convenient to present within an individual.

Therefore, there is a gradual change with respect to modern oncology treatment from a reactive model to a proactive model. The major success that occurs in the way we care for patients with cancer is not just through the use of advanced surgical techniques, robotics, HIPEC, immunotherapy and targeted therapies; it is due to our ability to identify the disease early before it becomes overtly aggressive.

The importance of the stage of cancer at diagnosis will have a significant impact on how patients respond to treatment. If diagnosed at an early stage, some cancers can be treated minimally and result in long-term cure rates of excellence. However, once diagnosed at a later stage, the same cancer can have prolonged treatment and significantly lower cure rates.

As healthcare providers, we cannot assume that every symptom or change in the body is cancerous nor can people be paranoid about every little thing that goes wrong. However, persistent changes within the body should always be evaluated, regardless of their level of pain or discomfort.

Due to the fact that cancer does not always develop with pain, sometimes it can develop without any discomfort to the individual.
Dr. Sanket Mehta, Founder & Director – SSO Cancer Hospital