Eye on early warning signs

There is no gender discrimination in cancer. Recognising the symptoms can go a long way in saving lives, writes Aznim Ruhana Md Yusup

MEN and women are at risk of various health issues as they age. But while there are many similarities, there are also differences.

Take cancer, for instance. Based on Malaysian Cancer Statistics for 2006, the most common cancers in men are, in descending order, colorectal, lung, nasopharynx, prostate and liver cancer.

Except for prostate, the other types of cancers can affect women as well. Colorectal cancer is the second most common cancer for women, after breast cancer.

While breast cancer is often associated with women, men do get it as well.


Whether you are a man or woman, the chances of being cancer-free are very high if the disease is detected in the early stages. So it is vital to recognise the warning signs.

"The signs depend on the type of cancer," says Dr Sulaiman Tamanang, consultant radiologist at the National Cancer Society Malaysia.

"Signs of colorectal cancer include changes in bowel habit. For instance, you would usually pass motion every day, then suddenly, you don't for two or three days," he says.

"Or you have constipation, or constipation alternating with diarrhoea. You may also see blood in the stool and a loss of weight or loss of appetite."

Meanwhile, a cough that doesn't go away may be a sign of lung cancer. Dr Sulaiman suggests a chest X-ray if the condition doesn't improve after the second visit to a GP.

"For prostate cancer, there are no specific signs," says Dr Sulaiman, adding that it typically affects men above 50. "But there are indications if the prostate is enlarged. You may have difficulty passing urine, or you wake up several times at night to go to the toilet.

"These signs are due to the enlargement of the prostate, not cancer per se. However, it's very rare to get an enlargement of the prostate without it being cancerous."


In the early stages, Dr Sulaiman says, a person with cancer may not know he has the illness as he may not be in pain.

There's also denial, the feeling that you can't possibly be ill even though you notice the warning signs. "Some men think that because they are the 'superior' sex, they cannot get cancer," he adds.

You may even be wondering if you're a hypochondriac as the signs are mild. But the only way to know for certain is to see a doctor.

In the case of suspected prostate cancer, doctors test for an enzyme called prostate-specific antigen (PSA). It is naturally present in small quantities but if found in high levels, it could be a sign of cancer.

"We may then do a rectal ultrasound to see if there is any nodule in the prostate. If there's none, we may do an MRI or a biopsy."

In all types of cancer, it's typical to have a barrage of tests just to make sure. Some say that it is better not to know. But if it is cancer, you will suffer later on and it will be difficult for the family as well.


Dr Sulaiman says that the prognosis for prostate cancer is much better than say, lung cancer, because it is slow growing. Lung cancer is usually very aggressive and resistant to chemotherapy treatments.

"Family support is very important. To fight cancer, you must be strong emotionally," he says.

Aside from cervical cancer which is caused by a virus (and for which there is a vaccine), we do not know what causes cancer. So we manage the risks by exercising, eating healthy, reducing stress and cutting out tobacco and alcohol, among others.

"You can relate smoking to any disease, not just lung cancer. It's also related to heart disease and gastric ulcers. There are a lot of harmful substances in cigarettes. The cause of cancer is multi-factorial, so we do what we can to avoid the risk factors," says Dr Sulaiman. "But if we do all that and we still get cancer, it is fated. So we try our best and at the end of the day, we leave it to God."


IN an effort to raise awareness on testicular cancer and self-exams, British organisation Check One Two has started online campaign #FeelingNuts.

Check One Two founders are two pairs of brothers, Simon and Andrew Salter, and Simon and Phil Tucker, who being blokes themselves, understand the male attitude towards health and knew that "we're all a little too laid-back to keep a check on our love grenades".

Wolverine star Hugh Jackman, celebrity chef Jamie Oliver and Tottenham Hotspur FC players have joined the campaign.

As far as hashtag health campaigns go, #FeelingNuts has not gone viral in the same way that the #IceBucketChallenge has done for motor neuron disease, but it has garnered more than 500,000 million mentions on social media.


TESTICULAR cancer, while relatively rare, is affecting more and more men each year. The reason for this is unknown, although it is more common among the younger age group (15-45) of males.

However, all men — young or old — should be aware of their personal risk factors for testicular cancer. In the same way that women are advised to do breast exams to check for signs of breast cancer, men should also conduct regular testicular self-examination.

The National Cancer Society Malaysia says that checks should be done once a month, preferably after a warm shower when the scrotum sac is soft and relaxed.

Look for change

Stand in front of a mirror and look for change in size and shape of both testes. It is common to have one testicle slightly larger or one that hangs lower.

Feel for change

Hold your scrotum in the palm of your hand. Place fingers under the testicle and your thumb on top. You should be able to feel a soft, tender tube at the top and back of the testicle. This is the epididymis that carries and stores sperms.

Gently roll the testicle between the thumb and fingers, with firm pressure. It should be smooth with no lumps or swellings, and painless. Repeat on the other side.

There also should not be any unusual difference between once testicle and the other. Other warning signs include a dull ache in the abdomen or groin, or blood in the semen.

Early detection is the key to curing cancer. Monthly self-exams can easily help you discover

any changes in size, shape and feel of the testicles. Talk to your doctor if you find anything unusual.