Is it just the hiccups?
By Elyse Notarianni

In early 2015, David Kershaw was painting a room in his house when the most normal thing in the world happened – he got the hiccups. Except, they didn’t stop.   

“The hiccups got so frequent and intense that I was having trouble holding a paint roller still,” says Kershaw, who went to the emergency room at Inspira in Woodbury. “I was admitted to the hospital, and after more tests over the next few days, I got a diagnosis of non-Hodgkin’s lymphoma. I had cancer. It turns out that a tumor was compressing my diaphragm and causing the hiccups.” 

After a successful surgery and 6 months of chemotherapy, Kershaw was cancer free. Hiccups are not a usual cancer symptom by any means. But for him, it was the sign he needed. 

When something is wrong, your body finds ways to sound the alarm. The problem is, they’re not always the warning you’d expect. Here are a few symptoms beyond the lumps, bumps and spots we’ve come to expect that may mean it’s time to see your doctor. 

Bleeding, pain & abnormal discharge *down there*

Courtney Griffiths, DO

One of the first signs of cervical, uterine or endometrial cancer is vaginal bleeding, which can be tricky because these are issues that many women see every month, says Courtney Griffiths, DO, a Cooper Health gynecologic oncologist.  

“Keep an eye on anything out of the ordinary, such as changes in your cycle, changes in discharge color or odor or bleeding during intercourse,” she says. “And for post-menopausal women who wouldn’t mistake any of these symptoms for their regular monthly cycle, see your provider immediately.”

GI Issues

Feeling full early, constipation, diarrhea, bloating, abdominal pain, discomfort – it could be a stomach bug, but if it persists, call your doctor. Prolonged symptoms could mean any number of cancers, such as colon, stomach or small intestinal cancer. 

“For women, especially women over 60, these symptoms can also point toward late-stage uterine cancer,” says Griffiths.

Nipple Changes

Rachel Levenbach, MD

It’s not uncommon for nipples to be sore every once in a while, but drastic changes could mean early signs of breast cancer, says Rachel Levenbach, MD, a medical oncologist and hematologist at Regional Cancer Care Associates.

Both women and men should look out for symptoms like nipple discharge (especially if there’s blood), extra-sensitive breast or nipple tissue, or if the nipple feels “red hot.” 

“You could have an infection, it can be hormonal, or even a side effect of breastfeeding,” says Levenbach. “But it could also be cancer. If you assume, you don’t give yourself the chance to catch it early when it’s very treatable.” 

Pain or swelling in the armpit, neck or shoulders

Cancer cells can travel to the lymph nodes, which help fight infection. When those cells get trapped, it can cause swelling where the lymphatic system is closest to the skin, like in the neck, shoulders or armpits

“Sudden pain or swelling in these areas is an immediate red flag because you now risk the cancer traveling through the body,” says Levenbach.

Persistent back & shoulder pain

Erev Tubb, MD

Pain can travel through the nervous system, which means chronic pain in your back or shoulder could be caused by something completely unrelated. 

“Cancers of the bowel, GI tract and liver can often grow undetected, because there aren’t a lot of pain fibers inside your organs,” says Erev Tubb, MD, medical oncologist and medical director of the Cancer Center at Inspira Medical Center Mullica Hill. “But once it reaches outside the organ, the pain can travel through your nervous system to other parts of the body.” 

For smokers, it can also be a sign of lung cancer.  

 “If there’s a tumor close to the apex of the lung, it can push on the blood vessels and refer pain to your back and shoulder,” he says.  

The sudden need to chew ice

“We don’t exactly know why, but chewing ice is often associated with iron deficiency,” says Tubb. “Many women have low iron because of their menstrual cycle. But for men or post-menopausal women, it’s a warning sign.”

Iron deficiency comes from blood loss, which means you may be bleeding and not know it. 

“Microscopic bleeding in the urinary tract causes frequent urination and burning. In the short term, it could be a UTI. In the long term, it could be a sign of bladder or kidney cancer,” says Tubb. “Also, look at your stools. If they’re a darker color than usual or more of a tar consistency, that could signal you’re bleeding internally in your gut and could be a sign of stomach cancer.” 

Any unexplained change

Extreme weight loss, excessive fatigue, trouble sleeping, sudden depression, mood or personality changes, even changes in how you look – if it seems out of the ordinary, it probably is.

“I once treated a patient for iron deficiency, and when she came in, I noticed the whites of her eyes were yellow,” says Tubb. “It turns out she had pancreatic cancer blocking her bile duct. Which is to say, sometimes, even the smallest, most unexpected changes can signal something important.”

When to worry (and when not to)

It’s important to stay in tune with what’s going on with your body, says Levenbach, but there’s a healthy balance between being aware of your symptoms and feeling like cancer lurks behind every ache, lump, spot or, apparently, hiccup.

“Sometimes, a headache is just a headache,” says Levenbach. “But the key is to pay attention to your body, notice changes and speak with your doctor. So many people put off getting issues checked because they don’t want to overreact.”

Symptoms that come around for a few minutes or even a few days are likely totally normal. But when they start to stick around for weeks or months, that’s a sign that there may be an underlying cause. 

“You know your body better than anyone else,” says Griffiths, “so if something doesn’t feel right, it probably isn’t. Worst case scenario, they say it’s all normal and send you on your way. Best case, you caught something early, and that can save your life.” 

March 2023
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