here’s what you need to know when there are no obvious signs

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The recent revelations about the Princess of Wales’ cancer diagnosis highlight a crucial aspect of cancer detection – the sometimes silent nature of the disease.

Silent cancers are those without noticeable symptoms. They are a particular challenge for early detection and treatment.

Contrary to popular belief, cancer does not always announce its presence through obvious signs or symptoms. Many people are diagnosed with cancer incidentally, when it is discovered during routine medical examinations or investigations into unrelated health concerns – as it seems for both the princess and King Charles III.

Although even silent cancers can sometimes be aggressive and progress quickly, they can lie dormant for years or even decades. Some prostate, breast and thyroid cancers, for example, often develop slowly without obvious symptoms or spread beyond the original area.

Research suggests that some of these cancers are overtreated. Sometimes it is best to leave patients alone or to treat them much more gently, perhaps even without medical intervention, using a “watch and wait” strategy. This approach may be taken with prostate cancer in the elderly, for example.

The importance of early diagnosis

Whatever the cancer, early diagnosis is always important – and in the case of silent cancers, this is clearly a challenge.

Some cancer symptoms can be vague and easily mistaken for benign illnesses. Fatigue, unexplained weight loss and persistent pain are among the non-specific symptoms that may be a sign of an underlying malignancy. But such symptoms can be easily misunderstood or dismissed, contributing to delayed diagnosis and treatment.

Fortunately, in many countries including the UK, we have screening tests for diseases such as breast or colon cancer, to increase early diagnoses.

Early diagnosis is a key factor in successful cancer treatment. Detecting cancer in its silent stage allows for early intervention and improved outcomes. The discovery of asymptomatic cancers through diagnostic imaging or screening tests emphasizes the importance of these proactive health care measures.

Identifying cancer at an early stage means that the disease is confined to its site of origin, smaller and potentially easier to cure. Diagnosing a smaller cancer often means that if an operation is needed, it may be a less invasive surgery. There may also be less chance of needing preventative chemotherapy post-surgery, to clear any residual cells.

Colorectal cancer (CRC) is a good example to illustrate the critical importance of screening. Studies show that patients who participate in CRC screening, such as colonoscopies or tests that look for blood in the stool, are more likely to be diagnosed while asymptomatic and have a more positive prognosis after treatment. Those diagnosed with CRC after showing symptoms, such as rectal bleeding or changes in bowel habits, tend to have larger tumors and poorer outcomes.

Public health initiatives aimed at raising awareness of the importance of cancer screening and symptom recognition play a key role in reducing diagnostic delays. By enabling people to take preventive health care measures such as HPV vaccinations and lifestyle changes that reduce risk, it can facilitate early detection and intervention, which can change the course of the disease.

Biomarker discovery

The latest advances in diagnostic technologies, often called “biomarker discovery” promise to improve early detection rates and refine treatment strategies for silent cancers. From molecular profiling to liquid biopsy techniques (blood tests to diagnose cancer), innovative approaches are reshaping the landscape of cancer diagnosis, offering new avenues for personalized and precise medicine.

For example, I worked with a team using blood tests to identify cancers in more than 1,000 women who recalled after screening for mammography. We looked at the DNA released by tumor cells – so-called cell-free DNA – and also at metabolites (rare markers of metabolism in the blood). From this information, we found healthy patients, benign disease, pre-cancer and breast cancer. Although there is increased awareness and use of this approach in Europe, it is not standard in the UK.

Asymptomatic cancers are a huge challenge for patient care. But, by encouraging patients to adopt preventive lifestyles and to engage in screening and tests, asymptomatic cancer does not have to be a hidden health threat.

This article from The Conversation is republished under a Creative Commons license. Read the original article.

The conversation

The conversation

Justin Stebbing does not work for any company or organization that would benefit from this article, does not consult with, own shares in, or be funded by any company or organization that would benefit from this article, and has disclosed no relationships relevant beyond their academic appointment.

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