“Nobody wants to think they’ll be affected by cancer,” says Dr Anisha Patel, GP. “Many people dismiss cancer symptoms as stress or ageing, or worry they’re wasting my time. Some have waited for months before coming to see me.”
Dr Patel, author of Everything You Hoped You’d Never Need to Know About Bowel Cancer, understands that instinct only too well. In 2018, she was diagnosed with stage-3 bowel cancer after a few months of subtle symptoms.
“Even with my medical knowledge, I could explain everything away,” she says. “I blamed constipation and tiredness on being a busy mum and GP. It was only when the symptoms became more persistent I realised I needed help.”
She’s far from alone. According to Cancer Research UK, around one in three people delay contacting their GP for six months after noticing a potential cancer symptom. That delay can have serious consequences. A study in The British Medical Journal found each four-week delay in intervention was associated with a 6 to 13 per cent increase in the risk of death, with the risk rising the longer treatment was delayed.
“A later diagnosis often means the cancer has had more time to grow or spread,” says Dr Patel. “That often leads to more intensive treatment and a worse prognosis.”
Following surgery and chemotherapy, Dr Patel made a full recovery and now works with Bowel Cancer UK to encourage more people to recognise the warning signs.
Here are the symptoms she says should never be ignored.
1. You’re more tired than usual
“Fatigue is a difficult symptom to catch because it’s so common,” says Dr Patel. “What’s key is whether it feels disproportionate to your activity level and distinctly different from your normal level of tiredness.”
Persistent fatigue can be a sign of many cancers but particularly bowel, kidney and blood cancers such as leukaemia and lymphoma.
As cancer cells grow, they consume more energy and nutrients which can leave the body depleted. Blood cancers and gastrointestinal cancers that cause slow, internal bleeding can lead to anaemia, resulting in weakness and fatigue.
Shortly before her diagnosis, Dr Patel was on holiday in Italy when she noticed she couldn’t manage her usual morning run. “I kept needing siestas and assumed it was because of the heat,” she says. “In reality, I was becoming increasingly anaemic because the bleeding was getting worse. I was relaxed, eating and sleeping well but the fatigue was pervasive.”
What to do
Book an appointment to see the GP if your fatigue lasts more than six weeks, is getting worse or significantly affecting everyday life, despite adequate rest, advises Dr Patel.
“It’s particularly important to seek help if fatigue is accompanied by another red-flag symptom, such as unexplained weight loss, bleeding, a lump or persistent pain,” she adds. “Don’t simply assume persistent tiredness is part of getting older.”
Your GP should check for anaemia and nutritional deficiencies, says Dr Patel. “They may also check thyroid function, diabetes and whether fatigue is caused by medication, an autoimmune condition or other illness,” she adds. “There may be an obvious explanation but, if it’s out of the ordinary, it needs investigating.”