The signs and symptoms of cancer vary widely, depending on the type and site of the tumor, as well as the stage of its development. Tumors of the skin and breast often present as lumps. Hollow tubes in the body, such as trachea, bronchi, ureter, intestine, and bile duct can be partially occluded by tumors, leading to symptoms from compromise of their function. Cancer can ulcerate and bleed into any of these hollow pathways. Pain occurs when hollow organs attempt to overcome the obstruction by contractions or when the tumor cells press on nerve fibers. Cancers can lead to weight loss by competing for energy supplies and diminishing appetite. Because the symptoms of cancer often imitate those of a broad category of other diseases, physicans must first eliminate possible alternative causes of the symptoms. Cancer diagnosis has enormous importance, but a false diagnosis is worse. Cancer sometimes presents with nonspecific constitutional complaints, such as anorexia, weight loss, fatigue, generalized malaise, or fever. Also, it is not uncommon for cancers to be identified incidentally during routine diagnostic or screening procedures, without any symptom at all.
A wide variety of additional symptoms may become apparent when there is spread of the malignancy to other organs. Pulmonary metastases are common because the lung is often the first organ to act as a filter and trap for malignant cells. Metastasis to the liver may originate via portal venous circulation from the gastrointestinal tract from cancers of colon, rectum, pancreas, and stomach. Metastasis to liver, lung, bone, or brain is generally associated with a grim prognosis.
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