Gynaecologist reveals often ignored silent signs of cancer in women: From persistent fatigue to unexplained bloating

To ensure timely diagnosis and improve the success of treatments, detecting early signs, particularly the silent ones, becomes essential.

There are several subtle signs that women may dismiss. They may seem manageable, easy to overlook, or may coincide with other everyday factors such as stress, hormonal changes or fatigue.

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However, the early signs of cancer are often quiet and non-specific, making them easy to ignore and endure until they become significantly disruptive and begin to affect daily functioning.

This is where awareness becomes critical. Prolonged downplaying of persistent symptoms can lead to delayed diagnosis and postponed treatment, ultimately reducing the chances of timely intervention and better health outcomes.

The women's menstrual cycle, particularly the follicular phase, ovulation, luteal phase, and menstruation, involves numerous emotional and physical changes. As a result, women tend to normalise any out-of-the-ordinary symptoms and dismiss them as routine hormonal fluctuations when they could mean something much more serious.

To understand the various subtle and persistent symptoms, we spoke with Dr Sabhyata Gupta, Chairperson, Gynaecology and GynaeOncology at Medanta, Gurugram, who also acknowledged that social conditioning often encourages women to normalise discomfort. But not all the symptoms can be normalised by saying ‘being a woman’, as ignoring early warning signs can have major consequences.

The scale of cancer in India is alarming, particularly because delayed diagnoses often worsen outcomes. “In India, one woman dies of cervical cancer every eight minutes. Each year, approximately 120,000–125,000 new cases of cervical cancer are diagnosed in India, accounting for nearly one-fifth (18–21%) of the global burden of cervical cancer," Dr Gupta said.

Most importantly, dismissing signs leads to the most grave concern: diagnosis at advanced stages, when treatment becomes more complex and outcomes significantly less favourable.

The gynaecologist noted that the symptoms often overlap with: stress, ageing, menstrual irregularities, or gastrointestinal disturbances. This can lead to reassurance and a shift in focus, causing women to delay or avoid seeking adequate medical evaluation.

Top silent signs

Dr Sabhyata Gupta emphasised that the initial signs are not severe pain or any dramatic symptoms in the initial stages.“They manifest as small but persistent changes in the body,” she noted.

Here are some of the signs she listed:

1. Ongoing physical changes: Persistent abdominal bloating, new or unexplained pelvic discomfort, or early satiety.
2. Menstrual or hormonal changes: Irregular or heavy menstrual bleeding, bleeding between periods, bleeding after intercourse, or any vaginal bleeding after menopause.
3. Changes in energy and weight: Persistent fatigue, unexplained weight loss or gain.
4. Everyday symptoms that do not resolve: Persistent urinary urgency, changes in bowel habits, chronic cough or breathlessness, or a lump that does not disappear.

Cancer-specific symptoms

Cancer has silent signs which many end up overlooking. (Unsplash)

Next, each type of cancer can present with its own set of symptoms. According to the gynaecologist, the most common cancers among Indian women include cancers of the breast, cervix, colorectum, ovary, and oral cavity. Even so, cancers may initially show unusual or subtle symptoms that do not match the commonly expected signs, making early detection more challenging. There are some atypical early symptoms which you need to pay attention to.

Dr Sabhyata Gupta listed these:

1. Ovarian cancer

• Ovarian cancer often presents with vague abdominal symptoms such as bloating, pelvic pain, early satiety, or altered bowel habits.
• This cancer has earned the reputation of a ‘silent killer.’

2. Cervical and endometrial cancers

• Signal their presence through abnormal vaginal bleeding, between menstrual cycles, after sexual intercourse, or any bleeding after menopause.

3. Breast cancer

• Breast cancer does not always present as a palpable lump.
• Warning signs may include nipple discharge, skin changes such as dimpling or redness, nipple retraction, a change in the size or the shape of the breast or persistent breast pain.

4. Colorectal cancer

• Colorectal cancer may initially manifest as changes in bowel habits, unexplained anaemia, abdominal discomfort, or rectal bleeding.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.