1. Training for Practice Nurses and Health Care Assistants on CANCER SIGNS AND SYMPTOMS

2. Objectives of this module The signs to look out for Symptoms a person might tell you about

3. Red flags Can you list as many signs and symptoms that might indicate a patient has cancer?

4. Red flags Rectal bleeding Blood in pee – Haematuria Post menopausal bleeding Coughing up blood – Haemopytisis Unexplained lump Unexplained soreness/pain Persistent cough Change in bowel habit Unexplained weight loss Tiredness and Fatigue

5. Lung cancer List as many signs and symptoms in your workbook that could suggest a patient has lung cancer

6. General symptoms of lung cancer Having a cough most of the time A change in a cough you have had for a long time Being short of breath Coughing up phlegm (sputum) with signs of blood in it An ache or pain in the chest or shoulder Loss of appetite Tiredness (fatigue) Losing weight

7. Less common signs A hoarse voice Difficulty swallowing Changes in finger nails – (clubbing) Swollen face – (SVC obstruction) Swollen lymph nodes in neck Changes in blood tests – raised platelets Pain under ribcage – swollen liver Fluid in the lungs causing shortness of breath

8. Anne’s story

9. Breast cancer List the symptoms and signs that you think might suggest breast cancer

10. Breast cancer – signs and symptoms in the size, shape or feel of a breast CHANGE REDNESS or RASH on the skin and/or the nipple DISCHARGE Blood stained, and from the nipple SWELLING Or a lump in your armpit or the breast tissue DIMPLING or puckering (a bit like the skin of an orange) TURNED IN or change in shape of a nipple. A NIGGLING PAIN or tenderness in the breast or armpit.

11. Colorectal cancer What signs and symptoms would make you think of cancer of the bowel? Please note the above graphic is not anatomically correct

12. Colorectal cancer Bleeding from the back passage (rectum Bleeding) or blood in your poo. A change in normal bowel habits A lump that your doctor can feel in your back passage or abdomen (more commonly on the right side) A feeling of needing to strain in your back passage (as if you need to pass a bowel motion), even after opening your bowels Losing weight Pain in your abdomen or back passage A lower than normal level of red blood cells (anaemia)

13. Prostate cancer Have a think about what a patient may tell you that would make you think about prostate cancer

14. Prostate cancer Having to rush to the toilet to pass urine Passing urine more often than usual, especially at night Difficulty passing urine, including straining to pass it or stopping and starting A sense of not being able to completely empty the bladder Pain when passing urine Blood in the urine or semen

15. Gynaecological cancer  List the symptoms that might be suspicious of cancer of the  womb  ovary  cervix  vulva 

16. Gynaecological cancer Abdominal pain Bleeding after the menopause Urinary symptoms Bleeding between periods Bleeding after intercourse Bloating and abdominal distension Change of bowel habit Weight loss/Fatigue/Back pain Vulval lumps or ulceration

17. Upper gastrointestinal cancers What symptoms might make you suspicious?  Oesophagus  Pancreas  Stomach  Gall bladder   Liver 

18. Upper gastrointestinal cancers Difficulty swallowing Persistent acid or indigestion Weight loss Food coming back Pain behind the breast bone or in throat Hoarseness Chronic cough Coughing up blood Darker Poo Please note the above graphic is not anatomically correct

19. Workbook On the left is a list of signs and symptoms. On the right is a list of cancer sites. Link the two. There may be more than one answer for each symptom.

20. Have we covered the objectives? The signs to look out for  Symptoms a patient might mention to you 