Cancer Warning Signs You Should Not Ignore: The CAUTION+ Guide

In India, an estimated 14.6 lakh new cancer cases were recorded in 2022, and about 1 in 9 people may develop cancer in their lifetime (ICMR-NCRP, 2022). Lung and mouth cancers lead in men; breast and cervical cancers lead in women. Many are found late because early signs are ignored — or because people are scared to get checked.

The goal of this post is early attention, not fear. Here is an easy memory tool I use: CAUTION+. It is based on the classic “CAUTION” list of cancer warning signs, with a few important additions.

C — Change in bowel or bladder habits

• Diarrhoea or new constipation lasting weeks
• Stools thinner than usual, or a feeling that the bowel is not fully empty
• Blood in the stool or black stools
• Passing urine too often, pain while passing urine, or blood in the urine

Remember: one day of loose motion after outside food is not the concern. A change that stays, keeps returning or has no clear reason is.

A — A sore that does not heal

• A mouth ulcer that has not healed in 3 weeks (NICE)
• A red or white patch inside the mouth
• A skin sore that keeps crusting, bleeding or reopening

U — Unusual bleeding, discharge or weight loss

• Bleeding: blood in stool, urine, cough or vomit; bleeding between periods, after sex, or any bleeding after menopause
• Discharge: a new, persistent or unusual discharge — for example from the nipple or vagina
• Weight loss: losing weight without trying — not dieting, not exercising more

Blood where it should not be deserves a check. And if your body is losing weight without effort, don’t just celebrate — find out why.

T — Thickening, swelling or a lump

A new lump, hardness or swelling in the breast, neck, armpit, groin, testicle, mouth, abdomen or under the skin. Many lumps are harmless (like cysts or swollen glands after infection), but a new lump that does not go away should be examined.

I — Indigestion or difficulty swallowing

• Food feels stuck, or swallowing hurts
• Indigestion or acidity that does not settle, especially if new after age 40–45
• Early fullness, poor appetite, nausea or belly discomfort that persists

Occasional acidity after spicy food is common. Difficulty swallowing should always be checked by a doctor promptly.

O — Obvious change in a mole or skin spot

Doctors use the ABCDE check (American Academy of Dermatology):

Letter	Look for
A — Asymmetry	One half does not match the other
B — Border	Uneven, ragged or blurred edge
C — Colour	More than one colour, or uneven shades
D — Diameter	Bigger than about 6 mm (a pencil eraser) — though some are smaller
E — Evolving	Changing in size, shape or colour; itching, bleeding or crusting

In people with darker skin, skin cancers are less common but may appear on the palms, soles or under the nails — a new dark streak in a nail should also be checked.

N — Nagging cough or hoarseness

A cough that does not go away or keeps getting worse, coughing up blood, or a hoarse voice that lasts more than about 3 weeks. Many coughs follow infections or allergies — but in India, a cough lasting 2 weeks or more should also be checked for tuberculosis.

+ The “plus” signs

• Persistent fatigue: severe tiredness that does not improve with rest
• Fever or night sweats: repeated unexplained fever, or night sweats that soak your clothes or bed
• Persistent pain: pain that stays or worsens without a clear reason

The NCI also notes that cancer often causes no pain in early stages — so don’t wait for pain before getting a lump or bleeding checked.

When to see a doctor — and how urgently

Situation	What to do
Any CAUTION+ sign lasting more than 2–3 weeks, returning or worsening	Book a doctor visit (general physician or nearest government hospital)
Bleeding after menopause, a new breast lump, difficulty swallowing, blood in urine	See a doctor soon — don’t wait weeks
Vomiting or coughing up a lot of blood, black tarry stools with dizziness, severe breathlessness	Emergency — call 112 or go to the nearest emergency department

Prevention and early detection go together

• Quit all forms of tobacco and limit alcohol
• Get the HPV vaccine as advised (it prevents most cervical cancers)
• Stay active, keep a healthy weight, eat more vegetables, fruits and fibre
• Use free NP-NCD screening for oral, breast and cervical cancer if you are 30+
• I will explain cancer screening tests in detail in my next post

Move more — one of the few levers with real evidence

The World Cancer Research Fund grades physical activity as convincing evidence for lower risk of colon, endometrial and post-menopausal breast cancer. The target most guidelines use is 150 minutes of moderate activity a week — roughly twenty minutes a day. That shifts risk across a population. It is not a guarantee for any individual.

Waist matters, not just weight

WCRF also grades greater body fatness as a convincing cause of several cancers, including bowel, endometrial and post-menopausal breast. Weight alone misses a lot — where the fat sits matters, and a waist measurement picks up what the scale does not.

Measure at the level of the navel, standing relaxed, at the end of a normal breath out. Same time of day each time, and write the number down rather than trusting memory.

• Measure once a month, not daily — waist moves slowly
• A rising trend over months matters more than any single reading
• If it is climbing while you are not trying to gain, mention it to a doctor

Key takeaways

1. Most warning signs are not cancer — but persistent signs need checking.
2. Remember CAUTION+: bowel/bladder change, non-healing sore, unusual bleeding/weight loss, lump, swallowing trouble, mole change, nagging cough, plus fatigue, fever/night sweats and pain.
3. Use the 2–3 week rule; see a doctor sooner for bleeding after menopause, breast lumps or swallowing difficulty.
4. Early attention saves lives. Fear should not delay a check-up.

Related reading

• Cancer screening tests available in India

Sources

1. Sathishkumar K et al. Cancer incidence estimates for 2022 & projection for 2025: National Cancer Registry Programme, India. Indian J Med Res (2022) — about 14.6 lakh new cases in 2022; 1 in 9 lifetime risk
2. National Cancer Institute (NCI). Symptoms of Cancer — most symptoms are caused by other problems; see a doctor if they last
3. NICE NG12. Suspected cancer: recognition and referral — recommendations by symptom — e.g. mouth ulcer lasting more than 3 weeks; bleeding after menopause
4. American Cancer Society. Signs and Symptoms of Cancer — general and specific warning signs
5. American Academy of Dermatology. Melanoma: the ABCDEs — mole changes to watch
6. MoHFW / PIB. NP-NCD screening for all aged 30+ (2025) — free oral, breast and cervical cancer screening

What actually lowers your risk. Worrying does not. WCRF/AICR grades the evidence as convincing that regular physical activity lowers the risk of colon cancer, post-menopausal breast cancer and endometrial cancer — alongside not smoking, limiting alcohol and keeping a healthy weight. None of this treats a symptom you already have. If you have one, see a doctor rather than changing your routine and waiting.