Some cancers cause symptoms while they are still early, but many cancers cause few or no symptoms until they have grown larger. This is why screening can be important can be important even when someone feels completely healthy.
Possible warning signs include unexplained weight loss, unusual or persistent fatigue, a new lump or swelling, unusual bleeding, blood in the stool or urine, persistent changes in bowel or bladder habits, a cough or hoarseness that doesn't go away, difficulty swallowing, persistent unexplained pain, or a mole/skin lesion that changes or doesn't heal.
However, having one of these symptoms does not mean you have cancer, these symptoms are much more commonly caused by non-cancerous conditions. The National Cancer Institute recommends getting persistent symptoms evaluated, particularly when they don't improve after a few weeks. Also, don't wait for pain: some cancers don't cause pain, even when something is wrong.
For example, breast cancer can sometimes be detected by mammography before any symptoms appear, while a new breast lump, skin dimpling, nipple changes, or breast swelling can be warning signs that warrant evaluation.
If you tell me which type of cancer you're concerned about (breast, lung, colon, stomach, liver, etc.), The early → intermediate → advanced symptoms and which screening/tests are typically used. used.
Yes it does. When you suddenly have symtomps out of nowhere and those symtomps do not reflect the origin of the symtomps that may be a sign. Like you have suddenly high blood pressure but nothing is wrong particularly with your heart. Another sign is a sudden weight loss with no reason. Another symptom is the change of your psychological mood, again with no reason. All sudden changes with no specific reason might be the early symptoms of a cancer.
Mother’s breast cancer metastasized to her bones, so she was incapacitated as far as being able to walk and use her hands to feed herself. She also in a good deal of chronic discomfort. It wasn’t until the final stage of her life signs showed themselves one Friday morning in October 2004 that she then slipped into a semi-conscious state that lasted until the following Tuesday night when she departed this life. At such time as she was mildly conscious during those final days, I’m not sure she was even able to see clearly because she would call my name from her favorite chair there in her home’s family room and look one direction and then another, and when I would say, “Yes, Mom, I’m here,” she would glance towards my direction and smile from ear to ear. As far as the last hour or two of her life, she was basically unconscious and I was sitting next to her, holding her right hand, and then suddenly I detected the end had come.
(read here)
It can happen that way, but it varies from person to person and by the type of cancer. With good hospice or palliative care, the final stage of terminal cancer can often be kept peaceful and comfortable, although some people do experience pain, breathlessness, anxiety, or agitation that needs treatment.
As the body becomes weaker in the last days or hours, a person commonly sleeps much more, eats and drinks very little, becomes less responsive, and eventually may be unconscious. Breathing often becomes slower or irregular, sometimes with long pauses. Eventually breathing stops and then the heart stops. In that situation, from the family's perspective, it can look very much like the person went to sleep and simply didn't wake up.
There can also be symptoms near the end—pain, shortness of breath, confusion or restlessness, nausea, and noisy breathing from saliva or secretions. Importantly, hospice teams have medications and other measures specifically intended to control these symptoms. Noisy or irregular breathing can look frightening to family members but doesn't necessarily mean the person is suffering.
One other reassuring point: when someone becomes unconscious near death, they usually aren't experiencing things in the same way an awake, alert person would. The medical team's priority at that stage is comfort rather than trying to keep the person awake.
Prospective study of 357 advanced-cancer patients
Hui D, et al. Clinical Signs of Impending Death in Cancer Patients. The Oncologist. 2014.
Read the full scientific paper — NIH/PMC
Researchers followed 357 patients with advanced cancer, assessing them every 12 hours. They found that declining consciousness was one of the earlier and more common changes.
Signs strongly associated with death within about three days included
- Cheyne-Stokes breathing,
- very low urine output,
- mandibular breathing movements and the "death rattle."
A follow-up analysis of the same prospective research also found that decreased response to verbal and visual stimulation was strongly associated with impending death.
This supports the observation that many dying cancer patients eventually reach a state in which they are very sleepy, minimally responsive or unconscious before death.
But can suffering still occur?
Yes. A systematic review involving 12 studies and 2,416 patients found that symptoms during the final two weeks included:
- Shortness of breath — 56.7%
- Pain — 52.4%
- Respiratory secretions/"death rattle" — 51.4%
- Confusion — 50.1%
However, the presence of these symptoms doesn't mean that every patient experiences severe suffering.
Symptoms can vary considerably, and palliative treatment matters greatly.
An older prospective study of 120 terminal cancer patients found that some developed difficult-to-control symptoms shortly before death, particularly breathlessness, pain and delirium. This is another reason hospice and specialist palliative care are important rather than assuming dying will automatically be symptom-free.
What the research suggests happens near the end
A common trajectory is approximately:
- Increasing weakness →
- more sleeping/drowsiness →
- less eating/drinking →
- difficulty swallowing →
- decreasing responsiveness/consciousness →
- changes in breathing →
- periods without breathing →
- breathing stops →
- heart stops.
But not everyone follows exactly this sequence, and the timing cannot be predicted precisely.
The NCI specifically cautions that not all signs occur in everyone.
So the scientifically accurate answer to your original question is: yes, for some people it can appear very much like going to sleep and not waking up.
But cancer can also produce pain, breathlessness, delirium or other distress near the end, which is why hospice/palliative medication and nursing care are so important.
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