If you show your doctor such a lump, he or she will firstly want to know the history of it. If it has only been there a short time (weeks to months) and is getting bigger this would be more suggestive of cancer than if it had been there for years and was staying the same size. Most cancer lumps are not painful. Next your doctor should carefully examine the lump for its size, hardness, tenderness and exact location, checking whether it is attached to any organs. At this stage, your doctor may be able to tell you quite definitely that it is not cancer. If there is any suspicion, it is necessary to take a specimen, either with a needle through the skin, or by actually removing all or part of the lump under a local or general anaesthetic.

There are some places that you can’t see but your doctor can see quite easily. There are simple instruments to help your doctor look quite painlessly up your nose, down your throat as far as the voice box (larynx), into a woman’s vagina as far as the neck of the womb (cervix) and 20cm or so up your back passage (anus and rectum). So, for symptoms like a blood-stained discharge from the nose, cough, hoarse voice, coughing blood, irregular vaginal bleeding or bright blood in the motions, your doctor can check the appropriate part in the surgery at your first visit without any anaesthetic. In some cases, he or she may also be able to take a specimen then and there. For example, in the case of vaginal bleeding, a smear test can be taken and may provide a definite diagnosis when examined under the microscope. If there is a lump or ulcer in the anus or rectum, a tiny specimen can be taken with forceps in the surgery quite safely and painlessly.

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