At age 47, Pati Lanning of Harvey, Louisiana, experienced some rectal bleeding. She had hemorrhoids, so it didn't alarm her, but then the bleeding increased. Her stools got narrower. "I knew these could be signs of colorectal cancer," she says. "I was paralyzed with fear." Pati was lucky to have symptoms, as colorectal cancer often causes none. Getting tested saved her life. While blood in the stool can signal other problems, it's one of the body's signals that should always be investigated.
Colorectal cancer kills more Americans than breast or prostate cancer combined. Everyone over age 50 should be screened regularly. If polyps are found, doctors can remove them before they become cancerous, or while still in the cancer's earliest stages.
Blood in the stool, weight loss, changes in bowel habits, a feeling that the bowel does not quite empty, a new shape to stools, abdominal pain or discomfort, anemia, or fatigue are all possible indicators of a problem.
Prevention: With regular screening and lifestyle changes, more than half of colon cancer deaths can be prevented. If there's a family history of bowel disease or polyps, screening should start earlier and be more frequent. Regular exercise can cut your risk of colorectal cancer in half. And eating a high-fiber diet, avoiding animal fats, and taking multivitamins containing folic acid can also help reduce your risk.
Tests: There are four -- fecal occult blood test, sigmoidoscopy, colonoscopy, and barium enema with X ray -- and no consensus on which is best.
Treatment: Surgery removes the cancerous area. Radiation and chemotherapy may follow.
For more information: Contact the Colon Cancer Alliance at 212-627-7451.
Stroke kills more women than do cancers, says Dr. Thomas Brott, a neurologist at the Mayo Clinic Jacksonville, in Florida. But few women or men -- who suffer strokes as frequently -- know how to recognize one.
One common signal is weakness or numbness in the arm and hand. Other signs include: inability to speak, to see, or to walk; inability to move or feel on one side of the body; a sudden, severe headache; numbness or paralysis of part of the face; sudden fever, vomiting, and nausea; loss of balance or coordination; or a brief loss of consciousness.
Arm and hand problems are especially serious when the face or leg also is affected. "For weakness in the arm and hand of sudden onset, call your doctor immediately," says Dr. Brott. "If it's arm and leg together, call 911."
Prevention: Know your blood pressure, and follow treatment if it's high. Don't smoke or abuse alcohol. Strokes can result from vessels damaged by fatty deposits, so everyone should exercise and follow a low-fat diet. If, despite exercises and diet, blood cholesterol remains high, medication may be useful. For those who have had a minor stroke or warning of a stroke, aspirin or another medicine which makes blood platelets less sticky may help to prevent stroke.
Tests: Blood tests, electrical activity tests, CAT scan, magnetic resonance imaging (MRI), and others.
Treatment: When a stroke is caused by a clot, patients have a greater chance of full recovery if Tissue Plasminogen Activator (TPA) is given within three hours of first symptoms. Other treatments include drugs and surgery.
For more information: Call the American Stroke Association at 800-553-6321.
The indicators of a heart attack and heart disease are more vague in women than they are in men. Yet heart disease is the leading cause of death for women. Even doctors may have trouble diagnosing it correctly. "Women lucky enough to survive a heart attack often realize they had symptoms, but never made the connection," says Dr. Patrice Desvigne-Nickens, who directs the Heart Research Program at the National Heart, Lung, and Blood Institute.
In men, heart disease and attacks may be heralded by chest pain. A woman may feel sudden, extreme fatigue; chest pressure or pain in the upper abdomen; breathlessness or windedness; nausea or vomiting; profuse sweating; or anxiety.
Prevention: Eat a nutritious diet, exercise regularly, and maintain a normal weight. Don't smoke. Don't drink excessively. Know your cholesterol levels and blood pressure, and keep them in check. If diabetic, control your blood sugar.
Tests: A doctor can select from many tests, including an electrocardiogram, a chest X ray, and a nuclear medicine echo stress test.
Treatment: Depending on the severity of the heart problem, intervention options include surgery, diet, exercise, and drugs. Drug treatment may include aspirin, beta-blockers, calcium channel blockers, and ACE inhibitors.
For more information: Call the American Heart Association at 800-242-8721 (or find a local chapter in your Yellow Pages).
Alexia Barnswell-Buford of New York City thought she was just getting clumsy. "It was difficult for me go downstairs without tripping. I thought, 'Maybe I just can't maneuver heels anymore.' " But she also had problems seeing cars in her rearview mirror.
Her father suggested an eye exam. The diagnosis was glaucoma. "I had lost over 90 percent of my peripheral vision," says Alexia, 40. She now has tunnel vision, with irreversible damage. "I'd always associated glaucoma with older people," she says.
Glaucoma can strike people of any age. "We call it the sneak thief of sight," says Dr. Jeffrey Liebmann, professor of ophthalmology at The New York Eye and Ear Infirmary. "For the vast majority of people there are no symptoms, and you won't know you have it unless you visit your doctor." But loss of peripheral vision, blurred vision, seeing rainbow-colored rings around lights, having headaches, or feeling pain around your eyes after watching TV or a movie, can be clues for some people.
The message here: Take any vision disturbances seriously, and have regular eye exams. People over age 45 should be especially vigilant about exams, as should anyone with African heritage, family history of glaucoma or diabetes, nearsightedness, eye injuries, or long-term steroid/cortisone use.
Prevention: Everyone under the age of 45 should have a full eye exam every four years, or every two years if at increased risk. After age 45, have an exam every two years, or every year if at increased risk. African-Americans should seek exams every year or two after age 35. Everyone should have annual eye exams after age 65.
Tests: A measurement of the pressure within the eye, examination of the optic nerves, and test of the visual field.
Treatment: Further vision loss can be prevented with pressure-reducing eyedrops and pills, or surgery or laser surgery to help the eye drain off pressure-causing fluid (or a combination of these two).
For more information: Contact the Glaucoma Foundation at 800-452-8266.
People with an underactive thyroid (hypothyroidism) may lack energy, feel chilled, retain water, become constipated, get leg cramps, and have dry skin and thinning hair.
Many people mistake these for signs of aging. "But if it's new for you, it's worth checking out," says Dr. Lawrence Wood, medical director of The Thyroid Foundation of America in Boston. One in 10 women have hypothyroidism at age 50; 8 percent of men by 60.
Prevention: None, other than avoiding too much iodine in medications and kelp supplements. Too little iodine can trigger the disease, but in the United States, where foods are supplemented, it's rare to be iodine deficient.
Tests: First, a blood test of Thyroid Stimulating Hormone. If the TSH level is high, a measurement of thyroid hormones is done.
Treatment: Usually a prescription for a thyroid hormone, thyroxine.
For more information: The Thyroid Foundation of America can be reached at 800-832-8321.
Women can expect changes in their periods with aging, but if flow becomes heavy, painful and prolonged, they should see a doctor. Dr. Charles Moniak, an OB-GYN at Fountain Valley Regional Hospital in Fountain Valley, California, says many women who have heavy, painful periods have fibroid tumors or noncancerous growths in their uteruses.
About 40 percent of women have fibroids, often with no symptoms.
Tests: A pelvic exam. If more questions arise, an ultrasound is done.
Treatment: Fibroids can be monitored every three to six months and left untreated. Monitoring is important, however, because fast-growing fibroids can be cancerous. For pain or increased bleeding, nonsteroidal pain relievers can help. Sometimes birth control pills or hormones are prescribed. Surgery can remove the fibroids, but they often grow back.
For more information: Talk to your gynecologist about your symptoms.
At 27, Sherry Latham, a visiting nurse in Herrin, Illinois, began craving liquids. "As soon as I would get to a patient's house, I would ask for water." Her coworker recommended she get tested for diabetes. The test was positive.
A diabetic's body either fails to produce, or to effectively use, the hormone insulin, which regulates glucose (blood sugar). Without enough insulin, blood glucose levels soar, damaging tissue and leading to stroke, heart disease, blindness, and amputations. Diabetes kills 200,000 people a year.
Symptoms include excessive thirst and urination, extreme hunger, weight loss, fatigue, and irritability.
Prevention: None for Type 1 diabetes. For Type 2, exercise and a healthy weight will cut your risk dramatically.
Tests: A blood test; every three years for anyone who is over age 45, overweight, African-American, Asian-American, Hispanic, Native American, or who has a history of polycystic ovary syndrome or gestational diabetes.
Treatment: Some diabetics require daily insulin shots. Others can control the disease through diet, exercise, and medications. Diabetics don't have to avoid sugar entirely, but they learn to follow restrictions to keep glucose levels in line.
For more information: Contact the American Diabetes Association at 800-342-2383.