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Lumps

Benign and Malignant Tumours

What and Why?

Most people are now very cancer-conscious, so that to find a lump anywhere on your body immediately makes you think the worst. Lumps in general are easy to find if you look and most of them are normal parts of your body.

To find a cancerous lump is actually very exceptional, but how are you to tell which is which without getting your doctor to check every one? You need to make good use of three important advantages you have over your doctor, however expert and experienced he is:

  1. You know your own body better than anyone else. You are familiar with all its idiosyncrasies. Some of these may seem unusual when compared with other people, and a doctor only has his experience of everybody else to judge your lump by. He cannot therefore allow for lumps you have always had and know about, whereas you can. However, you must sometime get to know that they are there! Often something draws your attention to a lump you didn’t know about that has been there for ages. You keep feeling it, fretting because it doesn’t seem to be going away. In this case a doctor often can sort things out quickly and easily by explaining that it has most likely been there all along.
  2. You can watch continuously how a new lump is going to develop. Ideally you look at quite long intervals to get the biggest possible contrast between before and after. However, the worst sort of lump may develop quite fast and you need to catch these early. You may spot something quite subtle about a lump that a doctor could not pick up in a one-off examination; it may come and go, or only show in particular circumstances that give it away as something simple. The opposite is also true — alarming developments may compel you to see the doctor sooner.
  3. You know how a lump feels from the inside as well as from the outside. The expert touch backed up by medical tests cannot reveal everything. The internal sensations and instincts that a lump gives you are often much more subtle. Even if you cannot work out what they mean, feelings of this kind may at least convince you that this lump is similar to others you have already had — or not, as the case may be.

Intelligent use of these three assets will enable you to sort out most of the commonest kinds of lump with confidence.

Bones: many bones have knobs but they are usually about equal on both sides of your body. Safe ones are painless, permanent, hard and rigid.

Glands: there are thousands of small soft painless lymph glands all over your body that will move about a bit under your fingers as if on elastic. Any of these may swell a bit and become tender whenever they have work to do. If you cannot find a scratch or patch of infection nearby that might be the cause, see your doctor. Otherwise expect the gland to be obvious for a week or two longer than the wound that caused it — it is still making antibodies to protect you.

Breast lumps: Adolescent boys and girls may both get tender lumps in their nipples as breast tissue starts to develop. This is alarming if one side starts before the other, but perfectly harmless. A woman’s breasts are liable to go lumpy before a period but quickly go back to normal after it has started — you can encourage this by contrast bathing. Avoid feeling for lumps with your finger-tips — they are too sensitive. Lumps you can feel with the flat of your hand that don’t go away after a period starts may be significant — unless they’re your ribs!

Warts: these are commonest on the palms and soles where they often turn up inside corny lumps of hard skin: the way they distort your fingerprint markings gives them away. Elsewhere a wart is much softer and may dangle on a thin fleshy stalk, in which case you can tie a thread tightly round it and it will drop off in a few days. Leave warts near your eyes alone: let your doctor advise you how to deal with these.

Moles: most dangerous moles never get lumpy but the few that do are inclined to break down or bleed. If you see any distinct change in a dark mole, even one you are used to, it is worth asking your doctor to check it. Unguarded sunlight and some kinds of chemical exposure are causing a few more moles to become cancerous nowadays.

Cysts: the commonest skin lump of all is the sebaceous cyst, which forms when the grease gland at the root of a hair gets blocked and gradually swells. You can find these most often in your scalp or armpits, firmly attached under the skin and often with a tiny dimple on the surface where the neck of the gland used to be. Most get to about the size of a pea or bean, never hurt or get in the way, and are best left alone. Sometimes they become inflamed and burst like an abscess, which may get rid of the cyst. If they catch in your comb or get really large they can be removed surgically.

Abscesses: an abscess or boil forms whenever your body needs to get rid of a large lump of festering rubbish that cannot be dissolved into your bloodstream. It can start anywhere inside but then rises like a bubble towards the nearest skin surface, where a tender red lump starts to form. If this is bigger than a small coin, gets very painful or shows in your groin or testicle, get it checked rather urgently. Otherwise soak it with hot water for three minutes every few hours to get the abscess to point and burst, which is the quickest way to get better.

Swollen gum: a lump near a tooth almost always means infection in a rotten one. Mouth-washes with hot, salty water are the best form of first aid. If a dentist cannot see you soon, consult your doctor.

Mumps: A swelling in your neck that makes it hard for you to feel the back of your jaw (just under your ear-lobe) is probably mumps. Rest will help prevent other swellings and stop you getting ill. Sour drinks or spicy food will make it hurt, so stick to very plain things.

Tonsils: a huge lump in your throat that alters your voice and makes swallowing an ordeal needs to be seen by a doctor the same day.

Tongue: the first time you really look at the back of your tongue you may be alarmed by the row of pimples across it. These are normal.

Ganglion: a painless gristly lump may suddenly appear near your wrist, move about a bit if you play with it, vary in size and frequency. This is a perfectly harmless pod on your joint and seldom needs treatment.

Knuckles: the bones of your knuckles may get nobbly or gristly swellings may develop on the tendons that pass nearby. There is nothing to be done unless the joint stops moving properly.

Hernia: hernias are soft painless swellings that come and go in the groin or navel. If one gets painful or cannot be made to go away, go straight to the nearest hospital — night or day.

Fat: large flattish pads of fat often form in middle aged people, usually under the skin of their backs. They grow very slowly and are not painful. Get your doctor to confirm its nature when you see him for something else.

Testicle: any new swelling of your testicle, whether painful or not, is always worth asking your doctor about within a few days. If the pain is relieved by lifting the testicle nearer your body, get it seen today.

Any lump you are still unsure about, you can present to a doctor along with your observations about its track record. Never feel foolish for going, even if your lump turns out to be harmless and commonplace.

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