Reducing Cancer Risk and Early Prevention for LGBTQIA+ People
Early signs and symptoms
Cancer can be hard to spot and can sometimes be symptomless at first which is why it is important to attend regular screening. It is important to keep an eye on any changes and symptoms such as:
- A recurring pain that does not go away
- A recurring cough that does not go away
- Blood in the stool
- Coughing up blood
- Pins and needles that do not go away
- Unexplained lumps
- Swollen lymph nodes
- Irregular shaped moles or dark patches on the skin
- Dry or scaled patches on the skin
- Changes to the size or shape of your breast/ chest area
While many of these can be symptoms of other conditions as well, you should talk to your GP if you are concerned.
Cancer prevention
People can develop cancer regardless of health, age, lifestyle or body weight. Family history can also be a large factor in who is at risk – see our section below for more genetics information.
However, like most health conditions, there are always adjustments you can make to reduce your risk.
- Attend regular screening programmes – see our Accessing Screening in Northern Ireland page for more information
- Get vaccinated for HPV if you have not already. Certain high-risk strains of HPV can increase the risk of getting cancers such as cervical, vaginal, vulval, anal, oral, and cervical – NHS HPV vaccination programme
- Practice safe sex and test regularly – Some STIs such as HPV and HIV can increase the risk of developing certain cancers – The Rainbow Project can provide free HIV & Syphilis testing for LGBTQIA+ people over 18 – See our sexual health page for more information.
- Quitting smoking – NHS support to quit smoking
- Reduce or quit drinking alcohol – NHS guide to drink less
- Practice safe sun (UV) exposure – Macmillan guide on staying safe in the sun
- Avoid using sunbeds – more information from Melanoma UK
- Regular exercise – keeping fit can reduce cancer risk, and improve cancer treatment outcomes – Macmillan guide on exercising and cancer
- Pursue a healthy diet – Macmillan: healthy eating and cancer
- Maintaining a healthy weight – weight loss can be difficult for many people, including those with existing health conditions however, being overweight can increase the risk of developing certain types of cancer such as bowel, kidney, womb, and gullet (oesophagus). People who are overweight and are going through menopause can also have a slightly increased risk of breast cancer – NI Direct guide to physical activity.
Self-checking for cancer:
Breast & chest cancer
Symptoms:
Breast cancer can initially be symptomless however, it can also present through certain symptoms such as:
- A lump or swelling in the breast, upper chest, or armpit
- A change to the skin such as puckering and dimpling
- A change in the colour of the breast – this may mean it looks darker, red, or inflamed
- A change to the nipple such as it becomes inverted
- Rash or crusting around the nipple
- Unusual liquid (discharge) from either nipple
- Changes in size or shape of the breast
- Pain – this is not usually a sign by itself but keep an eye on pain in the breast or armpit that is there all or most of the time
Testicular (ball) cancer
Symptoms:
Testicular cancer can initially be symptomless however, it can present with the following symptoms:
- A lump or swelling in part of one testicle (ball) – this can be the size of a pea or much larger
- A testicle that gets bigger
- Pain or discomfort in the testicle (ball) or scrotum (the sack of skin surrounding the testicles)
- A heavy scrotum
- A change to the weight in your testicles (balls)
- Changes to the shape or texture of your testicle (ball)
While these can often be signs of other conditions, and most testicular lumps are not caused by testicular cancer, it is important to get in touch with your GP and get checked. You can also talk to your GP if you feel you may be at higher risk of testicular cancer.
Self-checking:
It is important that you know your body and what is normal for your testicles in terms of size and weight. This will make it easier to notice any changes if you are checking. There is no set-way to check your testicles but some people find it easier to do this during or after a warm bath or shower. Check for:
- Changes in size and weight
- Any lumps or swellings
There is currently no national screening programme for testicular cancer as there is not a reliable test to detect testicular cancer early.
Mouth (oral) cancer
Symptoms:
Mouth cancer is one of the most common types of head and neck cancer. It can start in any part of the mouth including the:
- Lips
- Front part of the tongue, called the oral tongue
- Floor of the mouth, under the tongue
- Inside the cheek
- Roof of the mouth, called the hard palate
- Inside the cheek
- Roof of the mouth, called the hard palate
- Area behind the wisdom teeth
- Upper and lower gums
The most common locations are on the side of the tongue and the floor of the mouth.
While many of these symptoms can be signs of other conditions, you should check in with your GP or dentist if you have any of the following symptoms including:
- A lump or thickening in the mouth or on the lip
- Difficulty or pain with chewing, swallowing, or speaking
- Bleeding or numbness in the mouth
- Bad breath (halitosis)
- Loose teeth or dentures that no longer fit well
- A lump in the neck
- Red patches (erythroplakia) or white patches (leukoplakia) that do not go away
Mouth ulcers that do not go away for more than 3 weeks are the most common symptom of mouth cancer.
It is important to be aware of what is normal for your body and your mouth. Mouth Cancer Foundation has a guide on checking the oral area for changes.
Genetics, family history, and other risk factors
Genetics, family history, and certain conditions can increase the risk of cancer. This is why it is important to be aware of your family history and increased risks from genetic, and non-genetic conditions you may have.
Intersex and variances in sex characteristics:
Some people who are intersex/ have variances in sex characteristics can be at increased risk of cancer. Many intersex people may have surgeries carried out on them to reduce cancer risk at an age before they could give medical consent. Therefore, it is important to practice sensitivity as professionals; and if you are a patient do your best to let your cancer team know if you are uncomfortable with surgery due to past negative experiences, or detailing your experiences. You do not have to disclose your intersex status or gender identity to your care provider.
Variances with increased cancer risk include:
- Swyer’s Syndrome (also known as 46,XY complete gonadal dysgenesis) – can increase the risk of developing cancer in the gonads (the tissue that develops into testicles and ovaries).
- Klinefelter’s Syndrome (also known as 47,XXY) – can increase the risk of developing non-hodkins lymphoma and breast/ chest cancer.
Genetic risk:
Most cancers are not linked to inherited gene changes however, up to 12% of cancers diagnosed are linked to an inherited gene change. Gene changes are a permanent change in your DNA, this can be inherited by a parent, as well as caused by environntal factors such as unsafe sun exposure.
A change (mutation) in the BRCA1 and BRCA2 genes significantly increase the risk of developing breast cancer. Some ethnicities such as Jewish Ashkenazi people can have an increased risk of carrying a BRCA1 or BRCA2 gene change. BRCA1 and 2 mutations can also increase the risk of developing ovarian, prostate, and pancreatic cancer.
Breast cancer can affect all body types and genders, but your exposure to high levels of sex hormones like estrogen throughout your life, alongside your breast density, play a part in overall risk.
Trans women on estrogen therefore have an increased risk of breast cancer, and trans men who take testosterone have a lowered risk due to lower levels of estrogen. Trans men still have a higher risk of developing breast cancer than cis men – having top surgery also further reduces risk, but doesn’t eliminate it (Breast Cancer UK)
Certain genetic conditions may have increased risk of developing certain cancers:
- Lynch Syndrome – increased risk of bowel cancer (over 50% AFAB, 70% AMAB); increased risk of womb, ovarian, stomach, gallblader, prostate, urinary tract, brain cancer.
- Li-Fraumeni Syndrome (LFS) – increased risk of developing breast cancer (most commonly), bone cancer, acute myeloid leukaemia (AML), soft tissue sarcoma, brain tumours, cancer of the adrenal gland.
- PTEN Hamartoma Tumour Syndrome – increased risk of developing benign tumours as well as cancers such as breast, thyroid, womb, bowel, kidney, melanoma.
- Familial Adenomatous Polyposis (FAP) – increased risk of bowel, stomach, thyroid, small bowel (duodenal), pancreatic, and liver cancer.
- MUTYH Associated Polyposis (MAP) – increased risk of bowel cancer
- Peutz Jeghers syndrome (PJS) increased risk of breast, bowel, pancreatic, stomach, and ovarian cancer.
- Juvenile Polyposis syndrome (JPS) – increased risk of stomach, bowel, pancreatic, small bowel cancer.
- PALB2 gene – increased risk of developing breast (45% AFAB), pancreatic, and ovarian cancer.
- Tuberous sclerosis (TS) – slightly increases the risk of developing renal cell carcinoma, a kidney cancer.
- Birt-Hogg-Dube syndrome (BHDS) – increased the risk of certain types of kidney cancer
- Multiple endocrine neoplasia (MEN) type 1 and 2 – people with this condition can develop tumours that can be cancerous or benign in the parathyroid and pituitary glands. Most people with MEN2 develop medullary thyroid cancer.
- RB1 gene – increases the risk of developing an eye cancer called Retinoblastoma.
- Familial atypical multiple mole melanoma syndrome (FAMMM) – increased risk of developing melanoma
- Hereditary Papillary Renal Cell Carcinoma (HPRC) and Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC) – hereditary syndromes that have an increased risk of developing kidney cancer
- CHEK2 gene – increased risk of breast (25-30%of people), prostate, kidney, thyroid, and large bowel (colon) cancer.
- Von Hippel-Lindau disease (VHL) – increased risk of developing pancreatic
neuroendocrine tumours (pNETs), a kidney cancer called renall cell carcinoma.
