The American Diabetes Association suggests that diabetics should call the doctor if they aren’t sure how to care for themselves, or if they have these warning signs:

• If symptoms of illness, possibly including fever, have continued for a couple of days without improvement.
• If diarrhea or vomiting has continued for more than six hours.
• If there are moderate or large amounts of ketones in your urine.
• If, even after taking enough insulin to account for your illness, your blood sugar is 240 or higher before meals and stays there for more than 24 hours.
• If you have symptoms of ketoacidosis or dehydration, which may include chest pain, difficulty breathing, dry or cracked lips, and breath that smells like fruit.

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These can be symptoms of three cancers — oral, leukemia, and endometrial — that don’t get the attention they deserve. Even though they are among the most common cancers affecting women over age 55, these diseases can fall through the cracks as doctors focus on the biggest killers hogging the health headlines, says Elmer Huerta, MD, MPH, president of the American Cancer Society.

Read more for the facts behind these quiet dangers — and the simple ways you can protect yourself.

Oral cancer

Your risk: 1 in 98, with diagnoses peaking between the ages of 55 and 65. Oral cancer is lethal more often than it needs to be because people tend to ignore symptoms (it’s typically caught in late stages).

Stay healthy: Watch your mouth: See a dentist or doctor about any sore in your mouth or on your lips that doesn’t clear up in 2 weeks. A change in color or persistent pain, tenderness, or numbness anywhere in your mouth or on your lips should also prompt a fast visit.

Curb your vices: About 75 percent of oral cancers are caused by smoking and drinking alcohol. When such habits were considered unladylike, men with oral cancer outnumbered women 6 to 1, says Sol Silverman Jr., DDS, a professor of oral medicine at the University of California, San Francisco, School of Dentistry. "But in the last 50 years, the incidence in women has soared — now the ratio is two men to every woman." Limit your intake to one drink per day.

Guard your lips: They need protection, too. Sunscreen isn’t exactly tasty, so choose a balm with SPF and then apply your favorite gloss or lipstick.

The good news: Researchers at Ohio State University recently found that phytochemicals extracted from Hass avocados could kill or stop the growth of oral cancer cells. The study was done in test tubes, but there’s no need to wait for confirmation — bring on the guacamole!

Leukemia

Your risk: Many think of it as a children’s disease, but the biggest jump in cases occurs between ages 55 and 74.

Stay healthy: Note any symptoms If you find yourself extremely pale or bruising easily, or if your gums bleed (more than is normal if you neglect to floss), it’s time to get checked out. Extreme fatigue, unexplained fevers, and bone or joint pain are other common symptoms.

Avoid unnecessary scans: CT scans are a great diagnostic tool, but they deliver much more radiation than X-rays and may be overused, says Barton Kamen, MD, PhD, chief medical officer for the Leukemia & Lymphoma Society. In fact, researchers suggest that one-third of CT scans could be unnecessary. High doses of radiation can trigger leukemia, so make sure scans are not repeated if you see multiple doctors, and ask if another test, such as an ultrasound or MRI, could substitute.

The good news: The 5-year survival rate for all people with leukemia has more than tripled in recent decades, from about 14 percent in the 1960s to about 65 percent today. "New advancements now help us determine who is a good candidate for a bone marrow transplant and who might respond better to other therapies," says Kamen. "The result is more targeted treatment and better outcomes."

Endometrial (uterine) cancer

Your risk: 1 in 40. This is the fourth most common type of cancer in women — 90 percent of cases occur in women over age 50. You’re more vulnerable if you’re toting extra weight: Obese women are two to three times as likely to develop the disease. "Fat acts like another gland, which increases the levels of estrogen and other hormones in your system. That stimulates the growth of abnormal tissues," says Huerta.

Stay healthy: Mention any unusual bleeding. More than 80 percent of endometrial cancers are found in the earliest, most treatable stages because this symptom tends to send women promptly to their doctors. If you notice any vaginal bleeding after menopause or bleeding between your periods, or if you experience pelvic pain, especially during intercourse, tell your doctor immediately.

Know your family history: "The same genetic mutation that puts people at increased risk of colon cancer also ups their odds of getting endometrial cancer," says Edward L. Trimble, MD, MPH, head of Gynecologic Cancer Therapeutics at the National Cancer Institute. If you have a parent or sibling with that disease, get screened yearly for endometrial cancer starting at 30.

Move more all day: In a recent report on more than 250,000 women, those who exercised several hours daily reduced their risk of endometrial cancer by up to 52 percent, probably because staying active reduces estrogen levels while helping you maintain a healthy weight. Exercise frequency mattered more than intensity — light housework, gardening, and walking are enough.

Avoid iron: A Swedish study has found that taking iron supplements after menopause raises the risk of endometrial cancer by 70 percent. After age 50, the daily recommendation for iron drops from 18 mg per day to 8 mg, an amount easily obtained from food.

The good news: In the same study, calcium supplements halved endometrial cancer risk. (Researchers aren’t sure why, but eating high-calcium dairy products didn’t provide the same benefit.) Experts recommend that postmenopausal women consume up to 1,000 mg of calcium a day, and 1,200 mg after age 70.

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Researchers have been trying to understand more of the causes of high blood pressure, also called hypertension. Low birth weights also have been associated with an increased risk for high blood pressure later in life.

The new study sought to determine if growth patterns in the first five years of life also were associated with a risk of high blood pressure in adulthood. The researchers tracked 679 young adults around age 25 in Britain.

They found that those who gained weight more rapidly in the first five months after birth and again from about age 2 to 5 were more likely to have high systolic blood pressure.

Immediate weight gain after birth also was linked to higher adult diastolic blood pressure, they found.

Systolic blood pressure is the pressure in the arteries while the heart contracts. Diastolic blood pressure is the pressure when the heart relaxes between beats.

"When trying to understand why some people get high blood pressure in later life, we need to consider a life course approach that considers early life as well as adult life risk factors such as dietary salt and obesity," Yoav Ben-Shlomo of the University of Bristol in Britain, who led the study published in the journal Hypertension, said in a statement.

High blood pressure — sometimes called the "silent killer" because it can go undetected for years — raises a person’s risk of heart disease and stroke.

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The First Step: Talk About Your Pain

Telling your care team in detail about your pain is the best thing that you can do to assist in your cancer treatment. Sometimes patients don’t receive the best pain treatment because they don’t let their care team know about their pain. Patients may not want to complain, they may fear becoming addicted to pain medications, they may fear the side effects of pain more than the pain itself, or they may want to save their pain treatment options until they "really" need them. Each of these beliefs will hinder pain treatment and also hinder cancer therapy.

Why Pain Should Be Treated

Pain can affect you in many ways. It can keep you from being active, from sleeping well, from enjoying family and friends, and from eating. Pain can make you feel afraid or depressed. Pain may also prevent your full participation in general rehabilitation programs and may slow your recovery from treatment.

Most cancer pain can be controlled with treatment. When there is less pain, you will probably feel more active and interested in doing things you enjoy. Tell your doctor or nurse right away if you are feeling pain. Getting help for your pain early can make pain treatment more effective.

Answering the questions below will help you communicate with your health care provider about your pain. After discussing your pain, your doctor or nurse may want to examine you or order x-rays or other tests. These tests will help the doctor or nurse find the pain’s cause.

To communicate how you feel, ask yourself the following questions:

• Where is the pain?You may have pain in more than one place. Be sure to list all of the painful areas.
• What does the pain feel like?Does it ache, throb, burn or tingle? You may wish to use other words to describe your pain.
• How bad is the pain?You can use a number scale to rate your pain (pdf) from 0 to 10, where 0 means no pain and 10 means the worst pain you can imagine. Or, you can describe your pain with words such as "none", "mild", "moderate", "severe" or "worst possible pain". A special pain rating scale that uses faces(pdf)to indicate levels of pain has also been developed to help children communicate how they feel. You may find these scales useful for keeping track of how your pain changes in response to treatment, activities or the time of day.
• What makes the pain better or worse?You may have already found ways to make your pain feel better (for example, using heat or cold, or taking certain medicines). You may have also found that sitting or lying in certain positions or doing some activities affects the pain.
• If you are being treated for pain now, how well is the treatment working?You may want to describe how well the treatment is working by saying how much of the pain is relieved, such as all, almost all, none, etc.
• Has the pain changed?You may notice that your pain changes over time. It may get better or worse or it can feel different. For example, the pain may have been a dull ache at first and has changed to a tingle. It is important to report changes in your pain. Changes in pain do not always mean that the cancer has come back or grown. Describe how the pain was before and how it is now.

Next: Have a Plan

Work with your doctor or nurse to write a pain control plan that meets your needs. In a pain control plan, you and your doctor or nurse plan your pain control activities, including when you take your medicine, how and when to take extra medicine, and other things you can do to ease and prevent your pain. Your doctor or nurse may also list medicines and other treatments that will help with side effects or other aches and pains, such as headaches.

Many medicines and treatments can be used to treat pain. If a schedule, medicine or way that you are taking the medicine doesn’t work for you, your doctor and nurse can help you find the medicine or approach that will help the most.

It may be helpful to keep a record of how the medicine is working. Sharing that record with your doctor or nurse will help them make your treatment more effective.

When To Take Your Pain Medicine

Take your medicine on a regular schedule (by the clock) and as your doctor tells you. This will help to keep pain under control. Do not skip a dose of medicine or wait for the pain to get worse before taking your medicine. The goal is to prevent the pain. Once you feel the pain, it is harder to get it under control.

Your doctor will usually give you additional medicine for "breakthrough pain" (a brief and often severe pain that occurs even though the patient is taking pain medicine regularly). If some activities make your pain worse (for example, riding in a car), you may need to take extra doses of pain medicine before these activities. Ask your doctor or nurse how and when to take extra medicine.

Call your doctor or nurse immediately if your pain increases or if you have new pain.Also call your doctor early to receive a refill of pain medicines. Do not let your medicines get below three or four days’ supply.

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