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Understanding Blood Cancer & Its Symptoms

By Dr. Pawan Kumar Singh in Cancer Centre

Oct 17 , 2023 | 10 min read

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What is Blood Cancer?

Cancer means uncontrolled growth of cells. In a similar way, blood cancer means uncontrolled growth of blood cells. Blood cancer (also known as hematologic cancer) begins in the blood-forming tissues(primary and secondary lymphoid organs) like the bone marrow, lymphatic system, and blood cells.

It comes in various forms, such as leukemia, lymphoma, and multiple myeloma, all characterized by abnormal blood cell growth and division. Blood cancer is a major issue affecting people of all ages and backgrounds, with over 1.3 million reported cases worldwide in 2020.

A wide range of blood cancer treatment options are available, including stem cell transplantation, chemotherapy, radiation therapy, and targeted therapies. Immunotherapies depend on the specific type and stage of the cancer.

 Common Blood Cancer Symptoms

Common blood cancer symptoms can vary depending on the specific type of blood cancer. There are several shared indicators to be aware of:

  • Unexplained Weight Loss: Sudden and unintended weight loss, often occurring rapidly, can be a red flag for blood cancer. This usually happens because the body's metabolism changes and cancer cells require more energy(Warburg effect). Although weight loss can be caused by different diseases, it's essential not to overlook it, especially when it comes with other worrying symptoms. Significant weight loss is 10% in 6 months.

  • Fatigue: Fatigue is a pervasive symptom in blood cancer patients. It occurs due to anemia, which is a condition where there aren't enough healthy red blood cells to carry oxygen in the body. Consequently, people may feel ongoing fatigue and weakness that impacts their daily lives.

  • Bone/Joint Pain: Blood cancer can lead to bone and joint pain. This discomfort occurs when cancer cells invade the bone marrow or cause bone loss, leading to bone weakening. The pain can be persistent, often worsening at night or during physical activity.

  • Frequent Fever And Chills: Frequent fever and chills can be indicative of an underlying infection or an abnormal immune response triggered by blood cancer. These symptoms can come and go, but it's crucial not to disregard them, especially if they keep coming back.

  • Headaches: Headaches can happen when there's higher pressure inside the skull, which is called intracranial hypertension. This can be due to blood cancer affecting the central nervous system or causing inflammation due to increased white blood cell counts.

  • Night Sweats: Excessive night sweats, unrelated to room temperature or other factors, can be a symptom of blood cancer. These drenching sweats may soak through bedding and clothing, disrupting sleep patterns and causing discomfort.

  • Shortness Of Breath: Shortness of breath can result from anemia or the enlargement of lymph nodes or organs due to blood cancer. When the body's ability to carry oxygen decreases, people might feel short of breath, even with minor physical effort.

  • Frequent Infections: Blood cancer can weaken the immune system, making individuals more susceptible to infections. Recurring or severe infections, such as respiratory infections, urinary tract infections, or skin infections, may signal an underlying hematologic malignancy.

  • Swollen Lymph Nodes: Enlarged lymph nodes, particularly in the neck, armpits, or groin, can be a sign of blood cancer, as these nodes are part of the lymphatic system, which is often affected by hematologic malignancies. The swelling may be painless or tender to the touch.

  • Easy Bruising And Bleeding: Blood cancer can interfere with the usual role of platelets, resulting in easy bruising, nosebleeds, or extended bleeding from small cuts or wounds.

  • Abdominal Discomfort: Enlarged spleen or liver, common in some types of blood cancer, can cause abdominal fullness, discomfort, or pain.

  • Skin Changes: Some blood cancers can manifest as skin changes, including red or purple patches, itching, or the development of small, pimple-like bumps.

  • Cognitive Changes: If blood cancer extends to the central nervous system, people might encounter neurological issues such as confusion, memory troubles, or struggles with focus and attention.

Leukaemia Blood Cancer Symptoms

Leukaemia, a diverse group of blood cancers with distinct subtypes, often exhibits a range of symptoms that may include persistent fatigue, heightened vulnerability to infections, increased bleeding tendency, bone and joint discomfort, enlarged lymph nodes, unexplained fever, and night sweats, abdominal discomfort due to an enlarged spleen or liver, abnormal weight loss, cognitive changes when it affects the central nervous system, and potential skin alterations.

These symptoms, though indicative of leukemia, are not exclusive to the disease and can mimic other medical conditions. The disease's course and prognosis can significantly vary based on the specific subtype and stage at which it is detected. The common subtypes of leukemia include:

Acute lymphoblastic leukemia (ALL) Symptoms

Acute lymphoblastic leukemia (ALL), a fast-progressing subtype of leukemia (lymphoid), exhibits a distinctive set of symptoms:

  • Persistent fatigue is common in ALL due to a shortage of healthy blood cells, particularly red blood cells, leading to anemia.

  • ALL compromises the immune system, increasing susceptibility to infections like colds, flu, or skin infections.

  • ALL impairs normal blood clotting.

  • Children with ALL may experience bone and joint pain.

  • Enlarged lymph nodes can be an early sign of ALL.

  • Unexplained fever and night sweats can result from ALL cells interfering with the body's immune response.

  • Pain in bones and joints are quite characteristic of ALL.

  • An enlarged spleen or liver, palpable in the abdominal area.

  • ALL results in altered metabolism and increased energy demands.

  • ALL may manifest as skin changes, including rashes, red spots, or pale skin.

Acute Myeloid Leukemia (AML)

Acute Myeloid Leukemia is characterized by the rapid growth of abnormal myeloid white blood cells in the bone marrow and blood. Common symptoms are:

  • Swollen gum symptoms may be related to AML when the leukemia cells infiltrate the gums and oral tissues, causing inflammation and bleeding.

  • Because of how the cancer affects blood clotting, small red spots called petechiae can appear on the skin.

  • AML can cause rapid, unintentional weight loss

  • AML cells may infiltrate the central nervous system, causing headaches and neurological symptoms

Chronic Lymphocytic Leukaemia (CLL) Symptoms

Chronic Lymphocytic Leukaemia (CLL) is a slowly progressing blood cancer characterized by the accumulation of abnormal white blood cells in the body. It presents a range of subtle yet impactful symptoms:

  • Most patients present with low stage with any high TLC and they don’t need any treatment.

  • CLL can result in easy bruising, nosebleeds, and prolonged bleeding from minor injuries due to a lack of platelets.

  • CLL can lead to shortness of breath, particularly during minor physical activity.

  • Besides general susceptibility, CLL patients may experience recurrent or chronic infections, like sinusitis or pneumonia.

  • CLL-related symptoms can lead to sleep disturbances, including nightmares and anxiety.

  • Recurrent fevers, a common occurrence in all types of leukemia, are also seen in CLL patients

Chronic myeloid leukemia (CML) Symptoms

Like CLL, Chronic myeloid leukemia (CML) typically has a chronic phase but can progress to an accelerated or blast crisis phase more rapidly and affects myeloid White Blood Cells. Its symptoms include:

  • Most of CML patients present with massive enlargement of splech. Leading to heaviness in the abdomen, a dragging sensation, or early satiety.

  • Can also present with bone pain, especially in the central chest.

  • Generalized weakness and low-grade fever are other usual symptoms.

  • Rare symptoms are visual disturbances, priapism, and clothing in veins of the brain, legs, or lungs.

Childhood Leukemia is a devastating condition and can manifest differently in children than in adults. Recognizing the specific signs is crucial:

  • Children with leukemia often experience severe tiredness and a lack of energy, even after rest, due to the disease's impact on healthy blood cells.

  • Children who have leukemia might experience repetitive upper respiratory infections or frequent colds in the head.

  • A pale or 'washed-out' skin is a common symptom.

  • Apart from disease-specific signs, changes in behavior, such as decreased interest in activities or social withdrawal, may be observed.

  • In some cases, leukemia may lead to the swelling of testicles in male children.

Lymphoma Symptoms

Lymphoma is a cancer originating specifically in the lymphatic system. It is categorized into two types: Hodgkin lymphoma and non-Hodgkin lymphoma.

Non-Hodgkin Lymphoma(NHL)

  • Enlarged lymph nodes, often in the neck, armpits, or groin, are a hallmark of NHL.

  • NHL can lead to persistent tiredness and weakness, impacting daily activities.

  • Some NHL subtypes may involve the chest, causing chest pain or coughing.

  • Some NHL subtypes may cause pruritus or severe itching of the skin.

  • NHL affecting the gastrointestinal tract can lead to changes in bowel habits, such as diarrhea or constipation.

  • Classical B symptoms are fever, weight loss, and weight sweats which can be seen in NHL.

Hodgkin Lymphoma(HL)

  • It is characterized by the presence of Reed-Sternberg cells, which is a hallmark of HL.

  • Unlike NHL, HL tends to spread in an orderly, contiguous manner from one group of lymph nodes to the next.

  • Like NHL, HL can also lead to painless swollen lymph nodes in various parts of the body.

  • HL often presents with "B symptoms," which are systemic symptoms of weight loss, night sweats and persistent fever.

Myeloma Symptoms

Myeloma is a type of blood cancer that develops in plasma B cells that secrete antibodies. It is associated with a range of symptoms:

  • Elevated calcium levels(hypercalcemia) in the blood can occur, resulting in symptoms like constipation, frequent urination, and confusion.

  • Myeloma proteins can damage the kidneys, also leading to symptoms such as increased thirst, frequent urination, and swelling in the hands and feet due to fluid retention.

  • Some patients may experience tingling, numbness, or pain in the extremities(peripheral neuropathy) due to nerve damage.

  • Anemia and bone pain are characteristics.

Myelodysplastic syndromes (MDS) Symptoms

Myelodysplastic syndromes (MDS) are a group of rare blood disorders characterized by dysfunctional bone marrow, leading to insufficient production of healthy blood cells. Below are some of its symptoms:-

  • MDS is often associated with a low count of neutrophils that can cause recurrent or severe bacterial infections.

  • Some individuals may experience an enlarged spleen (splenomegaly), which can cause discomfort or fullness in the abdomen.

  • Due to the abnormal functioning of the bone marrow, the production and maturation of all types of blood cells are impaired, a condition known as pancytopenia and the symptoms accordingly like anemia, fever ,and bleeding.

  • Women with MDS may experience heavy or prolonged menstrual bleeding.

Myeloproliferative neoplasms (MPNs) Symptoms

Unlike MDS, Myeloproliferative neoplasms (MPNs) are characterized by the overproduction of one or more types of blood cells due to genetic mutations in the bone marrow stem cells. It has several specific symptoms:

  • Polycythemia Vera, a type of MPN, results in the excessive production of red blood cells, leading to thickened blood(hyperviscosity syndrome).

  • Development of fibrous tissue in the bone marrow.

  • Some MPNs can lead to elevated uric acid levels and an increased risk of gout attacks.

  • Some MPN patients may experience flu-like symptoms, including fever and chills.

  • MPNs can cause visible distension of veins in the head and neck.

Conclusion

To sum it all up, blood cancer encompasses a diverse group of malignancies that affect the blood, bone marrow, and lymphatic system. While these cancers share commonalities, they also exhibit unique characteristics and symptoms. Early diagnosis and targeted treatments have significantly improved outcomes for many individuals with blood cancer.

However, it remains one of the most complex and challenging groups of cancers that require ongoing research, vigilant monitoring, and specialized care. We can make significant progress in battling blood cancer by increasing awareness, backing research initiatives, and encouraging early detection.

Frequently Asked Questions

1. Where does blood cancer start?

Blood cancer starts in the bone marrow, where abnormal blood cells are produced and can affect the blood, lymphatic system, or the bone marrow itself.

2. What is Stage 1 blood cancer?

Conventionally staging of cancer depends on the extent of involvement which is relevant in solid cancer. Blood circulates in the whole body so staging is irrelevant. In Fact, blood cancer is prognosticated based on prognostic score.

3. Can blood tests detect cancer?

Yes, blood tests, including complete blood counts and specific markers, can detect various types of cancers.

4. What age does blood cancer start?

Blood cancer can affect people of all ages, but it's more frequently found in older adults. The likelihood of developing it rises as one grows older.

5. How long does blood cancer take to develop?

The development time for blood cancer varies depending on the type and aggressiveness but can span several days to months.

6. Is blood cancer genetic?

Some blood cancers do have a genetic component, increasing the risk for individuals with a family history of the disease.

7. Can fatigue be a symptom of blood cancer?

Yes, fatigue is a common symptom of blood cancer, often related to anaemia or the disease's metabolic demands.

8. Do blood cancer symptoms vary by type of blood cancer?

Yes, blood cancer symptoms vary widely based on the specific type of blood cancer.

9. What are the neurological symptoms of blood cancer?

Neurological symptoms of blood cancer can include numbness, weakness, confusion, and, rarely, seizures.

10. How does blood cancer affect the digestive system?

Blood cancer can affect the digestive system, leading to symptoms like abdominal pain, nausea, vomiting, or changes in bowel habits.

11. Can blood cancer cause changes in menstrual cycles?

Blood cancer can potentially lead to changes in menstrual cycles in women, because of low platelet count and coagulation disfunction.

12. Are there genetic factors that contribute to blood cancer symptoms?

While genetics can play a role in the development of some blood cancers, symptoms often result from the disease's impact on blood cell production and immune function.