Our bone marrow is where the majority of new cells are produced. Even though there are countless of new cells being produced in the long surface of the skin, the bone marrow plays an important role in exchanging blood cells rapidly. These cells grow and become mature very quickly, and this speed is fundamental in maintaining proper health. However, in some cases, the process becomes excessively rapid as a result of DNA alterations and mutations. That’s what leukemia is about.
Leukemia is a type of blood cancer where new blood cells are created too rapidly. They become too many, and they are immature to work correctly. Thus, patients with leukemia start displaying a series of alterations related to the normal function of their blood.
A few symptoms in leukemia will also overlap with women’s health risks and problems, which is why sometimes leukemia is even more severe in women. The most important symptoms of leukemia in women are as follows:
Fever
The vast majority of cases of leukemia start with a fever. This type of fever is known as fever of unknown origin because it is very difficult to track, and it is not always associated with a given infection. Fever of unknown origin has many different explanations, including tuberculosis, mononucleosis, intra-abdominal abscess, and HIV infections.
So, it is not only having higher temperatures and not knowing the reason why. Your doctor will perform a series of tests in order to understand the real cause, and in case it is leukemia, you might need to be hospitalized depending on your blood tests and other parameters.
Bleeding
One of the reasons why patients with leukemia are more commonly hospitalized is thrombocytopenia. This means low platelets in the blood, and it is a common condition in any stage of leukemia. Many patients do not have any other symptoms and would only start bleeding all of a sudden.
In these cases, doctors need to rule out hemophilia, an inherited bleeding disorder that is more common than leukemia. They will also need to rule out infectious diseases that cause bleeding, especially if the patient has recently traveled to tropical countries. But in some cases, sudden and unexplained bleeding is caused by leukemia.
Heavy periods
In women, bleeding problems are commonly noticed across periods. You might notice a slight increase in your period or a very heavy period with intense bleeding. This is because your platelets are lower than usual or not functioning as they should. Thus, when you have your periods, your blood does not form clots in the uterus, and it keeps on bleeding for a longer time.
Heavy periods are common in hormonal problems, and they are very frequent in young women before they give birth for the first time. Thus, even though this is a symptom of leukemia, your doctor will rule out other common causes before starting to think about blood cancer.
Slow healing
Along the same line, leukemia causes a dysfunction of the platelets, which are very important for the normal healing function. Thus, healing might become stagnant, and small lesions in the skin and mucosa take very long to become closed. Slow healing might become a big problem for patients with other diseases, especially diabetes, and diabetic foot.
In many cases, this might be the first symptom that leads to the diagnosis of the disease, and when it is very severe, it might require hospitalization. It all depends on your blood parameters and the rest of the symptoms you’re having.
Increased incidence of infections
There are several types of leukemia, and they affect the number of white blood cells. These cells are responsible for fighting infections, and even though they multiply rapidly, these new circulating cells are immature, and they do not work properly. Thus, you start having more frequent viral or bacterial infections, depending on which type of blood cell is involved in leukemia.
In women, this symptom might be a bit more difficult to detect because they have more frequent urinary infections than men. Thus, pay attention if you start having more frequent urinary infections than usual. Ask your doctor about them. It might not be leukemia but kidney stones or another disease that explains such a regular incidence.
Pale skin
In leukemia, there is an excessive number of blood cells, but they are immature and only giving extra bulk to your blood. Because they do not perform their function correctly, they would only impair the normal function of other blood cells. That’s why leukemia is associated with a blood condition called anemia.
Anemia is a low concentration of hemoglobin in the blood, and this protein is necessary for oxygen transport and gives the skin its normal color. Anemia is common during pregnancy, and women are more commonly affected. Thus, they may sometimes neglect their condition. As a woman, be careful to ask your doctor about your pale skin or any symptom of anemia, especially if you’re pregnant.
Rashes and spots on your skin
Hemorrhage is not only blood flowing through wounds, your mouth or feces. There are other forms of hemorrhage, as in hemorrhagic symptoms in your skin. They are very common in patients with leukemia, and often the first manifestation of clotting problems in these patients, both men and women.
There’s a typical rash in leukemia called petechial spots. They are bright red spots similar to those found in rubella, and they are usually dispersed in many parts of the body. Petechial spots are no more than small hemorrhages under the skin, and they can become more massive hemorrhages called purpura or very large areas that change their color, called ecchymosis.
Fatigue
This is a common symptom in the majority of chronic diseases, the majority of cancers, and that includes leukemia. Fatigue in leukemia has two different reasons that contribute to each other. First off, cancer takes a lot of energy from the blood and a lot of resources. Even though patients eat correctly, they may feel weak because cancer is feeding out of blood resources to keep on growing new cells and releasing them to the bloodstream. This process increases your metabolism and makes you feel very tired.
At the same time, we talked about anemia, which is associated with the majority of cases of leukemia. One of the symptoms of anemia is fatigue because the blood becomes unable to transport oxygen, and this element is fundamental in creating ATP, an essential molecule to store and use energy in the body.
Joint pain
Patients with leukemia may also feel various types of pain, especially joint pain. In the case of leukemia, the bone marrow is continuously producing cancer cells, and sometimes they create clusters or masses around the spinal nerves, creating a type of bone pain that affects around 25% of patients. This pain is often felt in long bones such as those of the legs and the arms. It may also be felt in the sternum or the ribcage, the hips and the shoulders.
Patients with leukemia may also feel various types of pain, especially joint pain. In the case of leukemia, the bone marrow is continuously producing cancer cells, and sometimes they create clusters or masses around the spinal nerves, creating a type of bone pain that affects around 25% of patients. This pain is often felt in long bones such as those of the legs and the arms. It may also be felt in the sternum or the ribcage, the hips and the shoulders.
Weight loss
As it happens with many other types of cancer, one of the most common and important symptoms of leukemia is weight loss. This is typically important for women and ironically overlooked, because they are more commonly worried about their weight than men. However, the type of weight loss in leukemia is not associated with any change in the dietary pattern or exercise activity. Thus, if you’re not doing anything different and experience significant weight loss for no apparent reason, talk to your doctor about it. There are many health problems you might need to rule out.
Weight loss is an important symptom and should be evaluated as a part of a series of symptoms that include fatigue and muscle weakness, too. This is typically known as cachexia, and it is common in the majority of cancers.
Bone fractures
Experiencing bone fractures in older women is often a signal of low mineralization. Anyone would think that a senior woman with a bone fracture has osteoporosis. But that’s not always the case. Leukemia may also cause bone fractures, adding to the risk of women along with osteoporosis and osteopenia.
In some cases, doctors reach the diagnosis of leukemia by having a patient with fever of unknown origin along with weight loss and a sudden bone fracture. When symptoms overlap like this, we shouldn’t take bone fractures lightly, and remember that osteoporosis-related fractures usually appear in the femur, the hips, and the spine.
There are many signs and symptoms of leukemia, and all of them should be confirmed by a series of blood tests. However, suspecting leukemia usually requires a combination of the symptoms we have described above and many others we can find in each subtype.
References
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Nabhan, C., & Rosen, S. T. (2014). Chronic lymphocytic leukemia: a clinical review. Jama, 312(21), 2265-2276.
Faderl, S., Talpaz, M., Estrov, Z., O’Brien, S., Kurzrock, R., & Kantarjian, H. M. (1999). The biology of chronic myeloid leukemia. New England Journal of Medicine, 341(3), 164-172.