Leukemia is a cancer of blood cells and bone marrow, a malignancy that causes specific blood cells to be formed abnormally. The normal functioning of blood cells tends to falter when abnormal blood cells crowd out healthy ones. Abnormal and unchecked multiplication of both red and white blood cells causes physical symptoms to appear. According to the American National Institute of Health, blood cancer may get worse quickly if you have a type called acute leukemia. Similarly, the disease may progress gradually over a few months to several years and get worse if you have chronic leukemia.
According to World Health Organization statistics, the occurrence of leukemia varies considerably by region and subtype. The most common type of childhood blood cancer is acute lymphoblastic leukemia. Around 85% of cases involving children occur in those younger than 15 years of age (mostly between two and five years of age). Acute leukemia appears to be more prevalent in men than in women. Here’re some of the silent and non-specific symptoms of leukemia you should not ignore.
Fatigue and weakness
According to Mark Levis, MD, Ph.D., at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, persistent exhaustion and weakness are some of the earliest and most common symptoms of leukemia. Such symptoms are often caused by anemia (low levels of circulating red blood cells in the body), which aggravates physical exhaustion.
You can experience a range from mild exhaustion to extreme physical weakness in both chronic and acute cases, but the symptoms only worsen over time in all cases. Tiredness and fatigue can also be a sign of cancer of the colon and other non-cancerous body conditions as well.
Shortness of breath
When patients get weaker and more exhausted, they may also develop shortness of breath due to anemia or a collection of cancerous cells in the lungs. They are typically out of breath, and it will become difficult for them to walk through the house. The reason behind the shortness of breath is the involvement of red blood cells. As they are the transport vehicles of oxygen, their death (in case of acute and chronic leukemia) causes a shortage of oxygen to the body cells and cause shortness of breath.
Shortness of breath may also be due to multiple other causes, including anemia, hyperthyroidism, pulmonary tuberculosis, and lung cancer.
Excessive or spontaneous bruising
Unexplained bruises, without any apparent physical trauma or injury, can be a symptom of acute onset leukemia. Excessive or spontaneous bruising results from a low number of platelets or clotting factors. Patients with leukemia may start spontaneously bleeding under the skin and result in bruise formation, obviously doing nothing. It can be anywhere but usually develop on the arms and legs.
In males, spontaneous bruising can also occur due to hemophilia A – another non-cancerous blood disorder that develops due to the deficiency of clotting factors.
Fever and chills
Fever and associated symptoms such as chills and rigors are not the initial and most common symptoms, usually occurring only in one-quarter of cases of acute leukemia and rarely in cases of chronic leukemia. However, persistent fever or frequent history of infections may be concerning, especially when doctors are unable to find the foci of infection or your fever is not subsiding despite taking multiple antibiotics and antipyretics. Since people with leukemia can not produce healthy white blood cells in their bodies, repeated episodes of fever can be a common symptom.
You may experience a mild cold or flu secondary to common infectious diseases, but if you have a persistent temperature of 101 ° F or higher, it will make it stand out from an ordinary illness. It is not common to have [high] fever in an adult. In about three to five days, many cold and viruses will run through our bodies, so anything far beyond that should be addressed with your doctor.
Unusual bleeding
Similar to bruising, unusual bleeding from the nose or in the gums, intestines, head, or lungs may be a sign of clotting factors and platelets that may indicate the development of acute leukemia.
Petechiae are the small red spots that develop under the skin due to the deficiency of clotting factors. Most patients often describe petechiae as: “like someone painted small red dots with a pen.” The spots you may not notice due to their size, painlessness, and placement in the lower extremities also indicate a low number of platelets. Petechiae are typically found around the ankle because gravity results in the accumulation of blood and other body fluids in the lower legs.
According to statistics, petechiae and bruise formation occur in more than 10% of people with both acute and chronic leukemia. Although certain viral and bacterial infections can cause them, you should always consult your doctor to rule out the underlying cause.
Swollen and enlarged gums
Also known as gingival hyperplasia, a growth in gum size or volume is usually found only in a small number of patients with acute leukemia. Despite its low incidence ratio, gum enlargement is one of the disease’s most obvious signs. “If we have a leukemia patient, we are still checking in their mouth to see if their gingiva is getting bigger,” says Dr. Crilley, cancer specialists at John Hopkins Hospital. The gum can look swollen, and a patient may always feel a peculiar tightness in his mouth.
According to Dr. Crilley, one should pay more attention to the enlarged gums when he/she is also experiencing other apparent signs and symptoms of leukemia such as tiredness and exhaustion, bruising under the skin, and swollen lymph nodes.
Swollen lymph nodes
Swelling of the lymph nodes in your armpits, neck, or groin area can be one of the initial symptoms of blood cancer. In a majority of acute leukemia cases, these swollen lymph nodes are painless.
Your lymph nodes contain lymph, which is made up of white blood cells that help your body fight disease and infection. However, when these lymph nodes swell without any other signs (such as pain in the ear or throat), it may be a sign of either leukemia or other types of body cancers such as lymphoma, which originates in the lymph nodes or metastatic melanoma that has spread.
According to the Mayoclinic, it’s normal for the glands in the neck or groin area to swell and go up in size during the periods of bacterial or viral infections. However, if they stayed swollen for keeping growing abnormally, it can be a warning sign that should be checked by an expert.
Feeling full or bloated
The enlarged spleen is a hallmark of chronic — and sometimes acute types of leukemia. Enlargement of the spleen occurs secondary to over-functioning and production of more than required different types of blood cells. An enlarged spleen is said to put pressure on the stomach and other gut organs – which can lead to anorexia or loss of appetite. You may have what is called early satiety – a condition in which patients eat a little food but feel full because the spleen pushes up on the stomach.
Enlargement of the spleen can also be due to infections like malaria and other metabolic body conditions such as decompensated liver disease.
Abdominal pain and swelling
Enlargement of the spleen or splenomegaly caused by leukemia may lead to abdominal discomfort or even severe pain. The size of the spleen can grow from a few inches to more than one foot in acute leukemia cases. Enlarged spleen puts pressure on the intestines and causes them to bulge out – giving an appearance of a distended abdomen.
It also causes pain in the abdomen. Most patients feel pain in the left quadrant of the abdomen, along with discomfort and bloating. If after eating only a small amount of food, you constantly feel bloated or get full easily, this could be an early warning sign that something more serious is happening. Consult your doctor if you have not recently traveled to malaria-endemic regions or don’t know the origin of abdominal pain and swelling.
Night sweats
There are many medical reasons why you may experience night sweats, but if you wake up often in the middle of the night, leukemia is one of the possible causes. Leukemia-related infections often cause night sweats. If you have to wake up in the middle of the night to change your clothes because they’re so wet or you find yourself sweating heavily during the day, it’s time for a medical professional to look into it. A good rule of thumb to consider night sweats as a sign of leukemia is that you have changed clothes during the night for more than seven days, provided that you are not suffering from other metabolic diseases, and environmental conditions are stable.
Pounding headaches
You may wonder what could be the possible relationship between blood cancer and headaches. Well, headaches are not common with this condition, frequent pounding headaches that are not relieved by taking common OTC or prescription drugs may be a sign of leukemia. Scientists and doctors explain this unusual sign due to leukemia-related anemia – that causes poor circulation of blood to the head. Some medical books also state that it could be due to bleeding in the head.
Extreme pallor
Besides nausea, exhaustion, and shortness of breath, in patients with acute and some chronic leukemia, paleness can be a symptom of leukemia-related anemia. Experts at Mayoclinic say that the development of extreme paleness means the disease has already progressed to advanced stages. It turns your skin, the palms of the hands, soles of the feet, and sclera of the eyes yellow.
Persistent anemia can also cause other associated symptoms such as shortness of breath, feeling tired, and easy fatigability.
Bone pain
Achiness in the bones is a relatively rare but often overlooked and clear symptom of both acute and chronic forms of leukemia. Blood cells are produced inside the bone marrow. The bone cells start producing blood cells at an abnormal rate in leukemia. Another thing that happens is the uncontrolled and unchecked production of the blood cells. This liver functioning can cause aches and extreme pain in your bones.
Some leukemia subtypes, such as acute myeloid leukemia (AML), often cause bone pain or joints in which it grows. That’s because it leaves the bone marrow overcrowded and swollen as the cancer cells take up space in the bone marrow, contributing to discomfort on or near the bones or joints.
A skin rash
Approximately one in 30 patients with leukemia may have a skin rash falling into one of two categories: skin leukemia, or a rash caused by Sweet’s syndrome, an inflammatory skin condition commonly associated with leukemia. The skin’s leukemia almost always seems to have a lump inserted into your skin. A small mound begins to grow – and occasionally, it may be a plaque-like condition. On the other hand, the rashes of the sweet syndrome appear red and furious – often associated with a high-grade fever, similar to an allergic reaction. While skin rashes occur in all shapes and sizes, rashes related to leukemia have one thing in common: they continuously tend to grow and spread.
Frequent or recurring infections
If you are experiencing that one small infection that is not going away, no matter how many prescription antibiotics your doctor has prescribed – it may be a sign to get a blood test called complete blood count”. This test will help check your white blood cell, hemoglobin, and platelet levels for abnormalities. Abnormal levels of white blood cells and platelets contribute to a weakened immune system that could explain repeated illnesses and the feeling that they are always on the brink of the flu or disease. That should be enough to send you to the hospital, along with other symptoms such as fatigue or bruising.
Because patients with leukemia may be asymptomatic or have non-specific symptoms common to other diseases, it is essential to have a physical examination, blood tests such as blood complete picture and peripheral film, and bone marrow biopsy, which will help your doctor characterize the exact form of leukemia you are suffering from and dictate the right treatment needed.