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Malignant hematologic conditions, or blood cancers, are diseases that originate in the blood or blood-forming tissues. While these conditions have some features in common, they can also have quite different effects on your body.
Many individuals diagnosed with a malignant hematologic condition turn to Regional Cancer Care Associates (RCCA) for treatment. RCCA is a group of more than 90 medical oncologists and hematologists who treat patients who have solid tumors, blood-based cancers, and benign blood disorders at more than 20 locations throughout New Jersey, Connecticut, Massachusetts, and the Washington, D.C. area. At RCCA, patients are able to receive comprehensive cancer care close to home.
Here, we discuss the most common blood cancer symptoms and when each becomes a red flag.
Blood cancers start in the blood or lymphatic system. These systems act as the body’s transport, drainage, and defense networks, delivering nutrients, waste, and disease-fighting cells to where they need to go. Cancer develops when cells in the blood or lymph system mutate and multiply out of control. Over time, the mutated cells crowd out healthy ones, impacting the system’s ability to perform its roles effectively.
Blood cancer is an umbrella term that covers all cancers of the blood and lymph systems. Underneath this umbrella are multiple subtypes of blood cancer, differentiated by what types of cells they form from. Each type of blood cancer has its own behavior and unique symptoms to watch for.
Leukemia is cancer of blood-forming cells. It starts in the bone marrow, which is a soft tissue inside bones where most blood cells are produced. The cancerous bone marrow cells produce abnormal white blood cells (lymphocytes) or red blood cells (myeloid cells). Leukemias can be fast-growing (acute) or slow-growing (chronic), with detection rates and treatment options that vary based on the rate of spread.
Lymphoma is cancer of the lymphatic system. It starts in the lymph nodes, which are small organs that trap and destroy bacteria, viruses, and other harmful substances. The lymph nodes also produce white blood cells (lymphocytes). Lymphoma causes the overproduction of abnormal lymphocytes that do not circulate as they normally should. Instead, they accumulate in the lymph nodes, causing the nodes to swell with a solid mass of cancer cells.
Multiple myeloma is a cancer of the plasma cells. Like white and red blood cells, plasma cells are formed in the bone marrow. They are responsible for producing antibodies, or specialized proteins that help white blood cells identify foreign invaders. When plasma cells become cancerous, they stop producing effective antibodies, and the body can no longer identify and fight disease. At the same time, the faulty antibodies build up in organs and cause internal damage.
Anyone can develop blood cancer. Certain health and lifestyle factors, however, are known to increase a person’s risk. The following have been connected to higher rates of blood cancer:
High-risk individuals should receive regular screenings as directed by their physician.
When many symptoms of blood cancer are easy to dismiss, it’s important for patients and physicians alike to know what to look for.
It is important to note that many individuals who experience one or more of the listed symptoms will not have blood cancer. Nonetheless, it is important to consult a physician about these symptoms, particularly if they are pronounced, arose suddenly, or have persisted for an extended period. Prompt evaluation will enable a doctor to address your concerns and to provide a treatment plan for whatever condition may be responsible for the symptoms.
Warning signs of blood cancer include:
Fatigue is one of the most common and noticeable signs of blood cancer. It occurs partially due to anemia. Blood cancer interrupts the body’s ability to produce blood cells, resulting in a deficit of cells and starving the body’s tissues of oxygen. Cancer also requires energy in order to fuel its rapid cell growth, sapping stores that are not being replenished.
Another sign of blood cancer is weight loss. Cancer hijacks the metabolism in order to use the body’s energy to fuel its own growth. As a result, the body loses calories at a rapid rate. The patient experiences rapid weight loss that is not connected to dieting or exercise. Note that unexplained weight loss is always a health concern, even if it is not caused by cancer.
Some types of blood cancers, particularly lymphoma, cause swollen lymph nodes. The lymph nodes are tiny glands located throughout the body. While many of them are located deep within the body, several are found close to the skin in the armpits, neck, and groin. Lymphoma causes these nodes to swell into hard lumps under the skin that may be painful or tender to the touch.
Infections, such as the common cold, the flu, and skin infections, can also cause lymph node swelling. In general, this type of inflammation will go away when the infection does. Lymph nodes that are swollen due to lymphoma will stay swollen for extended periods without returning to normal.
Blood cancer causes thrombocytopenia, or a low platelet count. Platelets are cell fragments found in blood that are responsible for blood clotting to stop bleeding. Without enough platelets, the body cannot stop even minor bleeding under the skin. Individuals bruise more easily and more severely than normal, sometimes even bruising from minor bumps.
Petechiae may also be present. Petechiae are tiny red or bruise-colored spots under the skin. They are usually flat, do not itch, and do not fade when pressed. They are caused by minor bleeding from capillaries. While petechiae have other non-malignant causes, they can be caused by thrombocytopenia from blood cancer.
Occasional sickness is normal, but if a person gets sick over and over, then their immune system is likely to be compromised. Blood cancer causes reduced numbers of healthy white blood cells or antibodies. Both are necessary components for preventing infection. Without a means of identifying or destroying viruses or bacteria, the body is left vulnerable to illness.
Bone pain is another common blood cancer symptom, specifically of multiple myeloma. Two cell types are responsible for regrowing bone: osteoclasts, which break down old tissue, and osteoblasts, which build new bone. Multiple myeloma activates the former and inhibits the latter. As a result, bones break down faster and do not produce enough new tissue to repair themselves.
Blood cancer also causes night sweats, especially full-body drenching. This symptom is specifically associated with lymphoma. The abnormal white blood cells release increased quantities of cytokines, a chemical that causes inflammation. The cytokines trick the brain into raising the body temperature, causing overheating and profuse sweating at night.
Fever is a common symptom that occurs with many types of illness. With less serious infections, however, the fever usually goes away within days or weeks. Persistent fever without a clear cause is often a sign of a serious underlying problem. Blood cancer, especially lymphoma, causes systemic inflammation that often results in fevers that do not go away.
Shortness of breath is another issue tied to anemia. Blood cancer causes a shortage of healthy red blood cells. As a result, the blood cannot distribute oxygen to other tissues effectively. The heart and lungs must work harder to keep the whole body oxygenated. This can leave patients feeling breathless, even after mild exertion or while at rest.
Blood cancer causes a feeling of fullness or discomfort in the abdomen. This sensation usually occurs due to an enlarged spleen or liver. Leukemia and lymphoma cells accumulate in these organs, causing them to swell and press against the stomach. The internal pressure creates a bloated feeling or can make patients feel full without having eaten much.
The different types of blood cancer share some symptoms in common. The following signs appear with all three types of blood cancer:
Despite these commonalities, blood cancers also differ in their presentations. Leukemia, lymphoma, and multiple myeloma each affect different organs in the body, causing varied symptoms.
Leukemia primarily affects the blood, bones, and bone marrow. It causes anemia (low red blood cell count), bone damage, and the accumulation of cancer cells in organs. Common signs include:
Not every patient gets the same symptoms. The exact symptoms depend on the type of leukemia the patient has and whether it is chronic or acute. Chronic leukemia comes on gradually and may not cause any symptoms at first. Acute leukemia, on the other hand, is extremely aggressive. Symptoms appear suddenly and get worse rapidly.
Acute leukemia can develop very quickly into leukostasis, a condition caused by an extremely high white blood cell count. Patients very suddenly feel extremely unwell, with symptoms that include:
Leukostasis is a medical emergency that requires immediate attention. If individuals experience any of the above signs, then they should go to the emergency room.
Lymphomas are divided into two subtypes: Hodgkin lymphoma and non-Hodgkin lymphoma. Hodgkin lymphoma is characterized by the presence of large and recognizable Reed-Sternberg cells. Non-Hodgkin lymphoma includes all lymphomas that do not produce Reed-Sternberg cells. The subtypes have specific behaviors and cause different symptoms.
Hodgkin lymphoma typically develops in the neck, chest, and underarm lymph nodes. It progresses very predictably, spreading from one cluster of lymph nodes to the next. This orderly progression makes it comparatively easy to identify. Symptoms include:
Weight loss, fever, and night sweats are commonly referred to as B symptoms. This specific group of symptoms indicates that the cancer has spread throughout the whole body. Their presence or absence is used to determine the cancer’s stage and plan an appropriate treatment.
Non-Hodgkin lymphoma develops from lymph nodes anywhere in the body, and it does not always progress predictably. As a result, its presentation is more varied. Non-Hodgkin lymphoma causes similar symptoms to Hodgkin lymphoma, but it does not have a clear set of B symptoms that can be used to determine its progression. As a result, non-Hodgkin lymphomas are more difficult to diagnose.
Multiple myeloma is identified based on the CRAB criteria: Calcium, Renal failure, Anemia, and Bone lesions. Each letter in CRAB includes its own set of symptoms:
Bone lesions may also lead to spinal compression, where vertebrae cannot support the body’s weight adequately. Spinal compression causes nerve symptoms such as numbness, tingling, muscle weakness, or loss of bowel or bladder control.
Symptom | Could Be: | Could Also Be: | Red Flag If: |
Fatigue | Leukemia, lymphoma, multiple myeloma | Stress, nutritional deficiencies, poor sleep, anemia | Fatigue is severe and does not go away with rest |
Shortness of breath | Leukemia, lymphoma, multiple myeloma | Respiratory viruses, asthma, lung diseases, anemia | Shortness of breath persists even when at rest |
Abdominal swelling | Leukemia, lymphoma | Food intolerances, hormonal fluctuations, bowel conditions | Swelling persists without a known cause |
Chest pain | Lymphoma | Cardiac conditions, lung conditions, acid reflux (GERD) | Pain gets worse or persists for long periods |
Bone pain | Multiple myeloma | Osteoarthritis, osteoporosis | Pain gets worse or is accompanied by fractures |
Easy bruising | Leukemia | Some medications, nutritional deficiencies, hemophilia | Bruises develop very easily |
Swollen lymph nodes | Lymphoma | Infections, autoimmune diseases, some medications | Swelling does not get better |
If you’ve been diagnosed with blood cancer, then now is the time to act. Regional Cancer Care Associates (RCCA) specialists provide care to more than 30,000 new patients and 265,000 established patients each year. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers close to home.
To learn more about RCCA, call 844-346-7222 or contact RCCA online.
What are the early symptoms of blood cancer?
Blood cancer does not always cause symptoms early on. As the disease progresses, it may cause persistent fatigue, unexplained weight loss, frequent infections, easy bruising, and swollen lymph nodes.
Can blood cancer be detected by a regular blood test?
Regular blood tests cannot detect blood cancer, but they can identify warning signs such as unusually low or high cell counts.
Are night sweats always a sign of blood cancer?
While night sweats can be a sign of blood cancer, they are more frequently caused by hormonal changes, medication side effects, anxiety, or infections.
Can blood cancer cause joint pain?
Yes, blood cancer can cause joint pain. Many types of blood cancers cause lesions on the ends of bones due to the breakdown of bone tissue.
What does a swollen lymph node feel like?
A swollen lymph node feels like a soft or rubbery lump under the skin. They may be tender or painful to touch and are most noticeable in the neck, armpits, and groin.
How quickly do blood cancer symptoms progress?
How quickly cancer progresses depends on the type of cancer a patient has. Some blood cancers develop gradually, while others spread very quickly.
What blood tests does a hematologist order to check for blood cancer?
Blood tests that check for blood cancer include a complete blood count (CBC), peripheral blood smear, blood chemistry profile, and genetic testing.
Can you have blood cancer with no symptoms?
Yes, you can have blood cancer without symptoms. Many types of blood cancer do not cause any symptoms in their early stages.
Why are blood cancer symptoms easily overlooked?
Symptoms of blood cancer are shared across numerous diseases. Indicators, such as fatigue, night sweats, and fever, are also caused by common, less serious conditions such as the flu or normal aging. While blood cancer may cause frequent infections, these are often common conditions, as well. As a result, many patients and doctors will overlook or dismiss blood cancer until it reaches advanced stages.
For more information or to schedule an appointment,
call 844-346-7222. You can also schedule an appointment by calling the RCCA location nearest you.
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