December 21, 2023
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December 20, 2023

Understanding Blood Cancer Symptoms and Why Early Diagnosis Is Key

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Understanding Blood Cancer Symptoms and Why Early Diagnosis Is Key

Blood cancers are a collection of cancers that affect the cells that make up our blood. Different types of cells are affected depending on the type of blood cancer. Currently, there aren’t any routine screenings for blood cancers in the United States. However, early detection is crucial and understanding common blood cancer symptoms can help. 

Here, we’ll outline the main symptoms of blood cancers, as well as causes, risk factors, tests that can be carried out, and different treatment options available. 

Where Do Blood Cancers Start? 

Blood cancers start in one of three places: circulating blood, bone marrow, or the lymphatic system. Bone marrow is the spongy center of some of the biggest bones in our body and is where most of our blood cells are made. 

Our blood is made up of four main types of cells — namely, red blood cells, white blood cells, plasma cells, and platelets:

  • Red blood cells carry oxygenated blood from our lungs and deliver it to all the body's cells. 
  • White blood cells are part of the immune system and help fight infection.
  • Platelets are involved in clotting blood when needed — for example, if you cut yourself — by sticking together. 
  • Plasma cells make up the liquid part of our blood, which carries the other types of cells. Plasma also contains antibodies that are part of the immune system and help fight infection.

The lymphatic system is a part of our immune system consisting of lymph vessels, organs, and nodes spread across the body. In addition to acting as a filter, the lymphatic system contains white blood cells that help protect us from infection and disease. Blood cancer symptoms are therefore dependent on where in the body is affected.

What Causes Blood Cancer? 

Blood cancers occur because of mutations in the DNA of blood cells that happen in a person’s lifetime. This means the DNA mutation has not been inherited (passed down) from previous generations and is a random mutation. There are risk factors that can make someone more susceptible to the mutations that cause blood cancer, which we’ll cover below.

Once the DNA in someone's blood cells has changed due to a mutation, the previously normal blood cells no longer behave normally. For example, they may grow uncontrollably.

What Are the Most Common Blood Cancer Symptoms? 

Blood cancer symptoms vary depending on the type of blood cancer, where it started in the body, and if it has spread elsewhere. These are the most common symptoms of blood cancers:

  • Tiredness even after enough sleep or rest
  • Feeling weak or dizzy
  • Unexplained bleeding, which can show up as nosebleeds, heavy periods, or bleeding gums
  • Bruising for no reason 
  • A rash that looks like little bruises or bleeding under the skin and doesn’t go away with the glass test (petechiae, which looks similar to a meningitis rash) 
  • Frequent infections
  • Looking pale
  • Night sweats
  • Weight loss without trying to or loss of appetite 
  • Bone pain or joint pain
  • Shortness of breath
  • Swollen lymph nodes (glands in areas such as your neck, groin, and armpits), which can be painless in lymphoma or sore to the touch in leukemias
  • Unexplained fever (100.4 degrees Fahrenheit or higher)
  • Having a full, painful, or uncomfortable feeling stomach
  • Persistent and widespread itchy skin 
  • Painful erections or those that don’t go down

Other less common blood cancer symptoms include:

  • Vomiting
  • Headache 
  • Persistent cough
  • Blurry vision
  • Fitting (seizures)
  • Swollen and red face, arms, neck, and hands (on brown or black skin the redness may be harder to see)
  • Swollen neck or chest veins

Blood cancers start within circulating blood cells, bone marrow, or lymph nodes. As such, early symptoms will occur in these areas. 

For example, abnormal bleeding and frequent infections can happen when the cells in the bone marrow are affected and a painful or full-feeling abdomen could be from cancerous cells that have spread and are building up in the liver or spleen. The first symptom of lymphomas is usually a painless swelling in a lymph node.

It’s very important to see a healthcare professional if you are persistently experiencing any of these symptoms (for two weeks or longer) to rule out blood cancers. Some of the symptoms listed are non-specific and could be due to other causes. However, this should not delay seeking medical advice. 

What Are the Different Types of Blood Cancer?

Blood cancer symptoms: entrepreneur looking at his laptop

Blood cancers are relatively rare forms of cancer and can affect both adults and children. There are several different types of blood cancers, which include: 

  • Leukemia
  • Lymphoma
  • Multiple myeloma
  • Myelodysplastic syndromes (MDS)
  • Myeloproliferative disorder (MPD)

There are also different types of leukemia and lymphoma within these categories, which we’ll detail below.

Leukemia

Leukemia is a cancer of the blood and bone marrow that mostly affects white blood cells. White blood cells (leukocytes) help protect us from infection. Leukemia occurs when abnormal white blood cells that aren’t fully formed grow uncontrollably and stop the normal white blood cells from being able to work properly. Leukemias are broadly categorized into acute (progresses quickly) and chronic (usually progresses slowly). 

Within these two subtypes, depending on where the cancer starts, leukemias are most often classed as either myeloid or lymphoid. These are two different types of stem cells that go on to produce different types of blood cells.

The different types of leukemia are:

  • AML (Acute Myeloid Leukemia) accounts for 1% of estimated total new U.S. cancer cases in 2023. Chances of developing AML increase with age, with most cases occurring in those over 75.
  • ALL (Acute Lymphoblastic Leukemia) accounts for an estimated 0.3% of all U.S. cancer cases. ALL is most common in children and young people, particularly aged 4 or under.
  • CML (Chronic Myeloid Leukemia) makes up 0.5% of all U.S. cancer cases. CML is most common in those aged over 65.
  • CLL (Chronic Lymphocytic Leukemia) totals 1% of all U.S. cancer cases. It’s more common as you get older, with the average age of diagnosis being 70. ‘

According to the American Cancer Society, the most common leukemias in children are ALL and AML — leukemia is the most common type of cancer in children overall. However, it’s important to note that cancers in general are rare in children. The most common types of leukemia in adults are AML and CLL.

With chronic leukemias (including CML and CLL), some people might not develop symptoms for years, and it can be found incidentally.

Lymphoma

Lymphoma is a cancer of the lymphatic system and affects white blood cells known as lymphocytes. These are found in the lymphatic system and normally help fight infections and remove abnormal cells (such as cancerous cells). 

There are two main types of lymphoma — Hodgkin lymphoma and non-Hodgkin lymphoma. In both types, the lymphocytes multiply abnormally and lose their ability to fight infections and other cells. 

It’s important to get an accurate diagnosis of either Hodgkin or Non-Hodgkin lymphoma as the treatment may differ. This is done by looking at the cells that are taken in a sample from someone with suspected lymphoma. If Reed-Sternberg cells are found, the diagnosis will be Hodgkin lymphoma; if Reed-Sternberg cells are not seen, the diagnosis will be non-Hodgkin lymphoma.

The National Cancer Institute estimates that non-Hodgkin lymphoma accounts for 4.1% of all cancers and Hodgkin lymphoma accounts for 0.5% of all cancers in the United States. Non-Hodgkin lymphoma can occur at any age but the chances increase with age. Hodgkin lymphoma is most common between the ages of 20-40 or over 75.

Multiple Myeloma

The other main type of blood cancer is multiple myeloma, which affects the plasma cells in the bone marrow. This type of cancer is called multiple myeloma as it usually affects more than one area of bone in the body, such as the spine, ribs, skull, and pelvis. Multiple myeloma accounts for 1.8% of all new U.S. cancer cases and is most common in people over 60.

What Are the Risk Factors for Blood Cancer?

Risk factors for developing blood cancer depend on the type of blood cancer and can include:

  • Sex assigned at birth, with blood cancers being more common in men
  • Age, depending on the type of blood cancer
  • Family history —for example, a close relative has had blood cancer
  • Ethnicity, differing for each type of blood cancer 
  • Smoking
  • Obesity
  • Certain viral infections 
  • Some blood disorders
  • Medical conditions such as HIV and Down Syndrome
  • Treatments such as taking immunosuppressant medication after an organ transplant
  • Exposure to radiation or certain chemicals
  • Previous chemotherapy

Many risk factors are related to genetics, age, and medical conditions, and all of these vary depending on the type of blood cancer. However, some lifestyle behaviors can reduce the risk of developing blood cancer. 

Use the Ezra risk factor tool to learn more about your risk for different types of cancer.

What Are Tests for Blood Cancers?

The tests used to diagnose blood cancers depend on which type of blood cancer is being investigated. These include:

  • Blood tests, including complete blood count (CBC): These check different blood cell counts such as red blood cells, white blood cells, and platelet levels
  • Blood film/smear: A blood sample is taken and smeared onto a slide in the laboratory and different cells are looked at under a microscope
  • Lymph node biopsy: Either a section or the whole lymph node is removed to test for cancerous cells
  • Urine (or blood) test: This test looks for particular proteins if multiple myeloma is suspected
  • Bone marrow biopsy/aspiration: A small sample of bone marrow is taken to be analyzed
  • Flow cytometry: A blood or bone marrow sample is taken, and the properties of the cells are reviewed one at a time
  • Lumbar puncture: A thin needle is inserted into the lower back to take a sample of fluid from the spinal cord and brain
  • Imaging: This includes chest, bone or other X-rays, ultrasound, positron emission tomography (PET), magnetic resonance imaging (MRI), or computed tomography (CT) scans 

What Are Blood Cancer Treatment Options?

Treatment options vary depending on the blood cancer type and the subtypes within each type of blood cancer. 

Treatments may include:

  • Chemotherapy: There are many different forms of this medicine to kill rapidly-growing cancer cells
  • Radiation therapy (or radiotherapy): High doses of targeted radiation are given to an area to kill cancerous cells
  • Targeted therapy drugs: These medications target the cancer cells directly by recognizing what makes them different from non-cancerous cells
  • Bone marrow/stem cell transplant: This involves giving a transplant of someone else’s or the patient’s own healthy stem cells usually via a drip in the patient’s arm
  • Immunotherapy: Helps the body to use the immune system to destroy cancer cells
  • Steroids: These are often given as a tablet, liquid, or injection into a vein and can help kill cancer cells. They may also reduce cancer symptoms and any side effects from chemotherapy treatment

Different treatments can cause side effects and an oncologist (cancer specialist) will go through these. There may also be clinical trials available to join if this is something the person would consider; this can be spoken about with a healthcare practitioner.

The length of treatment and prognosis depends on the type of blood cancer, whether it has spread and the characteristics of the person who has blood cancer. Some types of blood cancer need rapid treatment, such as ALL. Other blood cancers, such as CLL and non-Hodgkin lymphoma, may not require immediate treatment as they are slower to progress and there may not be many symptoms to start with. 

Research is ongoing to keep improving the treatment of blood cancers. In the last 40 years, the successful treatment rate for children with ALL has improved significantly. 

The 5-year survival rate for those under 15 with ALL went from 60% to 90% and for 15-19 year olds this went from 28% to over 75%. A 5-year survival rate refers to those still living at least 5 years after diagnosis based on statistics. However, a person may be given a prognosis more tailored to their individual situation. 

If the treatment is successful and there are no signs of any cancer remaining, a person is said to be in remission.

Early Diagnosis Is Key to Improved Outcomes

Blood cancer symptoms: family walking on a beach

Early detection and treatment of blood cancers is vital to give the best chance of successful treatment. While you can’t control some of the risk factors for blood cancer, there are lifestyle decisions, such as not smoking, that you can take to reduce your risk. 

When you’re aware of blood cancer symptoms, you become empowered to seek prompt medical attention if you experience any of them. Although an MRI scan isn’t the main test used to pick up blood cancers, an Ezra Full Body Scan can be used as part of a holistic approach to your health and may help detect signs of cancer.