The Early Signs of Leukemia—And When to See the Doctor
You've heard of skin cancer, lung cancer, breast cancer, prostate cancer, rectal cancer—maybe even cancers of the pancreas and kidneys. But less popularly discussed is cancer of the blood. That's because it's less common, with fewer than 200,000 cases a year, and because the most publicized type goes by a different name: Leukemia.
And it's time—especially during this Blood Cancer Awareness Month and Childhood Cancer Awareness Month—that we start talking about Leukemia.
What is Leukemia?
Leukemia is a cancer of the blood—specifically the body's blood-forming tissues, including the bone marrow and the lymphatic system. It impacts the three cells in blood: platelets, white blood cells, and red blood cells. Billions of blood cells are produced in the bone marrow daily, but when the body has leukemia, it produces more white cells (lymphoid and myeloid), and everything is thrown out of whack.
There aren't enough platelets to clot blood, red blood cells supplying oxygen, or white blood cells working as they normally would to fight infection.
There are two distinct forms of leukemia: acute and chronic. Acute forms of leukemia are severe and sudden in onset, while chronic develops over time and not as easily detected. Acute Lymphocytic is most common in children, while others, such as Chronic Myeloid and Lymphocytic, impact adults.
Here are the four common types of leukemias and who is mostly affected by each.
- Acute Lymphocytic Leukemia (ALL)—This cancer typically starts in the bone marrow where blood cells are made. It is the most common leukemia in children (making up 80 percent of cases) but, in rare instances, can also occur in adults.
- Acute Myeloid Leukemia (AML)—Starting in blood-forming cells of the bone marrow and invading the blood, this cancer typically impacts older adults, 65 years or older. Though rare, AML can also develop as early as a few days after birth.
- Chronic Myeloid Leukemia (CML)—Nearly 15 percent of leukemias in adults are CML, also known as myelogenous leukemia. Overall, one in 526 people will get CML in their lifetime.
- Chronic Lymphocytic Leukemia (CLL)—On average, those diagnosed with CLL are around the age of 70. CLL accounts for about one quarter of new cases of leukemia, according to the American Cancer Society, which estimates that there will be 20,720 new cases of CLL in 2019.
What are the Early Signs and Symptoms?
Leukemia symptoms may occur due to shortages of normal blood cells, which happens as the leukemia cells crowd out the normal blood-making cells in the bone marrow. "In general, symptoms of acute leukemia are ones that have to do with not having enough normal blood cells, and if you don't have enough normal white blood cells you may go to your doctor with infections," says Don A. Stevens, M.D., medical oncologist, Norton Cancer Institute. "Chronic, infections, fevers, chills, and the platelets can also be affected, which can present bleeding, bruising, small red dot under the skin—initially in the lower part of the body, below the knees, ankles or feet. As the disease gets worse you may see those dots elsewhere."
Distinct symptoms include:
- Dizziness or lightheadedness
- Shortness of breath
- Feeling weak
- Pale skin
- Infections that won't go away
- Bruises (small red of purple spots on skin
- Chronic bleeding (including gums, nosebleeds, etc.)
Unfortunately, when it comes to chronic leukemias, there aren't many clear symptoms, and these cases are typically found during a blood test when too many white blood cells may be detected. Some chronic leukemias don't have a lot of symptoms initially, according to Stevens. Patients may discover a chronic condition when they're gone to the hospital or emergency room for another problem.
"One of the scary things about this disease is how quickly it can come to you," says Stevens. "You can be very well, maybe fatigued but for the most part feeling yourself, and then three weeks later you can have difficult with bleeding gums, you bump yourself on the kitchen counter and you get a huge bruise instead of a little one, maybe you have blood in your urine, and all of that comes on really quick."