But because blood cancers like leukemia affect the entire body, their symptoms can often be mistaken for signs of other conditions. So, it’s usually a number of symptoms taken together that lead to a formal leukemia diagnosis.
However, some symptoms are common to most types of leukemia:
Abnormal blood counts – could be a very high white cell count or a very low platelet count; this has to do with the functioning of your immune system/propensity for infections
Bleeding/bruising –spontaneous bleeding either internally or externally (often from the nose or gums); bruising very easily
Fatigue – sometimes a low-level fatigue that’s not relieved by sleep or rest; other times, a sudden-onset exhaustion; often cannot be distinguished from other causes of fatigue
Fever – may be constant low-level fevers or a sudden spike in temperature
Infections –could be a sequence of infections or a single infection that’s resistant to treatment
Shortness of breath – often due to low platelet count, which reduces the blood’s oxygen-carrying capacity
Breakdown of the skin –lesions/rashes that do not resolve, bleeding/bruising of the skin, infections
Acute leukemia symptoms can often appear suddenly
With acute leukemia, symptoms tend to develop very quickly. You may suddenly spike a fever that won’t go away, develop an infection for no apparent reason, or start bleeding spontaneously from your nose or gums and not be able to stop it. You may also just wake up feeling wiped out one morning, or find yourself so exhausted that it’s hard to function.
This is the way we tend to see most of our acute leukemia patients. Often, they show up at the hospital extremely ill and need to start treatment right away.
Sometimes, we’re able to spot acute leukemia before it gets to that point, though, because the people who develop it are already patients at MD Anderson and under close observation. Patients who’ve been treated with chemotherapy or high doses of radiation therapy for previous cancers, for instance, can sometimes develop secondary blood cancers as a result: acute myeloid leukemia or myelodysplastic syndrome being the most common.
So, if a blood test shows that a breast cancer survivor’s platelets are low during a routine check-up, for example, then we know to start looking for that.
Chronic leukemia symptoms are more subtle
Chronic leukemia symptoms can also involve infections, bleeding and fatigue. But they tend to develop more slowly than with acute leukemia cases, so they’re not as noticeable. Symptoms are often attributed to other things, too, such as stress, allergies or a virus.
Sometimes, patients with chronic leukemia finally seek a doctor’s help because they can’t shake an infection, they’re feeling short of breath, or their low-level fatigue just won’t go away. But these patients are also identified through routine bloodwork that’s done for other reasons. You might discover you have leukemia at an annual physical, for instance, or because you need clearance for an upcoming orthopedic surgery or are simply changing insurance providers.
Again, the key is to listen to your body. Get to know what is normal and abnormal for you. And if something isn’t quite right, get it checked out. It’s important to listen to the clues your body may be giving you.
Why I’m optimistic about leukemia treatment advances
Regardless of which type of leukemia you might have, there is much cause for hope.
One reason is that chronic leukemia is being caught more frequently now, both because doctors see more cases of it and know what to look for, and because cancer survivors are living longer than ever after their initial diagnoses and treatment. That means patients who develop leukemia as a result of receiving chemotherapy or radiation therapy for other cancers can be identified earlier, when the disease is often easier to treat.
Another encouraging development is that the Food and Drug Administration (FDA) has approved several drugs in the past five years, many of which are oral therapies targeting various genetic mutations in patients with acute myeloid leukemia.
These breakthroughs are the direct result of scientific advances made based on cutting-edge research. Many – if not all – of these drugs were developed through clinical trials led by doctors here at MD Anderson.
And a lot of leukemia patients being prescribed these medications today didn’t even have an oral option available until just a few years ago. Now, these treatments can be administered at home. And that is definite progress.