When the first symptoms of leukemia appear, the person affected may not realize that anything out of the ordinary is happening. The symptoms can be very vague, and it's easy to blame things like excessive stress or even the flu for some. Common symptoms of leukemia include:
- Headache. Leukemia can cause frequent headaches when large numbers of lymphocytes (white cells) collect in the brain and spinal cord.
- Weakness or tired. The fatigue and feelings of weakness are caused by a shortage of healthy red blood cells to supply the muscles with oxygen. This shortage of red blood cells is called anemia.
- Pain in the bones or joints. Joint and bone pain is caused by abnormal white blood cells collecting under a bone's surface or in a joint.
Leukemia also has some distinctive signs. While symptoms are subjective feelings like pain, tiredness, or weakness that can only be felt by the person experiencing them, signs are indicators of a health problem that can be observed or measured by an outside person such as a doctor or nurse, things like laboratory results, changes in weight, or paleness. Signs of leukemia include:
- Abdominal or lymph-node swelling. Large numbers of abnormal white blood cells can collect in the spleen, causing abdominal swelling, or in the lymph nodes causing them to swell. Swollen lymph nodes can be felt from the outside in the armpits and the neck, but lymph nodes that are located deeper in the body can only be found with an MRI or a CT scan. Abdominal swelling can also be felt externally, although the source of the swelling must be confirmed with a scan.
- Abnormal bruising or bleeding. This sign can present itself in different ways, including frequent nosebleeds, bleeding of the gums (especially after brushing the teeth), or small red spots on the skin (called petechiae) that result from bleeding in tiny blood vessels underneath the skin. This tendency to bruise or bleed easily is caused by a shortage of platelets, the blood cells that clump together to slow or stop bleeding in the body. A shortage of platelets in the blood is called thrombocytopenia.
- Frequent infections. Leukemia can make the body extremely vulnerable to infection, which may seem confusing because of all the discussion of increased numbers of white blood cells. Unfortunately, the abnormal white blood cells that are produced do not have the ability to effectively fight infection, and there are not usually enough healthy white blood cells to keep the immune system strong.
- Fevers. Fevers are one response of the immune system to infections, and are caused by the release of chemicals that tell the brain to raise the body's temperature. When a person has leukemia, these chemicals may be released excessively, causing frequent or persistent fevers (although some may be caused by infections).
- Weight loss. Weight loss in leukemia patients is caused by a variety of factors. The release of certain chemicals caused by leukemia, the toll on the body of frequent infections, and other factors work together to cause weight loss.
- Abnormal blood test results. A complete blood count (a blood test that examines all three types of blood cells) will measure the number of white blood cells, red blood cells, and platelets. A person with leukemia may have much higher than normal levels of white cells, and possibly lowered counts of red blood cells and platelets.
Even if more than one of these signs or symptoms is present, it does not necessarily mean that a person has leukemia. All of these signs and symptoms can point to conditions other than leukemia. So it's important to talk to a doctor about any unusual or troublesome health issues. Leukemia isn't diagnosed based on the presence of one specific sign or symptom, but on a pattern of signs, symptoms, and test results that have been interpreted by a doctor who is qualified to make the diagnosis.
Sources: "What You Need to Know about Leukemia.” National Cancer Institute. Sep 2002. National Institute of Health. 13 Feb 2008.
"Understanding Blood Counts." 25 Oct 2004. Leukemia and Lymphoma Society. 20 Feb 2008. "How Is Childhood Leukemia Diagnosed?" 19 Aug 2007. American Cancer Society. 20 Feb 2008.
