Blood Cancer Awareness Month: Symptoms of Blood Cancer
Blood cancer is an umbrella term for cancers that affect blood, bone marrow, and lymphatic system. There are more than 130 types of blood cancers; but three main types of blood cancers are leukaemia, lymphoma and myeloma.
Leukaemia is a cancer of the blood or bone marrow, which produces abnormal cancerous blood cells that crowd out the normal and healthy blood cells. There are different types of leukaemia, it depends on the type of blood cell that becomes cancerous. It can be acute or chronic, lymphocytic or myelogenous. Leukaemia can be fatal, but there are ways of treating and controlling the disease.
In India, slightly more than 1 million new cases of cancer are diagnosed every year, in a population of 1.2 billion. India ranks third in the world, when it comes to hematological cancers, the US and China being first and second. India is likely to have 1.17 lakhs new cases of blood cancer in 2018. It occurs most commonly in adults above 55 years of age and children below 15 years of age. The treatment methods depend on the blood cell affected and whether the leukaemia is acute, chronic, lymphocytic or myelogenous. Chemotherapy or bone marrow transplantation is frequently used to treat leukaemia.
There can be multiple causes of leukaemia. It generally happens when DNA of immature cells, mainly white cells, are damaged in some way. This causes blood cells to grow and divide continuously, resulting into too many blood cells. As more cancer cells are produced, they stop healthy white cells from growing and functioning normally, by crowding out space in blood. Essentially, bad cells crowd out good cells in blood.
Risk factors of blood cancer are associated with artificial ionising radiation, viruses such as HTLV-1, benzene or any petrochemicals, alkylating chemotherapy used in treatment of previous malignancies, hair dyes and smoking. People with Down syndrome appear to have a higher risk, possibly due to certain chromosomal changes. It has been suggested that exposure to electromagnetic energy can be linked to leukaemia, but there is not enough evidence to confirm this.
Signs And Symptoms Of Blood Cancer
Leukaemia can be hard to diagnose because the signs and symptoms are common to other unrelated illnesses. Blood cancer symptoms occur as cancer cells outgrow normal blood cells.
Major symptoms of blood cancer are:
- extreme tiredness or fatigue.
- unexplained weight loss.
- easy bruises or bleeding.
- enlarged lymph nodes.
- abdominal discomfort.
- massive blood flow during menses.
- pain in bones and joints.
- night sweats and chills.
Common blood cancer symptoms can be explained as follows:
1. Anaemia (May lead to breathlessness and extreme tiredness or fatigue): It is caused by low levels of oxygen carrying red cells. Anaemia can cause extreme fatigue even when a person is resting. It may also cause chest pain, dizziness, and paleness.
2. Bruising or bleeding: It may be due to low levels of blood clotting cells (platelets). This can vary from extreme bruising to tiny pin-sized red spots in your skin (petechiae) or a purple skin rash (purpura). It can also cause bleeding from nose, gums, wounds or even heavy periods, or blood in stools. In very rare cases, there can be a bleeding in the brain, which leads to stroke-like symptoms.
3. Lumps and swelling: It can be caused due abnormal proliferation of white cells in lymph nodes. Common sites of these lumps and swellings are armpits, neck and groin. These lumps are usually painless, sometimes these swelling grow rapidly, and often, they grow slowly. If there are lumps or swellings inside the body, and they press against organs such as lungs; it can result in pain, discomfort and/or breathlessness.
4. Pain: Most common sites of pain include bones and joints. Causes are related expansion of bone cortex due to exponentially proliferating tumour cells. Other causes may include lytic lesions, which are very common in multiple myeloma.
5. Infections/High grade fever: Caused due to low numbers of infection-fighting white blood cells (neutrophils). One may get repeated infections, or have a high temperature even if there aren’t any other obvious signs of infection. Infections can cause flu-like symptoms, such as coughing or a sore throat.
6. Night sweats/Hot flashes: Lymphoma or leukaemia can cause night sweats that are severe enough to make clothes and bed linen wet. Reason for this kind of night sweat is unknown. It may due body’s response to increased temperature.
7. Abdominal discomfort or pain: It can be caused due to abnormal blood cells proliferating in spleen. Symptoms may vary from slight abdominal discomfort, abdominal fullness to persistent loose motions, which may happen as a result of the pressure on adjacent abdominal organs.
8. Weight loss: It is caused by dividing-cells that use up lots of energy (increased metabolism). Significant weight loss can be a sign of blood cancer. If a person loses more than 5% of body weight in a month or 10% over 6 months (when an individual is not following a diet or exercise for weight loss), that can be sign of cancer.
An individual can experience one of these symptoms in isolation or he can even experience more than one of these symptoms at a given time.
Some types of blood cancers such as acute myeloid leukaemia develop very quickly and make a person unwell, very quickly. Symptoms may vary as per age. In children, fever and swelling in lymph node are seen, while in adults, in addition to fever and swelling in lymph nodes, associated symptoms like increased abdominal swelling due to splenomegaly are seen.
Population At Risk
This very much depends on the type of blood cancer. With the exception of acute lymphoblastic leukaemia, which is one of the most common cancers in children, in general, the risk of developing blood cancer increases with increasing age. Men are slightly more affected than women. The level of risk varies across different racial groups, due to both genetic and environmental factors.
The Importance Of An Early Diagnosis
Early detection of cancer greatly increases the chances of a successful treatment. There are two major factors that play important roles in early detection of cancer: education to promote early diagnosis and screening. Recognising possible warning signs of blood cancer and taking prompt action can lead to an early diagnosis. Increased awareness of possible warning signs of blood cancer, among physicians, nurses and other healthcare providers, as well as, among the general public, can be of great help. This can contribute in curing blood cancer.
Dr Shrinath Kshirsagar is a Consultant, Hematologist/Hemato-Oncologist, and Stem Cell Transplant Physician at Global Hospitals, Mumbai.