Blood cancer can affect different parts of the blood and immune system. Because there are several types, symptoms and test results can look very different from one person to another.
This guide explains the changes you may notice. It also covers when to speak with a doctor and what may happen next.
Key takeaways
• Blood cancer is a broad term for cancers that affect blood-forming tissues or certain immune cells. The main groups are leukaemia, lymphoma and multiple myeloma.
• There is no single first sign of blood cancer. Early signs of blood cancer can vary depending on the type and how quickly it develops.
• Possible blood cancer symptoms in adults include unusual tiredness and repeated infections. Other signs can include fever, easy bruising or bleeding and swollen lymph nodes. Some types may also cause night sweats, weight loss or bone or back pain.
• These symptoms can happen for many reasons other than cancer. One symptom on its own cannot tell you that you have blood cancer.
• Speak with a doctor if an unexplained change does not settle, keeps returning or becomes worse. A CBC can provide useful clues but cannot rule out every type of blood cancer.
What is blood cancer?
Blood cancer is a broad term for cancers that affect blood-forming tissues or certain cells of the immune system. Different blood cancers begin in different cells and can behave in very different ways. (NCI)
The three main groups are leukaemia, lymphoma and multiple myeloma. Other blood cancers include myelodysplastic syndromes and myeloproliferative neoplasms.
Is there one “first sign” of blood cancer?
No. There is no single first sign that applies to everyone.
Some blood cancers develop quickly, and symptoms may appear over a few weeks. Others grow more slowly and may cause very few symptoms at first.
Sometimes the first sign is an unexpected blood or urine test result. That result may need further investigation. (NCI)
What symptoms can blood cancer cause?
Blood cancer symptoms depend on the type of disease and the cells affected.
The symptoms below can occur in some blood cancers. They can also happen for many other reasons.
What you may notice | Why this may happen in some blood cancers |
Unusual tiredness or weakness | Anaemia can develop when your body does not have enough healthy red blood cells. This can leave you feeling unusually tired. |
Paler skin or breathlessness | Anaemia can make the skin look paler and make normal activity feel more tiring. |
Repeated or severe infections | Some blood cancers affect the number or function of healthy white blood cells. This can make it harder for your body to deal with infection. |
Unexplained fever | Fever may happen because of an infection. It can also occur with some lymphomas and other blood cancers. |
Bruising more easily than usual | Low platelet levels can make bruising happen more easily. |
Unexplained bleeding | You may notice nosebleeds or bleeding gums. Bleeding may also take longer to stop. Low platelet levels are one possible reason. |
Tiny spots on the skin | Petechiae can appear when platelet levels are low. |
A swollen lymph node that does not go away | This can happen when abnormal lymphocytes build up in lymph nodes. It is more closely associated with lymphoma and some leukaemias. |
Drenching night sweats | Some lymphomas and other blood cancers can cause heavy sweating during sleep. |
Weight loss without trying | Unplanned weight loss can happen with some blood cancers. It is not specific to cancer. |
Bone or back pain | Bone pain is particularly relevant to multiple myeloma. It can also occur in some leukaemias. |
Feeling full quickly or discomfort under the ribs | An enlarged spleen or liver can cause fullness or discomfort in some blood cancers. |
One symptom does not mean you have blood cancer.
Most symptoms on this page are much more commonly caused by other conditions.
Tiredness can have many causes. So can fever, bruising and swollen lymph nodes. Infections are a particularly common reason for lymph nodes to become enlarged.
A symptom list cannot diagnose blood cancer. It can only help you recognise changes that may be worth discussing with your doctor.
How can symptoms differ between leukaemia, lymphoma and myeloma?
The symptoms can overlap, but each group tends to affect the body in a different way. Symptoms alone cannot tell you which blood cancer is present. Because they affect different cells, understanding the difference between leukaemia, lymphoma and multiple myeloma makes the symptom patterns easier to follow.
Leukaemia
Leukaemia can affect how normal blood cells are made. You may feel tired or breathless if red blood cells fall. Changes in white blood cells can make infections more likely. Low platelets can make bruising or bleeding easier.
Acute leukaemias can make someone unwell over a short time. Some chronic leukaemias cause few symptoms at first and may be found on a routine blood test.
Lymphoma
Lymphoma often causes a painless swollen lymph node that does not go away. Some people also have night sweats or unexplained fever. Weight loss and tiredness can occur too. Symptoms also depend on where the affected lymph nodes are located.
If lymphoma is diagnosed, its type and stage help determine the next step, including which lymphoma treatment and supportive care may be considered.
Multiple myeloma
Myeloma often affects the bones and bone marrow. Back or rib pain can occur and bones may become weaker. Anaemia may cause tiredness. Changes in immune function can increase the chance of infection.
Myeloma can also affect calcium levels and kidney function. Some people have no obvious symptoms when it is first found. Changes can appear gradually, so it can help to understand what happens when you have multiple myeloma over time.
When should you get checked?
You do not need to wait for several symptoms to appear.
Speak with a doctor if an unexplained change does not settle or keeps coming back. You should also get medical advice if it becomes worse or feels unusual for you.
Examples include:
• Significant unexplained bruising or bleeding.
• Repeated unexplained fevers or infections.
• A swollen lymph node that does not go away.
• New tiredness that is affecting normal activities.
• Unusual paleness or breathlessness.
• Blood-test results that your doctor says need further review.
Severe breathing difficulty needs urgent medical care. So does heavy bleeding that will not stop or a seizure. These symptoms can have many causes and do not automatically mean blood cancer. (Blood Cancer UK)
What happens at the first appointment?
Your first appointment is usually about understanding what has changed and deciding whether any tests are needed.
The doctor may:
Ask when your symptoms started and whether they have changed over time.
Ask about recent infections, other health conditions and any medicines or supplements you take.
Check your skin and lymph nodes.
Examine your abdomen if an enlarged spleen or liver is a possibility.
Recommend blood tests depending on your symptoms. A complete blood count (CBC) may be one of them. It measures red blood cells, white blood cells and platelets and can show changes that need further investigation. (NCI)
What a CBC can and cannot tell you
A CBC can give useful clues, but it cannot rule out every blood cancer.
Many leukaemias affect blood counts. Lymphoma is different because blood tests alone cannot confirm or exclude it. A biopsy of an affected lymph node or other tissue may be needed if lymphoma is suspected. (American Cancer Society)
Your doctor will read the result alongside your symptoms and examination rather than relying on the CBC alone.
What if you need more tests?
Needing more tests does not mean you have blood cancer.
Depending on what your doctor is looking for, further assessment may include specialist blood tests or imaging. Some people may need a bone marrow test or a biopsy. Not everyone needs the same tests.
If blood cancer is diagnosed, further tests may help identify the exact type or subtype. What happens after a blood cancer diagnosis depends on what those tests show and may include bone marrow evaluation before the next steps are decided.
What may help at your appointment
You may find it useful to bring:
• A note of when your symptoms started.
• Details of how they have changed.
• Recent blood-test reports.
• Any relevant scans you already have.
• A list of medicines and supplements you take.
• Details of important previous illnesses or treatments.
Writing these down beforehand can make the conversation easier.
Possible blood cancer symptoms can overlap with many other health conditions. A symptom list cannot tell you what is causing a change. If something feels unusual for you and does not settle, speak with a doctor who can assess it properly.
If you already have a diagnosis
If you have been diagnosed with blood cancer and want to discuss supportive care alongside your oncology treatment, you can schedule a consultation with Dr Tarang Krishna. This does not replace care from your haematology or oncology team.
