16 Silent Signs of Leukemia You Shouldn’t Ignore

Leukemia, or cancer of the blood cells, causes subtle and surprising symptoms throughout the body. These are clear signs you need to get checked.

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What is leukemia?


Leukemia is a cancer of the blood and bone marrow, a malignancy that causes an abnormal production of certain blood cells. As the unhealthy blood cells crowd out healthy ones, blood function begins to falter and you may notice physical symptoms. The disease may get worse quickly if you have a type known as acute leukemia; the disease may progress slowly and get worse over time if you have chronic leukemia, according to the National Institute of Health. Regardless of which type you have, if you notice a collection of these subtle signs of leukemia, see your health care provider for an evaluation. Here are other symptoms of cancer that are commonly ignored.

Fatigue and weakness


Fatigue and weakness are the most common symptoms for all types of leukemia, according to Mark Levis, MD, PhD, the director of the leukemia program at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center. These signs are often caused by anemia (a deficiency of red blood cells), which only compounds the physical exhaustion. In both chronic and acute cases, you may experience a range from slight fatigue to extreme physical weakness, but in all cases, the symptoms only worsen over time. “It creeps up on people, that’s the problem,” says Dr. Levis. Here are other possible medical causes of fatigue.

Shortness of breath


As patients grow weaker and more fatigued, they may also experience shortness of breath that stems from anemia or, in much rarer cases, masses in the chest. “They’re panting, they’re out of breath,” says Dr. Levis. “Walking across the room might be difficult.” Shortness of breath can also be a symptom of lung cancer.

Excessive or spontaneous bruising


Unexplained bruises without any physical trauma may be a sign of leukemia, according to Pamela Crilley, DO, chair of the department of medical oncology at the Cancer Treatment Centers of America and chief of medical oncology at the Eastern Regional Medical Center. Unusual bruising is a result of a low platelet count or clotting issues, explains Dr. Levis. “You will bruise spontaneously, seemingly doing nothing,” he says. “It can be anywhere, but typically they’ll be on the extremities—legs and arms.”

Unusual bleeding


Similar to bruising, unusual nosebleeds or bleeding in the gums, bowels, lungs, or the head may be a sign of platelet deficiency and clotting problems, which can indicate acute forms of leukemia, says Dr. Crilley.

Petechiae (small red spots under the skin caused by bleeding)


Dr. Crilley describes petechiae as: “like someone painted little red dots with a pen.” The spots, which you might not notice because of their size, painlessness, and placement in the lower extremities, indicate a low platelet count. According to Dr. Levis, petechiae are typically found around the ankles because gravity results in the accumulation of bodily fluids in the lower legs throughout the day.

Swollen and enlarged gums

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Although an increase in the size of the gums, also known as gingival hyperplasia, is usually only found in a small portion of acute leukemia patients, it’s one of the most obvious signs of the disease. “If you have a patient with leukemia, you always look in their mouth to see if the gingiva has gotten bigger,” says Dr. Crilley. The gum may look swollen, says Dr. Levis, and you nearly always feels a strange tightness in your mouth. Check out these other shocking diseases dentists find first.

Feeling full or bloated


One sign of chronic—and sometimes acute—types of leukemia is an enlarged spleen, which may result in a loss of appetite. You might have what’s called “early satiety,” according to Dr. Crilley. “Patients eat a little bit of food, they feel full quickly because the spleen is pushing up on the stomach,” she says.

Discomfort or pain in the upper left abdomen

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An enlarged spleen caused by leukemia sometimes results in abdominal discomfort or even sharp pain. “A patient that presented to me with chronic leukemia a few weeks ago, part of his spleen had died off from spleen enlargement,” says Dr. Levis. “It hurt like heck. It was a sharp pain in his abdomen.” Because the spleen is located in the upper-left quadrant of the abdomen, the discomfort usually occurs there.  Here are other possible causes of stomach pain.

Fever or chills


Feverishness or chills are not the most common symptoms, typically only occurring in a quarter of acute leukemia cases and almost never in chronic leukemia cases, according to Dr. Levis. More often, frequent low-grade fevers indicate an infection and a weakened immune system, which may also be related to leukemia.

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