Blood Cancer Symptoms and Diagnosis

People who have blood cancers — like leukemia, lymphoma, and multiple myeloma — value the advanced diagnostics that UPMC Hillman Cancer Center offers.

Our blood cancer experts use a team approach to your care. They have extensive training in diagnosing and treating blood cancers.

These include five distinct disease types:

What these diseases have in common is that most start in the bone marrow. This soft, spongy tissue found inside most bones is where blood cells form.

Blood Cancer Symptoms

While each type of blood cancer is different, they can share some common symptoms and signs.

Some people with blood cancer may not have any symptoms until the disease has advanced. Or they may also mistake the symptoms for a severe cold or flu.

Some common blood cancer symptoms include:

Coughing or chest pain. Possible cause is a buildup of abnormal blood cells in your spleen.
Frequent infections. Possible cause is not enough white blood cells to fight off routine pathogens.
Fever or chills. Possible cause is not enough white blood cells, leading to more frequent infections.
Unexplained rash, bruising, or bleeding. Possible cause is not enough platelets, which are the cells that help the blood to clot.
Itchy skin. Possible causes remain unknown.
Loss of appetite or nausea. Possible cause is a buildup of abnormal blood cells in your spleen so that it presses on your stomach.
Night sweats. Possible causes remain unknown.
Persistent weakness and fatigue. Possible cause is not enough red blood cells (anemia).
Shortness of breath. Possible cause is anemia.
Swollen, painless lymph nodes in the neck, armpits, or groin. Possible cause is a build-up of abnormal white blood cells in your lymph glands.

When to See a Doctor

Since many early cancer symptoms are not very specific, it can be hard to know when you should feel worried. But early diagnosis can lead to earlier, more effective treatment, so don't delay.

You should see your doctor if any blood cancer symptoms last more than a couple weeks without improving.

Some people worry about “bothering" their doctor if they do have just a cold or flu. But your doctor would much rather see you promptly to make that diagnosis.

Blood Cancer Diagnosis and Staging

Your blood cancer care team will conduct tests to classify the type and stage of your blood cancer.

Diagnosis and staging often happen at the same time.

Tests to diagnose blood cancer

Tests and procedures to diagnose blood cancers may include:

Blood tests.
Bone marrow tests.
Imaging tests — CT scan, PET scan, and X-ray.
Physical exam.
Surgical lymph node removal (to use in staging).

Staging blood cancer

Staging is a process that tells the spread and severity of cancer. It lets each member of your care team know the exact type, location, and spread of the cancer.

Doctors stage solid tumors (like lung cancer or breast cancer) by measuring tumor size and disease spread. But blood cancers are different.

Each type of blood cancer uses its own staging system.

Your doctor will explain how they decide the stage of your blood cancer.

In general, blood cancer staging looks at:

Blood cell counts, including the number of healthy cells.
The size and number of cancer cells.
Genetic mutations in the cancer cells.
The presence of cancer cells in other organs.
Bone damage (with leukemia and multiple myeloma).
Enlarged liver or spleen.

Doctors also assign a grade to non-Hodgkin lymphomas. Grading helps understand the cancer's growth patterns and aggressiveness.

Lymphomas can be:

Low grade: slow-growing or indolent.
Intermediate grade: moderate growth rate.
High grade: fast-growing or aggressive.

Questions to Ask Your Doctor About a Blood Cancer Diagnosis

If you receive a cancer diagnosis, you will likely have many questions.

Your doctor and other members of your care team will be your best source to learn about your specific situation.

Here are some questions from the American Cancer Society you might want to ask your doctor:

Can you do biomarker or molecular testing for my type of blood cancer?
What are my treatment choices?
What blood cancer treatment do you suggest? Why?
How soon do I need to start treatment? Is “watchful waiting" an option?
How will treatment affect my work, family, and daily activities?
How likely is my blood cancer to return after treatment?
Should I think about joining a clinical trial?

Contact Us About Blood Cancer Symptoms

To reach the Mario Lemieux Center for Blood Cancers at UPMC Hillman Cancer Center, call 412-864-6600.

UPMC Hillman Cancer Center has more than 70 locations in Pa., Ohio, Maryland, and western New York.

Find a UPMC Hillman Cancer Center doctor near you.

Or call 1-800-533-8762 to make an appointment between 8 a.m. and 5 p.m. Monday through Friday.