Leukaemia Screening
In England, there is no national screening programme for leukaemia. Yet diagnosing leukaemia in its earliest stages can improve the outcome for patients. This means that it’s important to get tested as soon as possible if you suspect you may have leukaemia.
The most common symptoms of leukaemia are fatigue, fever or night sweats, shortness of breath, bruising or bleeding, bone or joint pain, and repeated infections. A physical exam, blood test and bone marrow biopsy are the first-line tests to diagnose leukaemia.
What is leukaemia?
Leukaemia is a cancer of your white blood cells that are made in a spongy tissue found inside some of your bones, called the bone marrow. Leukaemia nearly always begins in the bone marrow and it usually spreads to your blood. It can also be found in other tissues including your lymph nodes and spleen.
If you have leukaemia, your body produces too many immature white blood cells. These abnormal blood cells don’t die when they get old as your healthy blood cells do. This results in a build-up of abnormal blood cells in your bone marrow that stop your body from producing normal blood cells, including platelets and red blood cells that are essential for the immune and blood system.
The type of leukaemia is based on:
- the type of blood cell which is affected
- whether the leukaemia is acute (fast-growing) or chronic (slow-growing).
The 4 main types of leukaemia are:
- Acute lymphoblastic leukaemia (ALL) – is the most common type of leukaemia in young children. It can also occur in adults. It affects the lymphocyte cells. ALL can cause symptoms very quickly. It usually needs to be treated as soon as possible after diagnosis.
- Chronic lymphocytic leukaemia (CLL) – is the most common type of leukaemia. Mainly affects people over 60 years old. It affects the lymphocyte cells. CLL develops slowly and often causes no symptoms in the early stages.
- Acute myeloid leukaemia (AML) – is a rare type of leukaemia that can occur in children and adults. It is more common in adults over 60 but can affect people of all ages. It affects the myeloid cells and can cause symptoms very quickly. It usually needs to be treated as soon as possible after diagnosis.
- Chronic myeloid leukaemia (CML) – mainly affects adults and is more common in middle age and older people but can affect people at any age. You may have few or no symptoms for months or years before entering a phase when the leukaemia cells grow more quickly.
How is leukaemia diagnosed?
Diagnostic tests are used to confirm leukaemia if you have signs and symptoms of leukaemia or you have chronic leukaemia that is detected during blood tests carried out for another reason.
Leukaemia can be diagnosed using the following tests:
- Physical exam - check for physical signs of the condition including swollen lymph nodes, pale skin from anaemia, and enlargement of your liver and spleen.
- Blood tests – includes a full blood count to check the numbers of the different blood cell types. It shows if you have abnormal levels of red or white blood cells or platelets, which may suggest leukaemia. A high number of abnormal white blood cells could indicate leukaemia. A blood test may also look for the presence of leukaemia cells. However, not all types of leukaemia circulate in the blood and they may stay in the bone marrow.
- Bone marrow biopsy - a sample of bone marrow is usually taken from your hip bone using a long, thin needle. The sample is sent to a laboratory to look for leukaemia cells.
Other tests that may be used to diagnose leukaemia
- Scans - including X-rays, MRI, CT, PET and ultrasound scans to create detailed pictures of the inside of your body.
- Immunophenotyping - looks at proteins on the surface of your blood or bone marrow cells to help identify the exact type of leukaemia. This is important for acute lymphoblastic leukaemia as treatments may differ slightly for each type of ALL.
- Genetic tests – sometimes called cytogenetics. Identifies the genetic make-up of the cancerous cells in a sample of blood, bone marrow or another type of tissue. Knowing the exact type of leukaemia can help in treatment decisions.
Symptoms of leukaemia
Leukaemia symptoms vary depending on the type of leukaemia you have. Chronic leukaemia develops slowly with many people having no symptoms in the early stages. Often chronic leukaemia is discovered by chance after a routine blood test. Acute leukaemia progresses quickly and is more likely to cause symptoms that often cause people to feel ill quite quickly.
Symptoms can vary from person to person. You may get some but not necessarily all of the typical symptoms of leukaemia. Symptoms can be grouped by the cells that are being affected.
Symptoms related to a low number of red blood cells, called anaemia:
- tiredness that lasts a long time and doesn’t improve with rest
- look pale
- feel short of breath
- feel dizzy or lightheaded.
Symptoms related to a low number of white blood cells:
- infections that are more frequent, severe or last longer
- generally feeling unwell and run down
- a fever or high temperature
- a sore throat or mouth
Symptoms related to a low number of platelets are related to unusual bleeding:
- bruising and bleeding more easily without any obvious cause, or bleeding that takes longer to stop
- bleeding gums, nosebleeds, blood spots or rashes on the skin, blood in your poo, and heavy periods in women.
Other leukaemia symptoms may include:
- unexplained weight loss
- loss of appetite
- swollen lymph nodes (glands in your neck, armpit and groin)
- night sweats
- aching joints and bones
- headaches
- a tender lump in the upper left-hand side of your stomach due to an enlarged spleen.
You should contact your GP if you're worried about any symptoms that you’re experiencing.
What are the screening tests for leukaemia?
Currently, there are no national screening tests for leukaemia that are recommended for regularly testing the general population. This is because there is no screening test that has been proven to be reliable enough to detect leukaemia in its earliest stages before symptoms develop.
This means that it’s important to be aware of the possible symptoms of leukaemia and to visit your doctor if you have any concerns. Your doctor will then be able to investigate your symptoms.
At Ramsay, we have a multidisciplinary team of leukaemia experts who use the latest tools and technologies to find out if patients have leukaemia. If a leukaemia diagnosis is made, they will develop a treatment plan tailored to the specific needs of the patient.
How do I get screened for leukaemia?
There is no national screening programme for any type of leukaemia. This is partly because Leukaemia generally is not a common condition.
If you have symptoms of leukaemia or you think that you are at higher-than-average risk of leukaemia, you should speak with your doctor.
At Ramsay, we offer convenient and timely appointments for patients who are worried about having leukaemia. Patients showing leukaemia symptoms or who are at higher risk of leukaemia can see one of our experienced consultant haematologists. Your haematologist will offer a physical exam. discuss your medical and family history and request any required diagnostic tests.
Leukamia Screening at Ramsay Health Care
It’s important to speak to an expert when you are worried about lympoma cancer symptoms, our conveniently located Ramsay hospitals offer tests to diagnose leukamia without waiting with oncology experts.
You can read more about our cancer care and treatments or please get in touch if you’d like to talk to us about any concerns.