Blood cancer symptoms and signs

On this page:

• Blood cancer symptoms
• Symptoms in different skin tones
• Free blood cancer symptoms guide
• Questions to ask your doctor
• Worried about blood cancer?
• About the suspected cancer pathway
• Common blood cancer symptoms explained

Blood cancer symptoms include:

• Weight loss that is unexplained
• Bruising or bleeding that is unexplained
• Lumps or swellings
• Shortness of breath (breathlessness)
• Drenching night sweats
• Infections that are persistent, recurrent or severe
• Fever (38°C or above) that is unexplained
• Rash or itchy skin that is unexplained
• Pain in your bones, joints or abdomen (stomach area)
• Tiredness that doesn’t improve with rest or sleep (fatigue)
• Paleness (pallor)

Some symptoms look different in different skin tones.

We have more specific information about symptoms for different types of blood cancer. Scroll down for more detailed information about blood cancer symptoms.

Not everyone will have the same symptoms, and some people may have symptoms that are not listed on this page.

Some symptoms of blood cancer can look different on different skin tones.

• Bruises generally start as red patches which change colour and get darker over time. They often feel tender. On black and brown skin, bruises may be difficult to see initially, but as they develop, they show up as darker than the skin around them.
• Rashes often appear as clusters of tiny spots (petechiae) or larger blotches (purpura). On black and brown skin, they may look purple or darker than the surrounding skin. On lighter skin, they typically look red or purple. If you press on them, petechiae and purpura don’t fade.
• Paleness (pallor) might mean someone looks unusually pale because they have too few red blood cells. Pallor is often more immediately noticeable in light skin. People with black or brown skin may look greyish and their palms may look paler than usual. They might also notice pallor in their lips, gums, tongue or nail beds. In all skin tones, pallor can be seen by pulling down the lower eyelid. The inside is normally dark pink or red, but if it’s pale pink or white, it’s a sign of pallor.

You can read more about the causes of these symptoms and others below.

We'd like to thank the ACLT (African Caribbean Leukaemia Trust) for their help reviewing this information. ACLT raises awareness about stem cell, blood and organ donation in all UK communities, with a focus on the African and Caribbean communities.

Our free blood cancer symptoms guide is a pocket-sized reminder of these symptoms and provides space for you to record any that you might experience. If you need to get checked out, it also includes things to think about before your appointment and questions to ask your doctor. 

If you go to get checked out, here are some questions you might want to ask your doctor:

• I’m worried about blood cancer – is that something you can rule out?
• Do I need a blood test?
• Do I need a lymph node biopsy?
• Do I need any scans?
• Do you need to take a urine sample?
• As my symptoms might be blood cancer, can I be referred for tests on the two-week suspected cancer pathway?

National guidelines say that anyone with suspected cancer should be referred to a specialist and seen within two weeks.

This may sound alarming, but keep in mind that most people referred on the suspected cancer pathway don't have cancer. The maximum two-week wait is recommended to help people get checked out quickly. For the few people who do have cancer, getting diagnosed earlier can mean treatment is easier and more successful.

Blood cancer often means you don’t have the right balance of blood cells in your body. You might have too many of a particular type of blood cell, not enough of a particular type of blood cell, or blood cells that aren’t working properly. This list explains what causes the most common symptoms of blood cancer.

We have more information on how blood cancer starts.

Caused by anaemia (a low level of red blood cells)

Red blood cells carry oxygen around the body. If you don’t have enough red blood cells, you can become anaemic. Anaemia can cause tiredness that doesn’t go away with rest or sleep, breathlessness even when you’re resting, and paleness (pallor). Pallor can be seen by pulling down your lower eyelid – the inside will look white or pale pink, rather than dark pink or red.

Other symptoms of anaemia include feeling faint and headaches.

Caused by a low level of platelets, which help the blood to clot

Bruises are a sign of bleeding under the skin and often happen after an injury, but if they appear for no reason, they can be a sign of low platelets. They show as darker or a different colour to the skin around them and may feel tender when you touch them.

You may see small spots in the skin (petechiae) or larger discoloured patches (purpura). These look like a rash but are actually clusters of small bruises. On black and brown skin petechiae and purpura typically look purple or darker than the surrounding skin and on lighter skin they tend to show as red or purple.

You may have bleeding from your nose or gums, prolonged bleeding from a cut, heavy periods, or blood in your urine or poo. In very rare cases, there may be a bleed into the brain, which can cause neurological symptoms.

Caused by a low level of white blood cells, which fight infection

You may get persistent, recurrent or severe infections, or have a high temperature (38°C or above) even if there aren’t any other obvious signs of infection. Infections can cause flu-like symptoms like chills or shivering, coughing or a sore throat.

Caused by abnormal white blood cells building up in your lymph glands

You’re most likely to notice these in your neck, armpit or groin. They’re usually painless, although some people find they ache. If there are lumps or swellings further inside your body, and they press on organs such as your lungs, this can cause pain, discomfort or breathlessness.

Caused by damage to your bones

Myeloma can cause pain in any major bones such as your back, ribs or hips.

Some people with lymphoma have drenching night sweats but we don’t know yet what causes this.

Some people with blood cancer experience itching but we don’t know yet what causes this.

Cancer cells and the body’s reaction to them can alter your body’s metabolism and reduce muscle and fat.

Caused by abnormal blood cells building up in your spleen

You may feel full after only eating small amounts, have discomfort under your ribs on the left side, have bloating or swelling, or occasionally pain.

Caused by a very high level of white blood cells

Some types of blood cancer such as acute myeloid leukaemia (AML) develop very quickly and make you suddenly very unwell. This is known as leukostasis or blast crisis. Symptoms may include breathing problems and neurological symptoms like visual changes, confusion, vomiting, loss of muscle control or seizures. Anyone with these symptoms needs medical attention immediately.