Approximately one-third of patients will report feeling weak or breathless as a symptom prior to being diagnosed with leukaemia. However, because breathlessness has many possible causes, ranging from a cold, chest infection to lack of fitness or smoking, it can often be mistaken as harmless or simply as a sign of getting older. Read on to learn more about how breathlessness presents itself in leukaemia and how to spot it.
What is breathlessness?
Breathlessness or “dyspnoea” describes the unpleasant feeling of not being able to fill your lungs with air properly, causing you to increase the speed at which you breathe.
Becoming out of breath is a completely normal response to strenuous exercise. However, shortness of breath that comes on unexpectedly, for example when doing small tasks that are normally effortless, can be due to a serious underlying medical condition. Depending on its cause, it may come on within hours or days (acute) or gradually, over a period of months or years (chronic). In the case of leukaemia, the specific type of blood cancer a person has will determine how quickly this symptom presents itself.
Spotting breathlessness in leukaemia
It is worth visiting your GP if you have noticed any of the following problems with your breathing:
- Sudden breathlessness that comes on unexpectedly – It is completely normal to become out of breath after exerting yourself physically; however, if you can’t explain your sudden feeling of breathlessness, it is vital that you seek immediate medical attention. Sometimes known as acute breathlessness, this is often the most concerning type of breathlessness as it could be anything from a heart attack, an asthma attack or leukaemia on rare occasions.
“I was travelling home from my office on the underground. As I stepped off a train, my legs suddenly buckled under me and I couldn’t keep walking. I became very breathless, and my smart watch showed a fast pulse. I also felt my brain become fuzzy, like cotton wool.”
- Breathlessness during everyday activities (that you would normally find effortless) – You might find yourself struggling with simple things such as washing up or changing a duvet cover. If you haven’t struggled with this before it is important to contact your GP.
“I was constantly breathless when trying to do everyday activities, such as changing a duvet cover or climbing upstairs.”
- Breathlessness that has lasted for longer than a month or has gradually become more noticeable – If you have struggled with your breathing for a while, don’t ignore it. It might be a sign of a long-term condition, such as asthma, chronic obstructive pulmonary disease (COPD) or perhaps chronic lymphocytic leukaemia (CLL).
“I worked within a 10 minutes’ walk from my home, and noticed that as the weeks went on, I was getting more out of breath on the way to and from work, and generally I was getting more and more tired.”
- You have noticed a “sudden drop in fitness” – If you consider yourself to be fit and active, you should make your doctor aware of any sudden trouble with breathing. Certainly book a GP appointment if you can’t work out what is causing it (i.e. you don’t have a cold or another ongoing illness).
“Whilst playing in competitive football matches, I wasn’t able to last more than 15 minutes in each game without needing to sit down as I was bright red, breathless and cramping.”
- You have also been coughing for three weeks or more – A persistent cough can sometimes be a sign of leukaemia, due to you having a compromised immune system. When paired with breathlessness, an ongoing cough could also indicate an underlying lung condition and so it is important to get it checked out by a GP.
“My health started to go downhill. I thought I had caught a bad cold, but this progressed quickly into a terrible, persistent cough.”
- You notice other symptoms of leukaemia or anaemia – As well as breathlessness, you may be experiencing seemingly unrelated symptoms that could in fact be an indication of leukaemia. Symptoms of leukaemia can include bruising, night sweats, bone pain, abdominal pain or frequent infections.
Since breathlessness in leukaemia is nearly always caused by anaemia, keep a look out for symptoms such as fatigue, dizziness, poor concentration or pale skin. Anaemia is usually diagnosed using a full blood count, and so leukaemia can also be picked up at this stage.
“I found out during the appointment that some of the symptoms I was having, and just shrugged off, were actually signs of leukaemia. These were: excessive sweating, tiredness (I thought it was just because I was doing more exercise), breathlessness (I had pinned this down to being out of shape), a rash (I thought it was a food allergy) and unintended weight loss.”
What causes breathlessness in leukaemia?
Breathlessness occurs when the body’s cells require more oxygen than they are currently receiving. You end up breathing faster to try and increase the flow of oxygen-rich air into the lungs.
In the case of leukaemia, oxygen can become depleted in the bloodstream as a result of the person becoming anaemic. An overcrowding of cancerous leukaemic cells in the bone marrow causes anaemia by preventing the bone marrow from efficiently producing red blood cells. Since red blood cells contain ‘haemoglobin’, which carries oxygen from the lungs to the body’s cells, a deficiency of red blood cells means there is less oxygen being carried around the body. Breathing more heavily is the body’s way of compensating for this loss of oxygen.
When should I be concerned?
We often hear of leukaemia patients ignoring breathlessness as simply a sign of age or lack of fitness. No matter your age or physical condition, it is important to treat breathlessness with a level of concern. Before dismissing shortness of breath as being due to inactivity or age, organise an appointment with your doctor for a professional opinion and diagnosis.
“As I had just turned 60 years old, I put this down to the ageing process and thought it was just something that I would have to learn to live with.”
Most people will know instinctively when breathlessness is disproportionate to the level of exercise they have undergone. As a general rule, if you feel like you are struggling more than you should be or are used to, visit your GP to rule out any underlying problem.
For more information on the signs and symptoms of leukaemia, click here.