Don’t Dismiss Frequent Infections: Understanding the Link to Leukemia

By Dr. R V Raghunandan, Senior Consultant – Radiation Oncology, HCG MNR Cancer Hospital, Ongole

Exhaustion that lingers even after a good night’s sleep, coupled with frequent infections that seem never-ending – these could be signs of something more serious than just a busy lifestyle or a run-down immune system. Leukemia, a cancer of the blood and bone marrow, can often masquerade as these everyday ailment, delaying diagnosis and treatment. Understanding the connection between fatigue, infections, and leukemia can empower individuals to seek timely medical attention.

Unveiling the Causes of Fatigue in Leukemia

Extreme fatigue is a common foe for people battling leukemia. Let’s explore the culprits behind this relentless tiredness:

•  Constant pain disrupts sleep, steals your appetite, and limits physical activity. This domino effect can lead to exhaustion and depression, further worsening fatigue.
•  Leukemia and its treatments can zap your energy, making exercise a challenge. This lack of activity can actually contribute further to fatigue, especially if you were previously active.
•  A healthy diet fuels your body and keeps you alert. However, leukemia and its treatments can throw a wrench in your eating habits. Loss of appetite, nausea, and mouth sores can make maintaining good nutrition difficult, leading to fatigue.
• Anemia, a common complication of leukemia, occurs when you have a low red blood cell count. These cells are responsible for carrying oxygen throughout your body, and a lack of them can leave you feeling weak and fatigued.
•  The type of leukemia you have can influence your fatigue level. Chronic lymphocytic leukemia (CLL) may involve early-stage hormonal changes that contribute to fatigue, along with the emotional stress of a cancer diagnosis and treatments.
•  Difficulties like insomnia, fragmented sleep, or poor sleep quality can leave you drained. Pain, medications, stress, and anxiety are all potential culprits behind restless nights. Additionally, night sweats, a symptom of leukemia or its treatments, can disrupt your sleep cycle.
•  Some medications used to manage leukemia symptoms, like antidepressants and pain relievers, can cause fatigue as a side effect. Even after treatment finishes, fatigue caused by chemotherapy can linger for six months to a year.

Symptoms to look out for:

Fatigue is a hallmark symptom of leukemia. Cancer cells crowd out healthy blood cell production, leading to a shortage of red blood cells, the oxygen carriers in the body. This oxygen deficiency leaves people feeling constantly tired and drained, even after seemingly adequate rest. Unlike fatigue caused by everyday stressors, this exhaustion is persistent and doesn’t improve with relaxation or a change in routine.

Leukemia also weakens the body’s immune system. Healthy white blood cells are crucial for fighting infections. In leukemia, abnormal white blood cells may be produced, but they are dysfunctional and unable to effectively combat germs. This leaves the body vulnerable to a wider range of infections, including bacterial, viral, and fungal. These infections can manifest in various ways, such as recurrent fever, chills, mouth sores, or persistent skin infections. The specific type of leukemia can influence the pattern of fatigue and infections. Acute leukemias, which progress rapidly, often cause severe fatigue and frequent infections early
on. Chronic leukemias, on the other hand, may present with more subtle symptoms that develop gradually over time. However, regardless of the type, persistent fatigue and recurrent infections should raise a red flag and prompt a visit to the doctor.

Difference between normal fatigue and the fatigue caused by leukemia

Normal fatigue is a familiar feeling of tiredness that improves with rest or catching up on sleep. It often stems from everyday activities like physical exertion, stress, or a late night. Leukemia fatigue, however, is a different beast. Medically termed cancer-related fatigue (CRF), it’s an overwhelming, persistent exhaustion that disrupts your daily life. Even after sleep, simple tasks feel draining, and concentration suffers. This unrelenting fatigue is caused by leukemia itself or its treatment, impacting your body’s ability to produce energy- carrying red blood cells. Unlike normal tiredness, leukemia fatigue can be accompanied by symptoms like shortness of breath, weakness, and difficulty fighting infections. If you experience such persistent fatigue alongside other unexplained symptoms, consulting a doctor is crucial for proper diagnosis and treatment.

How to get it diagnosed?

Early diagnosis of leukemia is crucial for successful treatment:

•  A simple blood test can provide initial clues. A complete blood count (CBC) measures the levels of red blood cells, white blood cells, and platelets. Abnormalities in these counts, such as a significant decrease in healthy white blood cells or an abnormal increase in immature white blood cells, can warrant further investigation.
•  A bone marrow aspiration and biopsy, where a small sample of bone marrow is extracted and examined under a microscope, can definitively diagnose leukemia by identifying the presence and type of abnormal blood cells.

What are the treatment options?

Fortunately, significant advancements have been made in leukemia treatment. Chemotherapy remains a mainstay, effectively eliminating cancerous cells. Newer targeted therapies and immunotherapies are also showing promise, offering more personalized and
potentially less toxic treatment options. Bone marrow transplants can be curative in some cases, particularly for younger patients. Early diagnosis allows for a wider range of treatment options and significantly improves the chances of a successful outcome.

Normal fatigue is a familiar feeling of tiredness that improves with rest or catching up on sleep. It often stems from everyday activities like physical exertion, stress, or a late night. Leukemia fatigue, however, is a different beast. Medically termed cancer-related fatigue (CRF), it’s an overwhelming, persistent exhaustion that disrupts your daily life. Even after sleep, simple tasks feel draining, and concentration suffers. This unrelenting fatigue is caused by leukemia itself or its treatment, impacting your body’s ability to produce energy- carrying red blood cells. Unlike normal tiredness, leukemia fatigue can be accompanied by symptoms like shortness of breath, weakness, and difficulty fighting infections. If you experience such persistent fatigue alongside other unexplained symptoms, consulting a doctor is crucial for proper diagnosis and treatment.