Diagnosis

Wilmot Cancer Institute provides the full spectrum of care for leukemia and other blood disorders, from initial diagnosis and treatment to recovery and rehabilitation. Our oncologists, and even many of our nurses, specialize in blood cancers.

In addition, Wilmot’s Blood and Marrow Transplant Program is one of the top in New York State, performing nearly 160 transplants in 2015. Learn more about certifications and credentials Wilmot has received for its quality care.

We work in multidisciplinary teams. Multidisciplinary means that our care providers include experts with a variety of specialties: surgeons, medical oncologists, radiation oncologists, pathologists, radiologists, nurse practitioners, nurses, chaplains, social workers and clinical researchers. They work together on your case to provide the most personalized care possible.

Blood cancer symptoms

People who have leukemia or myeloma may begin to feel worse or may find that they have changes in lab work that warrant further attention.

Blood cancers often produce symptoms that are similar to mononucleosis, pneumonia or the flu. Therefore, initial symptoms are not always recognized immediately. See a doctor if you experience fever, night sweats, fatigue, unintended weight loss, loss of appetite, shortness of breath, feeling weak, dizzy or light-headed, and swollen lymph nodes.

Other symptoms possibly related to leukemia or myeloma include:

• Bone and/or joint pain
• Recurring infections
• Blood clotting problems
• Bruising easily or having a bruise that doesn’t go away
• Excessive nosebleeds or bleeding gums
• Small red spots, called petechiae, which results from bleeding under the skin.

In some cases, symptoms might also include feeling cold, headaches, slurred speech, confusion, and becoming full on little food.

How is leukemia diagnosed?

Getting an accurate diagnosis is essential to getting the best treatment. Some types of blood cancer can be difficult to diagnose, but Wilmot has an in-house pathology team with expertise in leukemia and blood disorders to provide a precise diagnosis. The following information also pertains to diagnosis of myeloma:

Medical history and physical examination: This includes a complete medical history and assessment of risk factors and symptoms. A doctor may check for lumps, swollen lymph nodes, examine the skin, and generally assess your health. 

Lab and blood tests: Drawing blood and testing it in the laboratory allows pathologists to view your white blood cell counts, red blood cell counts, platelet counts and other information. Abnormalities as well as too many or too few of a type of cell can point to a leukemia. Usually more testing will be needed at that point to determine the specific type of cancer.  

Bone marrow biopsy/aspiration: Because blood cancer starts in the bone marrow, pathologists often need to examine the marrow. For this procedure, doctors place a needle into the body (usually the pelvis) and extract a small piece of tissue and bone marrow liquid. Pathologists examine the extracted material under a microscope.

Flow cytometry/immunohistochemistry: This type of diagnostic test can classify cells based on proteins they contain, to identify a specific type of leukemia. It’s also referred to as immunophenotyping.

Imaging: This includes x-rays, CT scans, MRI, PET scans, ultrasound, and bone scans.

Lumbar puncture (spinal tap): If doctors suspect cancer may have spread to the brain or fluid around the brain, a lumbar puncture may be needed to see if leukemia cells are present in the spinal cord or brain. 

Cytochemistry: Dyes are used to help identify substances found in cells that could help identify the type of leukemia present.

Molecular testing: These tests can include:

• Cytogenetics, which allows pathologists look at a patient’s chromosomes to determine if any have changed.
• Fluorescent in situ hybridization or FISH, which allows pathologists use fluorescent dyes that only attach to certain genes or chromosomes, allowing them to find chromosome changes that are too small to be seen with a microscope.
• Polymerase chain reaction, a test similar to FISH that can detect even smaller changes in cells.