Tiredness that a good night’s sleep does not fix. A niggling ache in the back or ribs. A third chest infection in one winter. A bruise on your forearm you cannot account for. Taken one at a time, none of these is alarming after 50, and the great majority of the time there is an ordinary explanation. But blood cancers, the family of conditions that includes myeloma, lymphoma and leukaemia, have a habit of announcing themselves through exactly these quiet, easily dismissed symptoms.
They are also strongly age-related. Most people diagnosed with myeloma or chronic lymphocytic leukaemia in Ireland are in their late 60s or older, and risk climbs steadily from midlife onwards. Unlike breast, bowel and cervical cancer, there is no national screening programme for blood cancers, in Ireland or anywhere else. That means diagnosis almost always starts with someone noticing that something is not right and mentioning it to their GP.
TL;DR
- Blood cancers cover three broad families: leukaemias (bone marrow and blood), lymphomas (lymphatic system) and myeloma (plasma cells). Risk rises sharply after 50.
- There is no screening programme for blood cancers, so early diagnosis depends on symptoms being raised with a GP rather than picked up automatically.
- Warning signs worth a GP appointment: a painless lump lasting more than three weeks, drenching night sweats, unexplained weight loss, persistent bone pain, repeated infections, unusual bruising or bleeding, and persistent breathlessness or pallor.
- Diagnosis usually begins with a simple full blood count, followed if needed by a blood film, protein tests and a referral to haematology.
- Many blood cancers are now managed as long-term conditions, and some slow-growing ones are actively monitored rather than treated straight away.
What “blood cancer” actually means
It is an umbrella term rather than a single disease, which is part of why it is poorly understood. Leukaemias start in the bone marrow, where blood cells are made, and crowd out healthy cells. Lymphomas begin in the lymphatic system, the network of glands and vessels that carries immune cells around the body. Myeloma affects plasma cells, a type of white blood cell that lives in the bone marrow and produces antibodies.
Within each family there are fast-moving (acute) and slow-moving (chronic or indolent) forms, and the difference matters enormously. Acute leukaemia is a medical emergency treated within days. Chronic lymphocytic leukaemia, by contrast, is often discovered by accident on a routine blood test and may never need treatment at all.
Why age is the biggest risk factor
Bone marrow accumulates genetic changes over a lifetime, in the same way skin accumulates sun damage. Most are harmless, but occasionally one gives a single cell line a survival advantage that expands over years or decades. Add the gradual shift in immune function that comes with age, sometimes called immunosenescence, and you have the reason blood cancers cluster in the second half of life.
This is also why a condition called MGUS (monoclonal gammopathy of undetermined significance) matters. MGUS is a harmless-looking abnormal protein found in the blood, and it becomes more common with age. Most people who have it never develop myeloma, but roughly one in a hundred progresses each year, which is why people with MGUS are put on periodic monitoring rather than treatment. If your GP has ever mentioned “a protein we keep an eye on”, this is usually what they mean.
Myeloma: the one mistaken for wear and tear
Myeloma is the blood cancer most often diagnosed late, because its symptoms look exactly like ordinary ageing. The classic combination is bone pain (commonly in the back or ribs), anaemia causing fatigue and breathlessness, recurrent infections, and reduced kidney function found on a routine blood test.
The detail that should prompt a conversation is bone pain that does not behave like a mechanical back problem: pain that is present at rest, wakes you at night, or does not settle with the usual few weeks of movement and physiotherapy. A fracture from a minor knock is another signal, particularly in someone not known to have osteoporosis.
Lymphoma: lumps, sweats and weight
The most recognisable sign is a swollen lymph node in the neck, armpit or groin that is painless and does not go away. Glands swell during infections all the time, so the practical rule is duration: a lump that persists beyond three weeks without an obvious cause deserves a GP appointment.
Alongside that, clinicians look for what are known as B symptoms: drenching night sweats that soak nightclothes or bedding, unexplained fever, and weight loss of more than a tenth of body weight over six months without dieting. Persistent itching with no rash is another one people rarely think to report.
What happens when you raise it with your GP
The starting point is usually a full blood count, one of the most informative and least dramatic tests in medicine. It can show anaemia, abnormal white cell numbers or low platelets. Depending on the picture, your GP may add inflammatory markers, kidney and calcium tests, a blood film, or the protein tests (electrophoresis and serum free light chains) used to look for myeloma.
Where results raise concern, the next step is referral to a haematology service, which may involve a lymph node biopsy or a bone marrow biopsy to confirm the diagnosis and type. It is worth knowing that Ireland’s rapid access clinic model covers lung, breast and prostate cancer, but there is no equivalent single front door for blood cancers. Referral runs through the usual GP-to-consultant route, which is another reason not to sit on symptoms for months.
Practical preparation helps. Write down when the symptom started, how it has changed, and anything that makes it better or worse. Say plainly that you are worried, and ask directly: “Would a blood test be reasonable here?” If you are on the Chronic Disease Management Programme for another condition, routine bloods may already be part of your regular care.
If you are diagnosed
Treatment for blood cancers has changed substantially over the past decade, with targeted therapies and immunotherapies now standard for several conditions that once had far blunter options. Many people live with a blood cancer for years as a managed long-term condition. For slow-growing lymphomas and chronic leukaemias, active monitoring (sometimes called watch and wait) is a legitimate treatment plan rather than neglect, though it takes some getting used to.
Vaccination becomes more important, because both the disease and its treatment can weaken immune defences. Ask your team about flu, COVID-19, pneumococcal and shingles vaccines, and about what to do if you develop a fever while on treatment.
For support, the Irish Cancer Society Support Line (1800 200 700) is staffed by cancer nurses, and Daffodil Centres in many hospitals offer face-to-face information. Multiple Myeloma Ireland runs peer support for people with myeloma and their families, and Cancer Trials Ireland can tell you what clinical trials are open here.
Keeping this in proportion
The point of knowing the warning signs is not to spend your 60s auditing every bruise. Most fatigue is not myeloma, and most swollen glands are a virus. The genuinely useful habit is simpler: when something persists past a few weeks, changes character, or arrives in combination with other odd symptoms, book the appointment rather than filing it under getting older. Blood cancers reward early attention, and a full blood count is a small ask.
At Críonna Health we keep coming back to the same principle: ageing well is largely about noticing changes early and knowing which door to knock on. This is one of the clearer examples.
This article is for general information and is not a substitute for individual medical advice. If you have symptoms that concern you, contact your GP.
📷 Photo by Vitaly Gariev on Unsplash
