Cll and night sweats

Spotting the difference: Night sweats in leukaemia VS normal night sweats

Sweating is the body’s natural way of cooling down. It happens to everyone throughout the day and most people will also sweat to some degree during the night. The key difference between harmful and harmless night sweats is the quantity of sweat, and the temperature at which they occur. Night sweats caused by illness are more than just breaking a light sweat because you have too many layers of bedding. Instead, they cause you and your bed sheets to become soaked to the extent that you can no longer sleep on them, often when your room is at a comfortably cool temperature.

It is important to visit your GP if:

  • You regularly have night sweats that wake you up at night – You may wake up drenched in sweat, unable to cool down even if your room is cool. Many describe the feeling as if they had just got out of a swimming pool and laid down in bed.

“There were a couple of occasions where I woke up in the middle of the night drenched with sweat, feeling like I was in a sauna.”

  • You have never experienced night sweats before – Night sweats that occur fairly consistently and constantly throughout the night and in small quantities are generally harmless. Unfamiliar night sweats that happen suddenly in hot flashes are more concerning.

“I had a few nights where I would get very bad night sweats – something that has never happened to me before.”

  • You are having severe night sweats but can’t work out why, i.e. you are sleeping in a cool environment.

“My night sweats were transient, I’d end up experiencing a week of night sweats, and then nothing.”

  • You also have a fever, a cough or diarrhoea – Generally, fevers and chesty coughs are caused by infections. If this is the problem, your doctor will be able to prescribe antibiotics. However, be sure to return if symptoms persist. Leukaemia can cause repeated infections by weakening your immune system.

“The night sweats were awful, and I had a temperature and felt like I had the flu a few days before diagnosis.”

  • You are experiencing unexplained weight loss alongside your night sweats – Rapidly dividing leukaemia cells use up energy that your body would otherwise use or store as fat, causing weight loss.

“I also noticed a change in my weight and I lost my appetite.”

  • You are also displaying other symptoms of leukaemia – As well as night sweats, you may be experiencing seemingly unrelated symptoms that when linked together could in fact be an indication of leukaemia. Other symptoms of leukaemia can include fever, bruising, breathlessness, bone pain, abdominal pain or frequent infections.

“I became bed bound with debilitating headaches, bruises, drenching night sweats, fatigue, no appetite, nausea, weight loss, nose bleeds and bone pain.”

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

People with Hodgkin lymphoma may experience the following symptoms or signs. Sometimes, people with Hodgkin lymphoma do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not cancer. Common symptoms or signs caused by Hodgkin lymphoma include:

  • Painless swelling of lymph nodes in the neck, underarm, or groin area that does not go away within a few weeks

  • Unexplained fever that does not go away

  • Unexplained weight loss

  • Night sweats, usually drenching

  • Pruritus, a generalized itching that may be severe

  • Fatigue

  • Pain in the lymph nodes triggered by drinking alcohol

  • Shortness of breath, cough, or chest discomfort may be caused if lymph nodes in the chest are affected

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

Use of symptoms in staging Hodgkin lymphoma

If the diagnosis is Hodgkin lymphoma, the doctor may also use certain symptoms to help describe the disease in a process known as staging. Each stage may be subdivided into “A” and “B” categories.

  • A means that a person has not experienced B symptoms, which are listed below.

  • B means that a person has experienced 1 or more of the following symptoms:

    • Unexplained weight loss of more than 10% of original body weight during the 6 months before diagnosis.

    • Unexplained fever, with temperatures above 100.4°F (38°C).

    • Drenching night sweats. Many people with Hodgkin lymphoma say their nightclothes or the sheets on the bed were so wet they needed to be changed during the night. Sometimes, heavy sweating occurs during the day.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may be called palliative care or supportive care. It is often started soon after diagnosis and continued throughout treatment. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Coping with cancer

Sweating can be a symptom of cancer, or may be due to cancer treatment. It can be very distressing. It can also be embarrassing if you are in a social situation.

There are things you can do to help. And your doctor may be able to prescribe medicines to control it.

Why do we sweat?

Sweating is how our bodies keep cool. We have sweat glands in the skin over most parts of our body. They are in the layer of the skin called the dermis. The nerve cells in the dermis control sweating.

Although we don’t realise it, we are actually constantly sweating. The amount of sweat we make depends on:

  • what we are doing
  • our emotional state
  • the temperature around our body

We sweat more when:

  • it is hot
  • we exercise
  • we are nervous, angry or upset
  • we go through the menopause (women only)
  • we are ill
  • we take medicines that cause sweating

Causes of sweating

When you have cancer, things that may cause sweating include the following:

Infection

Infection is one of the most common causes of sweating in people who have cancer. Infection can give you a high temperature and your body sweats to try and reduce it. Treating the infection can control or stop the sweating.

The cancer itself

Some cancers can cause you to sweat more than usual. These include:

  • non-Hodgkin lymphoma
  • Hodgkin lymphoma
  • carcinoid tumours
  • leukaemia
  • mesothelioma
  • bone cancer
  • liver cancer

People with advanced cancer of any type may also have sweating.

Hormone changes

Changes in hormone levels can cause hot flushes and sweats. Your hormone levels may change because of the cancer itself, or because of treatment such as surgery, chemotherapy, radiotherapy or hormone therapy.

Treatment for breast cancer can put women into an early menopause. For some women, this causes hot flushes and sweats. Women who have already had their menopause can have hot flushes again when they start hormone treatment.

Men can have hot flushes and sweating when they have hormone treatment for prostate cancer or breast cancer, because it reduces the amount of testosterone in the body.

Recent research is helping us to understand why changes in sex hormone levels cause hot flushes and sweats. This is needed in order to find better treatment for these symptoms.

Medicines and cancer drugs

Sweating and hot flushes can be a side effect of some drug treatments, including chemotherapy and morphine.

How Can I Relieve Night Sweats From CLL?

Q1. I have chronic lymphocytic leukemia (CLL) and experience night sweats brought on by my disease. Do you have any tips for relieving these night sweats?

Night sweats are one of the common complications of CLL. Although the exact mechanism by which these occur is unknown, we suspect that the cancer cells release certain hormones, only during sleep, that cause patients to sweat. Because we don’t know exactly why this happens, it is hard to target the symptom with any known medicine.

Finding relief can be a challenge. The obvious method is to treat the CLL directly. However, if the CLL is not very severe and is progressing very slowly, such that you have no life-threatening complications, treatment could potentially be put off for years. Because night sweats in and of themselves are not considered dangerous, they are rarely a reason to initiate treatment for the CLL.

I can offer only basic advice. Leaving a window open or having a fan blowing on you or nearby could help. Wear a thin nighttime shirt or gown that you can easily remove if necessary. Also, make sure that you talk to your doctor about whether you might be experiencing menopause or andropause (the male equivalent), because these two conditions are also associated with hot flashes and night sweats. Talk to women who are going through or have gone through menopause to see what has worked for them — those techniques could also work for you.

Q2. My night sweats at times are severe. When this happens, should I drink an electrolyte solution or would regular water suffice?

Night sweats are a common problem for persons with CLL or lymphoma. However, severe dehydration or electrolyte abnormalities are unusual with night sweats. If you feel dehydrated, either regular water or an electrolyte solution is fine.

Learn more in the Everyday Health Leukemia Center.

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

People with CLL may experience the following symptoms or signs. Most often, people with CLL have no symptoms. Or, the cause of a symptom may be a different medical condition that is not leukemia

Often, people are diagnosed with CLL when the doctor finds many white blood cells during a blood test done for another reason. Also, the immune system of people with CLL may not work well. This means that the body’s immune system sometimes makes abnormal antibodies against their own red blood cells and/or platelets. The antibodies destroy these cells, causing anemia or low numbers of platelets. These type of antibodies are called autoantibodies. People with CLL can develop autoantibodies at any time and this is not necessarily related to the severity of the CLL.

Other possible symptoms of CLL are:

  • Swelling of lymph nodes or glands in the neck, under the arms, or in the groin. This is a common symptom that people with CLL usually notice first. The enlarged lymph nodes are not usually painful.

  • Discomfort or fullness in the upper left part of the abdomen, caused when the spleen increases in size

  • Symptoms often called “B symptoms” that include fever, chills, night sweats, and weight loss

  • Recurrent infections

  • Abnormal bleeding

  • Shortness of breath

  • Fatigue

  • Feeling full despite not eating much

  • Malaise, or generally not feeling well

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

If leukemia is diagnosed, relieving symptoms remains an important part of care and treatment. This may be called palliative care or supportive care. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Andrew Schorr:

Okay. Dr. Ferrajoli, so one of the things on the slide there is what are the symptoms? And I’m going to tick off some. Tell me if I leave off some. So certainly, in the blood count, higher white count, I know I developed lymph nodes on the side of my neck and in my groin, places like that.

Anybody have night sweats? So a few people, night sweats, so that would be another symptom. Fatigue, anybody have fatigue? Pretty common in CLL. And maybe at risk for infection? Did I leave something out?

Dr. Ferrajoli:

Those are the most common ones. And we have to remember that, in a number of people, actually, the diagnosis is done just by chance by doing a blood count, for example, because your work requires it or to get an insurance. The only one that you have left are the most rare occasion that we can have patients that, at the time of the CLL diagnosis, they already have a problem like a severe anemia, because they are destroying their own red cells, or the platelet count can be very low, again, related to CLL. So they can be occasional. But those are rare. In the majority of cases, you covered everything.

Andrew Schorr:

All right. Dr. Munoz, let me ask you this. So the bone marrow is kind of a confined space, and it’s sort of the blood cell factory, right? So we’re making these lymphocytes in there, a lot of them, taking up some space. And they’re not great. So she’s talking about anemia and low red cells and problems with—is that because there’s not room? What’s going on there in this blood factory?

Dr. Munoz:

Suffice it to say, there are many causes of anemia in a patient with CLL. And it could be definitely because the bone marrow, the bad cells, the leukemic cells, are crowding out the normal cells. So that is definitely one of the causes that we see of anemia. There are autoimmune phenomena as well. That would be your body getting confused and attacking your own red blood cells or platelets causing low counts.

There is autoimmune hemolytic anemia. There is idiopathic thrombocytopenic purpura causing low platelets. There is pure red cell aplasia sometimes seen as well. Finally, the spleen can be enlarged sometimes in patients with CLL, and this can cause sequestration. It can highjack some of those red blood cells and platelets, and they could be lower when we test them in the peripheral blood.

Andrew Schorr:

And George is going to tell us later how your spleen has gotten enlarged now. And I know any of you go to the doctor, the doctor pokes around like that, right, trying to feel the spleen. And so that’s what happens, right, Dr. Jain? The spleen kind of sucks these cells in, right?

Dr. Jain:

Right. So for splenomegaly, or enlargement of spleen, is one of the signs and symptoms. And the symptom would be pain in the left upper quadrant, which is right around here. And the symptom for big spleen will be generally patients will say that they cannot eat a large meal.

In medical terms, we call it early satiety. So there patients will be able to eat small meals but not a large, full meal. Right. So when the spleen gets enlarged, it just mops up all of the platelets within the spleen and can also decrease the platelet count of our patients with CLL.

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *