Blood cancer

Several factors can elevate the likelihood of developing blood cancer. These include:

Family History

• Individuals with a close family member who has been diagnosed with leukemia have a higher risk of developing the disease themselves.

Smoking

• Smoking tobacco products, including cigarettes, is a known risk factor for leukemia. Approximately 20% of acute myeloid leukemia (AML) cases are associated with smoking.

Chemotherapy and Radiation

• Previous chemotherapy or radiation treatments for cancers such as breast, ovarian, or Hodgkin's lymphoma can increase the risk of developing leukemia later in life.

Genetic Syndromes

• Genetic conditions such as Down's syndrome, Fanconi’s anemia, and Li-Fraumeni syndrome are linked to a higher risk of leukemia due to inherited genetic abnormalities.

Viral Infections

• Infections from viruses like Epstein-Barr virus (EBV) and human T-cell leukemia virus (HTLV) can raise the likelihood of leukemia.

Exposure to Carcinogens

• Chemicals like benzene are recognized carcinogens that can heighten the risk of leukemia.

To diagnose blood cancer and determine its specific subtype, a doctor will perform a detailed physical examination and review the patient's medical history, in addition to various diagnostic tests:

Physical Examination

• The doctor will look for signs such as pale skin (indicative of anemia), swollen lymph nodes, and an enlarged liver or spleen, which may suggest blood cancer.

Laboratory Tests

• Flow Cytometry: This test detects antigens on or inside cells, helping identify the type of blood cancer, monitor disease recurrence, and assess treatment effectiveness.
• Cytochemistry: This test helps identify different types of acute blood cancers by using special stains to detect specific characteristics of cells.
• Complete Blood Count (CBC): This test measures the quantities and appearance of blood cells, providing important information for diagnosis.
• Peripheral Smear Examination: A more detailed assessment of blood cells to detect abnormal cells.
• Additional tests, such as coagulation profiles and kidney and liver function tests, may be conducted to evaluate overall health.

Bone Marrow Studies and Biopsy

• Bone Marrow Biopsy: A needle is used to remove a sample of bone marrow tissue to check for cancerous cells.
• Bone Marrow Aspiration: A fine needle draws a sample of the liquid part of the bone marrow to test for abnormal or cancerous cells.
• Lymph Node FNAC & Biopsy: Used to examine lumps or lesions detected either manually or through scans, helping to identify cancer spread.

Imaging Studies

• PET CT Scan (Whole Body): This scan checks for signs of blood cancer throughout the body.
• CT Scan: In addition to detecting cancer, CT scans are important for planning treatments such as bone marrow transplants.
• Depending on symptoms, a chest X-ray or MRI scan may also be ordered to detect leukemia-related complications.

Lumbar Puncture

• A lumbar puncture (spinal tap) may be performed to check if the cancer has spread to the spinal fluid surrounding the brain and spinal cord.

Reducing exposure to known risk factors, such as carcinogens like benzene, smoking, and radiation, can help lower the chances of developing blood cancer.

Specialists to Consult

Diagnosing and treating blood cancer requires a multidisciplinary approach. The following specialists are essential for managing the condition:

• Hematologist: A medical professional who specializes in diagnosing and treating blood disorders, including blood cancers.
• Hemato-oncologist: A specialist in both blood disorders and blood-related cancers.
• Medical Oncologist: An expert in managing cancer treatment, including chemotherapy, immunotherapy, and targeted therapies.
• Pediatric Oncologist: A specialist who focuses on treating cancers in children, such as leukemia and other blood cancers.
• Bone Marrow Transplant Specialist: A doctor who performs transplants to replace damaged or diseased bone marrow with healthy stem cells.

The treatment for blood cancer depends on the specific type of cancer and the patient’s overall health. Common treatment approaches include:

Chemotherapy

Chemotherapy treatment durations can vary, ranging from six months to potentially indefinite, depending on the prescribed regimen. Common drugs used in chemotherapy include:

• Vincristine
• Daunorubicin
• Cytarabine
• Mercaptopurine
• Ifosfamide

Targeted Therapy

Targeted therapy involves using drugs that specifically target cancer cells. These drugs generally do not affect normal, dividing cells in the body. Examples include:

• Monoclonal antibodies such as Inotuzumab, Gemtuzumab, Rituximab, Ofatumumab, Obinutuzumab, and Alemtuzumab
• Tyrosine kinase inhibitors such as Imatinib mesylate, Dasatinib, Nilotinib, Ponatinib, Ruxolitinib, and Fedratinib

Immunotherapy

Immunotherapy boosts the body’s immune system to fight cancer cells. It uses substances that stimulate the immune system to attack cancer cells. Examples of immunotherapy drugs include:

• Pembrolizumab
• Atezolizumab

Radiation Therapy

Radiation therapy uses high-energy rays, similar to X-rays, to destroy cancer cells or stop them from growing. This method targets specific areas affected by cancer, such as lymph nodes or leukemia cells, and can also be used in conjunction with chemotherapy or surgery. Radiation therapy may be applied to the entire body during a stem cell transplant.

Stem Cell Transplant

Also known as hematopoietic stem cell or bone marrow transplant, this procedure replaces damaged or cancerous blood-forming cells with healthy ones. These cells may be harvested from the patient (before chemotherapy or radiation) or from a donor’s blood or bone marrow. The transplanted cells grow and generate new bone marrow and blood cells, including red blood cells, white blood cells, and platelets.

Supportive Care

Supportive care helps manage side effects of treatment, boost blood cell production, and prevent infections. Medications such as antiemetics (ondansetron, palonosetron) help manage nausea and vomiting, while recombinant human erythropoietin preparations support red blood cell production. Antibiotics and antiviral medications are used to prevent infections.

Chimeric Antigen Receptor (CAR) T-cell Treatment

This innovative therapy involves harvesting the patient’s own T-lymphocytes, genetically modifying them in a lab to fight leukemia cells, and then reintroducing them into the patient’s body.

In the advanced stages, a blood cancer patient may experience prolonged periods of sleep, a significant loss of appetite, severe muscle wasting, and a weak heartbeat.

Additional complications that may arise include:

• Recurrent Infections: Patients may suffer from frequent and serious bacterial or fungal infections.
• Tumor Lysis Syndrome: A side effect of chemotherapy, where the rapid death of tumor cells leads to high levels of metabolites in the bloodstream, which can damage the kidneys.
• Disseminated Intravascular Coagulation: This condition causes abnormal blood clotting, leading to either thrombosis or bleeding.
• Increased Risk of Other Cancers: Leukemia survivors are more likely to develop other forms of cancer later in life.

Alternative therapies can offer symptomatic relief for individuals with blood cancer. However, these should not replace conventional medical treatments. Always consult with your healthcare provider before trying new treatments.

Yoga and Exercise

• Engaging in yoga and regular exercise can help increase energy levels and alleviate fatigue. Breathing exercises can promote relaxation and induce a positive mindset to cope with the diagnosis.

Massage Therapy

• Massage techniques, including foot and body massages, can provide relaxation and ease some symptoms associated with treatment.

Aromatherapy

• Using specific scents, aromatherapy helps promote mental and physical relaxation, creating a sense of calm and well-being.

Acupressure and Acupuncture

• These methods can help relieve pain, reduce fatigue, and improve other symptoms of blood cancer.

Meditation

• Practices like focused breathing and positive imagery can reduce stress and anxiety. Meditation can strengthen mental resilience and empower individuals to face the challenges posed by the disease.

People with blood cancer often face chronic fatigue, a high risk of infections, and the side effects of chemotherapy. Here are some steps to provide care for yourself or a loved one:

Eat Nutritious Meals

• Ensure a balanced diet by consuming fresh home-cooked meals and drinking plenty of water or energy drinks.

Try Home Remedies

• To ease nausea and vomiting caused by chemotherapy, consider using peppermint lozenges or other soothing remedies alongside prescribed medications.

Prevent Infections

• Practice good hygiene, avoid crowded or unhygienic areas, and wear a surgical mask when visiting the hospital to reduce the risk of infections.

Stay Active

• Engaging in light physical activity can help combat chronic fatigue and improve overall well-being during treatment.

With advancements in treatment, many people with blood cancer live long and healthy lives, though the emotional journey can be tough. Here are some helpful strategies to manage the experience:

Learn About Your Diagnosis

• Don’t hesitate to ask your healthcare team for clarification on anything you don’t understand. It’s important to ask your doctor rather than rely on internet searches or others’ opinions.

Join a Support Group

• Support groups provide an environment for sharing experiences and coping strategies, helping patients stay positive and inspired by others facing similar challenges.

Take Care of Your Mental and Emotional Health

• Communicate openly with family and friends about your feelings. Get all the necessary information about your treatment, be aware of your physical limits, and resolve practical matters like childcare or work issues.

Monitor Treatment Costs

• The financial burden of cancer treatment can be overwhelming. Look into benefits or grants from social workers who can assist with the process of claiming financial support.

Prioritize Sleep

• Although sleep may be difficult during treatment, it’s important for both physical and mental well-being. Lack of sleep can exacerbate anxiety and depression, so make sleep a priority.