Health Desk- Cancer is a disease in which the cells inside the body start dividing abnormally. Under normal circumstances, healthy cells grow and divide according to the needs of the body, but cells in cancer grow and divide abnormally. With aging, cells die or become damaged and are replaced by healthy cells.

What is blood cancer?
Blood cancer, also known as leukemia, is a type of cancer related to the blood and bone marrow. There are several categories of blood cells, including red blood cells (RBCs), white blood cells (WBCs), and platelets, leukemia is associated with cancer of the WBCs and rarely associated with premature red blood cells and platelets. It can affect a person of any age. There are two types of leukemia – acute and chronic leukemia. In acute leukemia, the condition develops and worsens rapidly, whereas in chronic leukemia, the condition worsens over time. There are different treatment options for leukemia, but depending on the type of leukemia the patient has, the treatment method is decided.
How many types of blood cancer are there?
There are three main types of blood cancer:
1. Leukemia- This type of blood cancer is known for excessive production of white blood cells, which are unable to fight infection. Leukemia can be divided into four categories. Which are as follows:
First: Acute lymphocytic leukemia (this affects the white blood cells of the bone marrow and spreads very rapidly).
Second: Acute myeloid leukemia (it originates in myeloid cells, which are found in white blood cells, red blood cells and platelets. It also spreads very rapidly).
Third: Chronic lymphocytic leukemia (this starts in the lymphocytes located in your bone marrow but spreads slowly).
Fourth: Chronic myeloid leukemia (it affects myeloid cells and develops slowly).
2. Lymphoma- This form of blood cancer affects your lymphatic system. This is a network of nerves located in your lymph nodes, spleen and thymus gland. Lymphoma arises in two types of lymphocytes:
First: B cells (Hodgkin lymphoma)
Second: T cells (non-Hodgkin lymphoma)
This inhibits your immune activities and causes swelling in the lymph nodes.
3. Myeloma- This cancer affects the plasma cells of your bone marrow. These white blood cells are responsible for making antibodies to prevent infection. Myeloma damages your bone, blood and kidney, resulting in diseases like bone pain, weakening/fractures, excess calcium in the blood (hypercalcemia), anemia, bleeding, kidney failure, etc.
What is the cause of blood cancer?
Leukemia develops when the DNA of white blood cells becomes damaged. Cancer cells grow in the bone marrow, which is the normal site of blood production after childhood. This is a result of poor production of healthy blood cells due to the replacement of marrow with cancer cells. These new cells are not only unhealthy, but also abnormal and they live longer than normal cells and have unlimited reproductive potential. These cells live in the bone marrow and prevent healthy blood cells from growing and functioning normally. This results in the presence of more cancer cells than healthy cells in the blood. The exact causes of leukemia are not yet known. Several factors have been identified that can increase the risk of leukemia. This includes:
1. Family history of leukemia.
2. Smoking, which increases the risk of developing acute myeloid leukemia (AML).
3. Genetic disorders like Down syndrome, Fanconi anemia.
4. Blood disorders, such as myelodysplastic syndrome, sometimes called “preleukemia.”
5. Treatment of cancer by chemotherapy or radiation therapy.
6. Exposure to high level of radiation.
7. Being exposed to chemicals like benzene.
8. Obesity.
9. Weak immune system.
What are the symptoms of blood cancer?
Symptoms depend on which blood cell production is affected and which cancer cells are growing too fast.
1. Bleeding-
Platelets play an important role in blood clotting. Platelet production is affected due to marrow replacement. In some, the functions of platelets also change. This can result in easy bruising or bleeding. Small red and purple spots are formed on the body which are called petechiae or unithimosis.
2. Frequent infections-
One of the important functions of white blood cells is to protect the body from infection. At times, when the white blood cells fail to function properly and are insufficient in number, a person can easily get affected by infections. A simple infection in a normal person can become life-threatening in a leukemic patient. They may have fever, chills, redness at the site of infection, cough or any other symptoms depending on which organ is affected.
3. Anemia-
A person may become anemic due to the lack of RBCs. Decreased RBC means that there is a lack of hemoglobin in the blood. Since hemoglobin transports iron around the body, any deficiency in iron can result in the following symptoms:
4. Difficulty in breathing.
5. Pale skin.
6. Feeling tired.
7. Heavy menstruation.
8. Black stool or bleeding during defecation.
9. Fever and profuse sweating at night.
10. Unnecessary weight loss
11. Sometimes the spontaneous breakdown of RBCs in the body may lead to jaundice.
All these symptoms can also be the result of other diseases. Consultation and tests are necessary to confirm whether it is leukemia or not.
12. Bone and joint pain-
This is one of the common symptoms that are mistaken for rheumatoid arthritis. Sharp pain in the bones, joint pain and swelling are commonly seen. It is caused by the rapid multiplication of leukemic cells in the bone marrow.
13. Other symptoms-
Leukemic cell leakage may cause gingivitis, bleeding, painless lymph node swelling, enlarged liver, spleen, headache, seizures, difficulty in breathing, jaundice, etc.
Blood cancer diagnosis-
You need to consult your doctor if you experience the symptoms mentioned above. Your doctor may recommend certain tests to detect blood cancer. Common diagnostic tests that can be done for blood cancer are:
1. Complete blood count test: This blood test gives your doctor detailed information about the amount of a particular type of blood cell in the sample. If the number of blood cells is higher or lower than normal, it could be a sign of blood cancer. In such cases, your doctor may also recommend other tests to confirm cancer.
2. Blood protein test: Blood cells also contain immunoglobulins, which are immune cell proteins and help you fight infection. In the case of myeloma cancer, there is an abnormal production of these cells. Therefore, your doctor may recommend a blood protein test to determine whether you are suffering from blood cancer or not.
3. Biopsy: If the CBC report shows an increase or decrease in the number of blood cells or a blood protein test shows abnormal levels of immunoglobulins, a bone marrow biopsy is done to confirm blood cancer.
Additional tests such as flow cytometry and cytogenetics are also performed to diagnose specific types of blood cancer and related diseases.
What is the treatment for blood cancer?
The treatment of leukemia depends on the age of the person, his health and the type of leukemia the person has. The most preferred treatment for leukemia is chemotherapy. If this treatment is adopted at an early stage, then the chances of a person’s recovery are high.
Following are the types of treatment for leukemia:
1. Chemotherapy-
In chemotherapy, IV drugs are given through a drip. In acute leukemia, a central line is maintained because of repeated checks and injections. These have long term utility and save the patient from being pricked again and again. Although chemotherapy drugs target and kill cancer cells, they also affect other non-cancerous cells, causing serious side effects such as hair loss, weight loss and nausea, decreased blood cell counts. However, these effects are temporary and go away completely. There are different chemotherapy treatments depending on the type of leukemia. In children, 90% of acute lymphoblastic leukemia and 70% of acute myeloid leukemia are cured with therapy alone.
2. Targeted therapy-
In targeted therapy, doctors use drugs to target cancer cells. These drugs target only cancer cells without affecting other cells, thus minimizing potential side effects. Rituximab, imatinib, dasatinib, and nilotinib are some of the drugs used under targeted therapy. One study found that those who received treatment with imatinib had a 5-year survival rate of about 90%.
3. Interferon therapy-
Terferons are a family of naturally occurring proteins produced and secreted by cells of the immune system. Interferons control the immune system’s response to viruses, bacteria, cancer, and other foreign substances that invade the body. This therapy acts as a preventive for the growth of leukemia cells and eventually stops their growth. Though it is helpful in curing leukemia, this therapy has serious side effects.
4. Radiation therapy-
This type of treatment is recommended for adults and some children over age 3 who have acute lymphocytic leukemia (ALL).
Stem cell transplant-
In this procedure, existing bone marrow is destroyed by chemotherapy, radiation therapy, or both. This is done so that new stem cells can be infused to generate non-cancerous cells in the bone marrow. Stem cell transplantation is an effective treatment option for people with high-risk leukemia and those whose leukemia does not respond quickly to chemotherapy. The latter conditions can be fatal if treated by chemotherapy alone.
How to reduce the risk of blood cancer?
As we have said that the exact cause of blood cancer is unknown, so there is no specific way to prevent it. However, you can reduce your risk of cancer by following a healthy lifestyle. Here are some tips to help you reduce your risk:
1. Get into the habit of exercising for at least 30 minutes a day
2. Follow a balanced diet rich in antioxidants and nutrients
3. Stay away from pesticides if possible
4. Avoid excessive exposure to radiation
5. Drink lots of water (at least three liters every day)
6. If you experience any unexplained symptoms related to cancer, discuss them with your doctor and get treated immediately.
When a patient is diagnosed with blood cancer, their outlook towards the disease undergoes a major change. Patients greatly benefit from caring family, friends and relatives who provide emotional, mental, physical and financial support. With advancements in technology, innovations are being developed that create a ray of hope for all cancer patients around the world. Advances in supportive care have made cancer therapy less painful.
Note- This article has been written for educational purposes. If the above-mentioned symptoms appear in the body, do not ignore it, rather seek the advice of a qualified doctor. Thank you.
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