Leukemias are medical conditions associated with abnormal and rapid growth of immature cells in the bone marrow that spills in the blood and spreads to other parts of the body. The early symptoms may mimic any common medical condition . Early diagnosis and treatment is mandatory.
- How does one get blood cancer ? The main controlling power of a multiplying cell is the DNA. Abnormality in the DNA can lead to various medical conditions including Leukemias . Premature forms of blood cells known as blasts get accumulated in the bone marrow of the person. Bone marrow is the factory of our body that produces Red and White blood cells and platelets. Too rapid and erratic production of these cell lines causes Leukemias .
- What are the different types of Leukemias ? There are 4 main types of leukemias.
These are Acute lymphoblastic , Acute myeloid leukaemia. Chronic lymphocytic leukemias and Chronic myeloid leukemias. There are many other subtypes of these. Acute lymphoblastic leukemias typically occurs in young children and carry a good prognosis. Chronic lymphocytic leukemias occur in adults and also carry a better prognosis.
- What are the predisposing causes for leukemias ? The causes are genetic and
environmental .The most common cause is mutation in the DNA. They can occur
due to activation of oncogenes or deactivation of tumour suppressor gene .Exposure to ionising radiation, certain viruses, exposure to benzene , tobacco previous chemotherapy are the main predisposing factors. Different leukemias have different predisposing factors.
- What are the main symptoms ? Prolonged fever, weight loss, reddish spots on the skin known as purpura or severe prolonged body ache , repeated chest infections could be a few presenting symptoms. Bleeding from the nose or abnormal bleeding from other sites could be a predisposing factor. Severe exhaustion with abnormal sweating at night could be a symptom. Leukemias may mimic other medical conditions like arthritis , severe malaria, septicaemia etc. In many it could just be an accidental detection when blood is tested for other purposes. Enlargement of spleen, liver or lymph nodes could be the first symptom.
- How is the diagnosis made ? Examination of blood helps you to make a preliminary diagnosis . In some the blood test may not confirm the diagnosis . Bone marrow biopsy is the mainstay of diagnosis. It may also help you to assess response to treatment .
- How is blood cancer treated ? Different blood cancers have different forms of treatment . In some it could just be a wait and watch policy. In a few aggressive form of treatment is required . Chemotherapy that is anti cancer drug therapy is the mainstay of the treatment . In a selected few additional radiotherapy , biological therapy or bone marrow transplant are required. All of them require periodic blood tests. Additional supportive treatment with blood transfusion , antibiotics , may be required from time to time.
- Is there any hope for the unfortunate sufferers ? That depends on the type of leukemias . Chronic lymphocytic leukaemia for instance has a good prognosis. In children acute lymphoblastic leukemias respond well to treatment . However acute myeloid leukemias have a guarded prognosis . Imatinib is a wonder drug for chronic myeloid leukemia and patients with this leukemia do very well. Proper aggressive chemotherapy , good supportive treatment has improved prognosis in most of the blood cancers in the last decade.
- What are the myths of blood cancers ? The disease is thought to be contagious which is not true. The disease spreads due to physical contact which is untrue as well. There are no herbal medicines or naturopathy to cure leukaemia and this is true. Chemotherapy is very dangerous and is associated with severe side effects is again to the contrary. If appropriate precautions are taken by the patient and the family most of the regimens are well tolerated by the patients and this is a fact.
- What is the role of family members, friends and society ? Be calm and do not get depressed or very anxious . Take all proper precautions to avoid or transmit infection to the patient. Always cheer up the patient and his immediate family. Maintain a dignified and happy atmosphere whenever you visit such patients. Do not express your grief or emotions . Be positive and encourage the patient.
Blood cancers or leukemias are seen in large numbers in the population as compared to the last few decades . The overall outlook and prognosis has changed for the better due to better chemotherapy . Inevitably a better life style may help to reduce the incidence in selected leukemias. Though very few leukemias can be cured, many patients do well with newer chemotherapy and advanced forms of treatment.
Author: Dr Jay Deshmukh
Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.