Myths & Facts About Blood Cancer: Understanding & Fighting Leukemia

Just the thought of blood cancer or leukaemia seems like a veritable death sentence to newly diagnosed patients. A lot of this anxiety comes from ignorance and some of the fear from the way blood cancer is portrayed in social media. The most important weapon in fighting ignorance and fear is awareness and knowledge. Let's understand what exactly the function of blood in the body and how to fight blood cancer.

Blood has three important functions - carrying oxygen to various parts of the body which is accomplished by red blood cells, fighting infections which is accomplished by white blood cells and stopping bleeding which is accomplished by platelets. All the blood in the body is made in the bone marrow where primitive stem cells mature due to various body signals into the required blood components. Whenever there is a malfunction in this signalling process, there might be an unnecessary overproduction of defective blood cells which in other words is called blood cancer. There are many different types of blood cancers including leukaemias, lymphomas and myeloma.

The symptoms of blood cancer vary depending on the exact subtype of blood cancer. For example, there are two main types of leukaemia - acute leukaemia and chronic leukaemia. Acute leukaemia as the name suggests presents more rapidly over a few weeks with non-specific symptoms like persistent fatigue, easy bruising, continuous fevers and high susceptibility to infections. Chronic leukaemia is often an incidental diagnosis, especially in the elderly when a routine health check shows very high WBC counts for no apparent reason. Another type of blood cancer called lymphoma is more common in the younger age group and can present with symptoms like enlargement of the lymph glands in the neck, armpit or groin, unexplained weight loss and loss of appetite over many months. Multiple Myeloma is a type of blood cancer seen more commonly in the sixth decade and beyond. It presents with a classic set of symptoms like anaemia, low back pain and unexplained kidney failure.

Here are some of the common myths about blood cancer -

1) Myth: Blood cancer presents suddenly with no warning and is rapidly fatal. 

The fact is that although symptoms of acute leukaemia can present over the course of a few days or weeks, the accompanying fever and bleeding manifestations are almost always picked up by the doctor at the initial visit and there is very rarely a delay in diagnosis.

2) Myth: Blood cancer is very difficult to diagnose and needs expensive tests.

The fact is that a simple blood test like a complete blood count and peripheral smear can give a definite clue regarding the presence or absence of leukaemia. More complicated tests like a bone marrow study and flow cytometry are often required for the exact sub-typing of the disease but the first clue is always in the complete blood count which is available at almost all centres including in the peripheral areas.

3) Myth: Blood cancer is caused by eating non-vegetarian food.

The fact is that the exact causative agent for blood cancer cannot be pinpointed. While it is known that exposure to high-dose radiation and certain harmful chemicals can increase the risk of developing blood cancer, a direct causality is yet to be found. 

3) Myth - Blood cancer is incurable.

The fact is that blood cancer is amongst the most curable types of cancer. Even certain types of advanced, stage 4 lymphomas can be cured with the use of targeted therapy and immunotherapy.

4) Myth - Blood cancer treatment has a lot of side effects and the body will not be able to tolerate it.

The fact is that medical science has advanced to such an extent that we can find out the exact mutation causing many types of blood cancer. For example - a disease called chronic myeloid leukaemia is caused by a specific chromosomal translocation leading to the mutated Philadelphia chromosome. As a result, we can use targeted therapies in the form of simple daily tablets which turn off the mutation switch and stop the production of the unnecessary, defective WBC. In the era of targeted and immunotherapy, blood cancer treatment has not only become more effective but also has become a lot safer which very few side effects and disruption to quality of life.

5) Myth - Blood cancer treatment is expensive.

The fact is that many reputed Indian companies are now making quality generic monoclonal antibodies which are very effective in treating various types of Non Hodgkins Lymphoma and Multiple Myeloma. They have been around for more than a decade now and the efficacy has stood the test of time.

6) Myth - A bone marrow transplant is a surgical procedure and the donor's life will also be at risk.

Bone marrow transplant (BMT) is a life-saving procedure used for treating high-risk acute leukemia, relapsed lymphomas and multiple myeloma. There are 3 main types of BMT - Autologous BMT  which involves infusing the patient with their own stem cells, Allogenic BMT which involves using the stem cells from a genetically matched donor and Haplo-identical transplant which involves using the half matched cells from the parent or sibling. In all of these procedures, the stem cells from the donor are extracted in the same manner as a routine blood donation with no significant risk to the donors life.

The treatment of blood cancers is often an intensive but a very rewarding process. In fact, pediatric blood cancers have high cure rates and better long-term prognosis and adult blood cancers. Also children have a better bone marrow reserve and have a higher ability to tolerate chemotherapy than adults. This has lead to the development of standardised and intensive pediatric cancer treatment protocols across many centers in the country. The fight against blood cancer has to be fought with many weapons including awareness, myth busting along with the latest targeted and immunotherapy. This fight however is also one of the most rewarding and successful journey for both the blood cancer patient and the treating oncologist.

Dr. N Aditya Murali

Guest Author MBBS, MD (Internal Medicine), DNB (Medical Oncology), DM (Medical Oncology), MRCP (Medical Oncology), Senior Consultant, Apollo Hospitals, Bengaluru