Blood Cancer

What is Blood Cancer?

Blood cancer is a cancer type that impacts your blood cells. Lymphoma, leukemia, and myeloma are all key types of blood cancer.

This cancer type impacts both the production and functioning of blood cells. It usually initiates in the bone marrow, the primary blood cell production source.

The disease causes changes in the DNA of the healthy blood cells, causing the cells to behave abnormally. An abnormal process of blood cell development hinders the normal process of blood cell development. Such abnormally produced blood or cancerous cells prevent the functioning of the normal ones. The normal functioning of the healthy blood cells, such as avoiding severe bleeding and fighting off infections, is severely interrupted.

Globally, blood cancer is attributed as the fifth most common cancer type, affecting around 1.3 million new blood cancer cases diagnosed globally in 2020. Doctors currently believe that there are around at least 100 blood cancer types existing today. Some types develop quickly, while others develop over the course of time. Each has its own challenges, treatment outlook, and recovery.

Early detection of blood cancer symptoms significantly facilitates more effective and less invasive options to treat cancer progression. It potentially leads to better remission chances and improves the quality of a patient’s life. Early detection contributes to improved treatment outcomes, a better prognosis, reduced treatment cost, enhanced life quality, minimal complications, and increased survival rates.

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Detailed Development and Progression of Blood Cancer

Blood cancer arises from a combination of genetic changes, environmental exposures, and lifestyle influences. Grasping how this disease evolves is essential for timely diagnosis and personalized care.

How Blood Cancer Develops

Individuals generally suffer from blood cancer when their healthy blood cells undergo mutations. These mutations occur in the cell’s DNA or genetic material, which contains instructions for the cell to perform its routine functions.

Under normal conditions, the DNA regulates the cell to grow at a defined rate and die at a specified time. DNA instructs the cell to grow and divide abnormally in blood cancers. With this mutation in place, the individual suffers from an uncontrolled production of blood cells.

Over time, these cells can kick off the healthy cells in the bone marrow. As a result, the individual will have fewer healthy cells to fight off the infections.

Stages of Blood Cancer

The staging of blood cancers differs from solid tumors and doesn’t follow the typical TNM (Tumor, Node, Metastasis) system used for most cancers.

Blood cancers, particularly leukemias and lymphomas, have specific staging systems tailored to their characteristics. Here’s a more accurate representation of blood cancer staging:

Lymphomas (e.g., Hodgkin and Non-Hodgkin Lymphoma)

Lymphomas often use the Ann Arbor staging system:

• Stage I: Cancer is found in a single region of lymph nodes or a single organ.
• Stage II: Cancer is found in two or more lymph node regions on the same side of the diaphragm, or the cancer has spread from one lymph node region to a nearby organ.
• Stage III: Cancer is found in lymph node regions or organs on both sides of the diaphragm.
• Stage IV: Cancer has spread throughout one or more organs outside the lymph system.

Additional modifiers:

• A: No B symptoms present
• B: Presence of B symptoms (fever, night sweats, weight loss)

Chronic Lymphocytic Leukemia (CLL)

CLL often uses the Rai staging system:

• Stage 0: Increased lymphocyte count in blood and bone marrow.
• Stage I: Lymphocyte increase plus enlarged lymph nodes.
• Stage II: Lymphocyte increase plus enlarged liver or spleen (with or without enlarged lymph nodes).
• Stage III: Lymphocyte increase plus anemia (with or without enlarged organs).
• Stage IV: Lymphocyte increase plus low platelet count (with or without anemia or enlarged organs).

Acute Leukemias

Acute leukemias (like AML and ALL) are not staged but are classified based on cellular characteristics and genetic markers. The specific staging and classification depend on the type of blood cancer, and treatment decisions are based on a combination of staging, genetic markers, and individual patient factors

Structural Impact on the Blood Cell

• The normal process of blood cell formation is severely disrupted in this process.
• Individuals’ bodies show abnormal blood cell production, resulting in leukemia, myeloma, or lymphoma.
• These cancerous blood cells grow and divide uncontrollably, outnumbering the counts of an individual’s healthy blood cells.

Functional Impact on the Blood Cell

The abnormally developed white blood cells do not function appropriately, resulting in the following:

• Anemia: A decrease in the total counts of blood cells triggers health concerns related to fatigue and breath shortness.
• Reduced Immune Functioning: Abnormally developed white blood cells fail to fight off infections. As a result, the affected individual has a higher chance of developing severe infections.
• Bleeding and Bruising: A platelet deficiency is responsible for blood clotting issues, which results in excessive bleeding and bruising.
• Genetic Mutations: Often, blood cancers are considered genetically mutated disorders. They may be passed on to the next generations.

Types of Blood Cancer

There are five critical types of blood cancer such as lymphoma, leukemia, myeloma, myelodysplastic syndrome, and MPNs. There are further subdivisions classified according to the specific type of cells they impact:

1. Leukemia

Leukemia is a blood and bone marrow cancer that produces abnormal blood cells. This type of cancer particularly impacts your white blood cells. As white blood cells help fight infection, leukemia hinders this body the body’s defence mechanism with several subtypes:

• Acute Lymphoblastic Leukemia
• Acute Myeloid Leukemia
• Chronic Lymphocytic Leukemia
• Chronic Myeloid Leukemia
• Hairy Cell Leukemia
• Chronic Myelomonocytic Leukemia
• Juvenile Myelomonocytic Leukemia
• Large Granular Lymphocytic
• Blastic Plasmacytoid Dendritic Cell Neoplasm
• B-cell Prolymphocytic Leukemia
• T-cell Prolymphocytic Leukemia

2. Lymphoma

Lymphoma is a blood cancer type impacting the individual’s lymphatic system. The lymphatic system is a crucial part of your immune system that supports your body in fighting infections and other associated diseases. Unlike leukemia, this type of cancer impacts your lymphatic system directly, including the spleen, lymph nodes, and lymphoid tissues. There are various kinds:

• Non-Hodgkin Lymphoma
• Hodgkin Lymphoma
• Waldenstrom Macroglobulinemia

3. Multiple Myeloma

Multiple myeloma is a blood cancer type affecting your plasma cells. These are your white blood cell types for producing antibodies that help humans fight off external pathogens. In this cancer, abnormal plasma cells start accumulating in an individual’s bone marrow. This accumulation contributes to several complications, such as anemia, bone marrow, and kidney problems.

4. Myeloproliferative Neoplasms (MPNs)

MPN is a rare blood cancer type where the spongy tissue of your bone marrow produces abnormal counts of blood cells. The symptoms of this blood cancer type vary significantly, resulting in several complications such as bleeding issues, blood clots, and increased risks of conditions such as fibrosis. There are three key subtypes:

• Essential Thrombocythemia
• Myelofibrosis
• Polycythemia Vera

5. Myelodysplastic Syndrome (MDS)

MDS is a blood cancer type formed by dysfunctional blood cells. It results from the individual’s bone marrow’s inability to produce sufficient quantities of healthy cells. This abnormality results in complications such as frequent infections, severe anemia, and bleeding issues.

Causes and Risk Factors

DNA mutations in healthy blood cells usually trigger blood cancers. They are associated with several risk factors, including age, personal or family medical history, prolonged exposure to chemicals and radiation, certain genetic disorders, and earlier cancer exposures.

This medical condition results from mutations within healthy cells, resulting in abnormal cell behaviour. In most cases, the exact reasons for this transition are unknown and may be associated with several factors that may even be beyond the individual’s control.

Risk Factors

Several risk factors are associated with the development and progression of blood cancers, including:

• Age: The chances of developing blood cancers increase with age.
• Family History: A family history of blood cancer is suggestive of a genetic disposition.
• Exposure to Chemicals or Radiations: Prolonged exposure to certain chemicals, such as benzene, increases the risk.
• Previous Cancer Exposures: Individuals who have been earlier subjected to radiation or chemotherapy are at high risk for blood cancer development.
• Genetic Disorders: Individuals with other medical conditions, such as Down’s syndrome, are at an increased risk.
• Smoking: Smoke addiction is associated with the development of certain blood cancer types.
• Weakened Immunity: A weak-immune individual is often at high risk of blood cancer.
• Certain Viral Infections: Individuals dealing with viral infections, such as the Epstein-Barr virus, are at increased risk.

Symptoms of Blood Cancer

There are many indicators of blood cancers. The symptoms of blood cancer vary widely according to the type and stage of the progression of the disease. Some of the key symptoms are:

• Long-lasting fatigue
• Persistent fever or chills
• Weaknesses
• Unexplained weight loss
• Bone or joint pain
• Night sweats
• Swelling
• Abnormal discomfort
• Breath shortness
• Frequent infections
• Swollen lymph nodes
• Unexplained bruising
• Itchy skin
• Rash

Early Symptoms

In the early stages of blood cancer, you may witness symptoms such as unexplained weight loss, persistent fatigue, frequent infections, bleeding, and easy bruising.

Advanced Symptoms

Swollen lymph nodes, bone or joint pain, breath shortness, rash, weakness, and frequent infections are advanced symptoms of blood cancers.

Brief Histopathology of Blood Cancer

The histopathology of blood cancer involves microscopic examinations to understand its abnormalities, morphological characteristics, and immunophenotyping. These microscopic assessments are important for diagnosing and classifying types.

• Cellular Characteristics: Blood cancers often present with an increased number of abnormal white blood cells that impair normal blood function, leading to symptoms such as anemia, increased infection risk, and bleeding disorders.
• Tissue Architecture: In lymphomas, for example, histopathological examination reveals disrupted architecture due to malignant cell infiltration in lymphoid tissues.

Histopathology Techniques

• Morphological Analysis: Includes examining blood cell types’ size, shape, and characteristics.
• Immunophenotyping: Includes assessing the cell surface markers to identify different cell populations.
• Cytogenetics: Includes studying genetic material and chromosomes of blood cells to determine their chromosomal abnormalities.
• Biopsy: Microscopic evaluations of lymph nodes and bone marrow samples.

Diagnosis of Blood Cancer

Diagnosing blood cancer types involves a series of tests and is not limited to just the complete blood counts or CBCs, biopsies of bone marrows, imaging tests such as MRI/CT/PETm, and potentially a lumbar puncture test or spinal tap.

A. Initial Assessment

Your doctor conducts the initial assessment through a physical examination and evaluation of your medical and family history.

B. Blood Tests

Once your doctor understands your symptoms, he advises you to go for specific blood tests like a complete blood count, or CBC, to measure the total number of your blood cells.

• Blood Chemistry Tests: These tests help assess the presence of chemicals and other substances in your blood.
• Peripheral Blood Smear Tests: This test involves a microscopic evaluation of your blood smear to identify abnormalities.
• Flow Cytometry: This test identifies the abnormalities in your blood cells with the help of fluorescent markers.
• Coagulation Tests: This test assesses the ability of your blood cells to form clots.

C. Bone Marrow Tests

The next stage of diagnosing your blood cancer is undergoing bone marrow tests like:

Bone Marrow Aspiration and Biopsy: This test assesses a sample of the bone marrow of your hip bone.

D. Imaging Tests

Your doctor may then subject you to several imaging tests, such as CT scans, MRI scans, PET scans, and X-rays.

E. Other Tests

Sometimes, you may even be asked to undergo additional tests such as a lumbar puncture, spinal tap test, and lymph node biopsy.

Staging and Grading

• Once your blood cancer presence is confirmed, it will be further staged on the basis of its size, type, location and extent of spread.
• It is a key for your doctor to determine your line of therapy and interpret the outlook.

Prognosis and Survival Rates

The prognosis of blood cancer varies significantly on the type, stage, individual’s response to treatment and overall lifestyle.

Overall Survival Rate

The five-year survival rate for blood cancer patients is approximately 70%.

Survival Rates by Blood Cancer Type

• Leukemia: The five-year survival rate varies by subtype:
  • Acute Lymphoblastic Leukemia (ALL): 72%
  • Chronic Lymphocytic Leukemia (CLL): 88.5%
  • Chronic Myeloid Leukemia (CML): 70%
  • Acute Myeloid Leukemia (AML): 31.9%

• Lymphoma:
  • Hodgkin Lymphoma (HL): The five-year relative survival rate has increased to 88.9%.
  • Non-Hodgkin Lymphoma (NHL): The five-year relative survival rate is 74.3%.
• Multiple Myeloma: The five-year relative survival rate is 59.8%.

Most of the survivors live happily ever after, while others may still face long-standing impacts of the several treatments they undergo.

Recognizing Symptoms, Treatment Pathways, and Recovery

Whenever you experience persistent symptoms listed in this blog, seek immediate attention from your family doctor. He is the right person to guide you with a qualified haematologist-oncologist to diagnose and treat you further.

Treatment of blood cancer often depends on cancer type, stage, location, and patient health. Options include:

1. Chemotherapy: This includes the use of chemotherapeutic drugs to kill cancerous cells.
2. Targeted Therapies: Includes blocking abnormalities noticed in the impacted cells.
3. Radiation Therapies: Includes the use of high-energy beams for damaging cancerous cells.
4. Stem Cell Transplants: This includes replacing damaged cells with healthy cells.
5. Other Treatments: Includes surgeries to remove lymph nodes, hormone therapies, and supportive therapies such as blood transfusions.

Recovery from any blood cancer type may take time and effort. Prioritize adopting a better lifestyle by including a nutritious diet and exercise in your routine.

Living with Blood Cancer

It could indeed be a complex and daunting journey for individuals to live with blood cancer. However, you can live fulfilling lives with the proper support from your doctor, family, peers, and support groups. With advances in medical technologies, the survival rates of individuals effectively dealing with blood cancers have significantly increased. Navigating your emotional turmoils effectively while managing your physical symptoms is the key to a healthy and sustained life.

Key Takeaways

• Symptoms such as shortness of breath, fatigue, night sweats, and unexplained weight loss should not be avoided.
• Genetic mutation of the DNA of the blood cell is the primary cause of blood cancer.
• Treatment options are highly individual-specific and require immediate medical support for supportive therapies such as radiation, chemotherapy, immunotherapy, and targeted therapy.
• Recovering from blood cancer post-treatment is possible with an adapted lifestyle, healthy nutrition, physical activity, and complete rehabilitation.

Need Expert Care for Blood Cancer?

It is wise to consult an experienced healthcare provider today for an accurate prognosis and treatment. Early detection and the initiation of treatment plans help to save lives. Schedule an appointment today with a qualified healthcare professional in your town.