Stick a RED ribbon! It’s time for RED-athon!
Blood is often called the lifeline of our body. And for good reason. This fascinating red fluid performs more functions in our body than we know about. Apart from serving each and every cell of our body with oxygen and fuel (glucose), it is also home to cells that protect our body from invasions (immune system) and serves as a means for transmitting messages between different organs (hormones).
An average human being contains about 5 litres of blood. Our blood contains different types of cells and other important compounds that help it perform all of its varied functions. With the help of these components, it works round the clock, circulating oxygen and nutrients to cells and removing waste, protecting us from infections and bleeding and maintaining the water balance in our body.
Blood, like any other organ in our body, is also prone to cancer. In this excellently controlled and well-oiled machine that is the human body, cancer is an aberration. Cancer is an uncontrolled division of cells. It happens when a normal cell loses control over its life cycle and keeps on dividing even when there really is no need.
Blood cancer can affect any of the different types of cells present in the blood. It is a broad term that encompasses three basic types of blood cancers, classified on the type of blood cell affected- Leukaemia, Lymphoma and Myeloma. While some types of blood cancers (acute lymphocytic leukemias) are common in children the others affecting the bone marrow (acute myelogenous leukemia) are commonly diagnosed in adults. Caucasians happen to be more prone to this cancer, compared to other populations, with an inclination towards the male sex. It has been estimated that in 2017, 62,130 new cases of blood cancer and 24,500 deaths are likely to occur. 
What Causes Blood Cancer?
Technological progress has made the circulation of information easy. Every now and then, various reports relating to cancer research, establishing a link between things we use or are exposed to in our daily lives and cancer crops up. Being one of the most dreaded diseases, such pieces of information is bound to cause a surge of emotions and questions. How much of this is relevant to me? Should I be concerned about my family? Does ‘this’ cause cancer? All these questions, though relevant, are very difficult to answer.
Cancer research is very complex and takes months, or even years to establish a definite link between a potential carcinogen (factor that can cause cancer) and cancer. Also, it is not possible for us to stop using certain things as they are a part of our lifestyle.
As is true with cancer, the exact cause is still unknown. However, there are a few risk factors associated with it and experts have broadly classified them into the following:
- Habits: Tobacco- chewing and smoking
- Diet and Physical activity
- Infections- viral and others
- Exposure to radiations
- Family history
In the case of blood cancer, one or more than the above enlisted carcinogens may play a role, but whether the cancer is caused due to the carcinogen cannot be ascertained. Along with the probable carcinogen, factors such as ethnicity, age and sex also play a role in determining whether you will get cancer. Various specialists have reported that taking certain measures in your daily activities can lower the risk of blood cancer considerably. These include reduced exposures to radiation or chemicals (occupational hazard: appropriate safety measures to be taken), avoiding tobacco habits, eating a balanced diet of rich, fresh greens and reducing fats, starch, meat/ fish intake and of course, a good, exhaustive exercise regimen.
Common Myths Associated With Blood Cancer
Blood cancer, or any cancer for that matter, is still a confounding disease and looked at with apprehension that results from misinformation. While there are countless myths that attempt to address the causes behind this mysterious disease, let’s look at a few of them.
- Cancer is genetic and there’s nothing much a person can do: This is certainly not true. Even with risk factors like smoking, there isn’t a surety that the smoker will get cancer. Or even if you have a genetic variation, like on the BRCA1 gene, it does not mean for certain that you will get cancer. As the saying goes, “Genes are the bullets; the environment is the gun that fires them.” So if you practice a healthy lifestyle, your genetic risks are certainly reduced to a great extent.
- Taking vitamins and supplements will lower one’s cancer risk: While this statement has been promoted and marketed like crazy, there is no scientific evidence that it decreases one’s risk of cancer risk. In fact, in some cases, taking higher doses increases the risk. It is better to eat whole foods rather than rely on artificial vitamins and “health supplements.”
- Anemia causes blood cancer: Certainly not true. Anemia is a condition where the number of red blood cells are less. While this condition has its own set of problems, causing blood cancer is certainly not one of them.
- Blood cancer is incurable: Not true. Every single day brings something positive in our long battle against cancer. With countless labs engaged in cutting edge research, we now have in our arsenal effective and targeted therapeutic agents using which we can beat cancer. What is required is information to understand how this disease happens, what symptoms act as “warning signals” and when to consult a doctor. The sooner you catch the disease, the better are your chances of a complete cure.
Look out for T.E.S.T!
Depending on the type of blood cancer, symptoms will vary. Experts from the UK have come up with the acronym T.E.S.T that you can keep any eye on. It stands for:
T- Tiredness and exhaustion
E- Excessive sweating
S- Sore bones or joints
T- Terrible bruising or unusual bleeding
Particular attention should be paid to night sweats, cuts or other minor injuries that don’t heal quickly and bleeding from gums, rectum or a heavy flow during menstruation.
Other Symptoms Include
- Recurrent infections
- Unintended weight loss
- Loss of appetite
- General weakness
- Shortness of breath and
- Swollen lymph nodes.
These physical symptoms may be evident in the earlier or later stages of the disease and are not exclusive to blood cancer. They may be indicative of another less fatal, common disease. In any case, seeking your doctor’s assistance promptly is essential.
How is Cancer diagnosed?
Diagnosis begins with a clinical examination followed by a routine blood test. If any abnormality surfaces, the treating doctor could ask for additional tests which may include studying the bone marrow, performing imaging studies or genetic tests.
How Can Genetic Testing Help?
Advances in technology have made it possible to identify markers that contribute to the risk. Medical experts often recommend genetic tests for confirming diagnosis and for identifying inheritance patterns in families. Such individuals and families can also benefit from genetic counselling, where our board-certified genetic counsellors study the health history and recommend genetic tests on the basis of their findings.
What Are The Available Lines of Treatment?
The line of treatment will depend on the health of the patient and the type and stage of cancer. An interdisciplinary team of doctors work together towards alleviation of symptoms, decreasing disease progression and ultimately, eradicating it completely. Treatments include chemotherapy, radiotherapy, stem cell (bone marrow) transplantation, cord blood transplantation and immunotherapy (strengthening the immune system to fight cancerous cells). Supportive therapies such as pain management, palliative care, counselling and a diet plan also assist in the treatment.
Should I blame it On My Genes?
Blood is a complex tissues with different types of cells. Any type of blood cell can turn cancerous and hence the term “blood cancer” is really an umbrella term for a group of cancers that affect various blood cells.
There have been studies that indicate a close relationship between blood cancers and certain genes. For instance, acute lymphoblastic leukaemia (ALL) that is seen predominantly in children between 2 to 5 years of age is related to a mutation in the gene ETV6, that is concerned with the development of blood cells . Another gene mutation attributed to this condition is PAX5 that plays a role in the development of B cell cancers .
Another type of blood cancer called Familial Acute Myeloid Leukaemia is caused due to a heritable mutation in the gene CEBPA . People with this cancer have a diminished number of white blood cells and hence are more prone to infections.
More studies are needed to establish a direct link between genes and blood cancers so that these genes can be used to diagnose the condition. Some research has been promising and has unearthed certain genes that may have significant use in diagnosis and to understand disease risk in an individual . Some of these are –
- JAK2 in ALL in Down Syndrome patients
- TP53 and ATM in chronic lymphocytic leukemia
- V600E mutation in BRAF gene in hairy-cell leukemia (a rare kind of blood cancer)September- Blood Cancer Awareness Month:
Thanks to the Lymphoma Research Foundation’s (LRF) Advocacy Program, September was declared as Blood Cancer Awareness Month in 2010 by the US Congress. Throughout this month, different organizations and independent professionals contribute their bit to spread awareness about this condition and the latest treatment strategies available in their region. They encourage everybody to participate in this campaign by a variety of channels; for instance, you can make contributions, organize your events, spread the word through social media and even share your experiences.
Cancer is a difficult disease – both for the patient as well as her near ones. It is easy to despair at the diagnosis. Being there with your loved one in such difficult times and never losing hope is as important as the treatment regimen. An early prognosis, sticking to the treatment plan and having a positive mental outlook is key to effectively fighting this disease.
- Walter H A Kahr WHA, Porter CC, Paola JD et al. Germline mutations in ETV6 are associated with thrombocytopenia, red cell macrocytosis and predisposition to lymphoblastic leukemia. Nature genetics 2015; 47:535-538.