BENGALURU:India has the third highest number of haematological cancers in the world, after US and China according to Globocan 2012, a report prepared by World Health Organisation’s International Agency for Research on Cancer. Among the top 20 cancers affecting the Indian population in 2012, leukaemia ranked at nine. It affected an estimated 32,000 men and women in the country that year and caused 26,000 deaths. Non-Hodgkin’s lymphoma, meanwhile, ranked 13, with 23,000 fresh cases and 16,000 deaths reported. With data collection and reporting infrastructure not being completely accurate, this may be just the tip of the iceberg.
Blood cancer occurs when something goes wrong in the development of blood cells. Depending on the type of blood cancer, patients may have different symptoms, treatments and prognosis. Blood cancer may be described as either, acute, which means an aggressive or fast-growing cancer that spreads quickly, or chronic, which means a slower-growing or ‘indolent’ (lazy) cancer that takes longer to spread.
Blood cancer occurs when the DNA changes (mutates) in the stem cells that make our blood cells in our bone marrow. The blood cells might start to develop abnormally, or fail to die when they should. These are the ‘cancerous’ or cancer cells.
The risk factors for developing blood cancer include, age, sex, ethnicity, family history, radiation or chemical exposure, some inherited conditions like Down’s syndrome and previous exposure to chemotherapy medications like Anthracyclines. The risk factors vary between different types of blood cancer.
While blood cancer is caused by defects in our DNA, in most cases it doesn’t mean that it is hereditary, that it is transmitted from the parent to their offspring. Although there is evidence that shows that having a family member with blood cancer slightly increases the risk of getting the disease.
There’s some evidence to say that environmental factors such as radiation or chemical exposure may be linked to some types of blood cancer. Survivors of the Hiroshima and Nagasaki atomic explosions had a 15 per cent higher risk of developing blood cancer. The excess absolute risk of developing leukaemia among Chernobyl survivors was nine per cent. Blood cancer has been reported among survivors of the Bhopal gas tragedy and the Fukushima nuclear power plant tragedy as well. There is evidence that chemicals like benzene may be directly linked with incidence of leukaemia.
Blood cancer can manifest with multiple symptoms. The common warning signs are unexplained fever for more than three weeks, unexplained weight loss, swelling in the neck or abdomen, unexplained gum bleeding or excessive bleeding.
Early stage lymphomas is curable in more than 85 per cent of the cases. Molecular cytogenetic testing has helped in identifying a particular type of blood cancer called Acute Pro-myelocytic Leukaemia which can be cured in up to 85 per cent of the cases, by giving a combination of targeted medications, which eliminates the need for using cytotoxic chemotherapy. State of the art treatment modalities like targeted therapy, immunotherapy, and bone marrow transplantation have revolutionised the management of blood cancer, and provides hope for long term cure in deadly diseases
The author is a consultant oncologist at Aster CMI, Hebbal