What are blood cancer symptoms?
If you are reading this page, you may have been diagnosed with blood cancer due to the presence of one or more symptoms. Symptoms usually occur when blood cancer cells crowd out other blood cells or affect other organs.
If your blood cancer has been diagnosed before any symptoms appear, the chances are high that you are in the early stages of the disease. Coincidental discovery of blood cancer during routine blood tests is common.
Symptoms of blood cancer often depend on the blood cells that are either in short supply or are immature.
Low white blood cell counts will lead to frequent infections, fatigue, fever, sweating and skin rashes. You may or may not have swollen lymph glands in the neck, armpits or groin.
Low platelet counts mean easy bruising and slow healing; if you accidentally cut yourself, you may bleed for longer than usual.
Low red blood cell counts lead to anaemia. You may look pale and have very little energy. As red blood cells carry oxygen to the tissues of the body, you could experience shortness of breath and feel extremely weak.
More generalised symptoms are loss of appetite, bone pain, nausea and weight loss. An enlarged spleen or liver may be visible or palpable.
Can I prevent blood cancer?
Blood cancer is caused by damage to blood cell DNA. This is the combined result of your genetic makeup, your environment and your lifestyle.
One of the most damaging lifestyle habits is smoking. Stopping smoking and avoiding areas where indoor smoking occurs is extremely important when you want to lower the risk of any type of cancer. This also applies to excessive alcohol use.
Care should be taken when exposed to certain chemicals such as formaldehyde and benzene. If you work in an environment where chemicals are used, use specialised breathing equipment where this is available. If your work involves chemicals and you are not offered sufficient health and safety advice, take the time to look into any risks and follow the guidelines of companies that adhere to strict occupational health standards.
If you live in an area of high pollution, moving to a greener area may lower risk. In addition, buying an electrically-powered car and keeping vehicle windows closed when on busy highways can lower the levels of those pollutants responsible for some forms of blood cancer.
Exposure to radiation is also a risk factor for blood cancer. Those who have previously undergone cancer treatment and have absorbed significant levels of radiation may be more likely to develop blood cancer at a later stage. While certain dietary supplements are advertised as anti-cancer therapies, their actions as antioxidants are minimal. Reducing airborne pollutants is key to lowering the risk of developing any type of blood cancer, while remaining healthy through regular exercise and a varied diet low in processed foods means our bodies are able to respond more effectively when in the presence of toxins.
Unlike many other forms of cancer, six-monthly blood tests can trace blood cancer in its early stages. If you are over 60 years of age, smoke, have an unhealthy weight and/or unhealthy eating habits or live or work in a high-risk environment, asking your general practitioner to add certain blood cancer tests to your annual or biannual check-up can mean an earlier and easier to treat diagnosis.
How is blood cancer diagnosed?
The first step towards diagnosing blood cancer is usually in response to your reporting one or more symptoms to your general practitioner or when routine blood tests show low blood counts. The blood tests that initially point to a possible blood cancer diagnosis are the complete blood count (CBC), blood clotting tests (PT, PTT) and blood chemistry tests. If you also present with other risk factors such as previous cancer treatment, he or she will arrange for further tests to rule out or confirm a blood cancer diagnosis. These tests are:
Blood smear. The laboratory looks at your blood cells under a microscope to see whether you have an overly high percentage of immature cells or if any cells look abnormal.
Bone marrow aspiration. The doctor inserts a fine needle into the hip bone and removes a small sample of bone marrow. Bone marrow is liquid in form. This is not a pleasant test and those who have experienced it report a sense of pressure and short-lived pain lasting 3 to 5 seconds, even when a local anaesthetic is used.
If blood cancer is confirmed, you will be sent for further testing. One or more of the following tests will be advised:
Medical imaging tests look to see if bone marrow cancer has spread to other organs or to view the lymph nodes, liver and spleen. The most common medical imaging tests are ultrasound, CT, MRI and dotatate-PET.
Lumbar puncture proceeds in very much the same way as spinal anaesthesia but without the injection of an anaesthetic. A needle is inserted into the cerebrospinal fluid via the spine and a sample of this fluid is removed to see if blood cancer has spread.
Cytogenic testing or karyotyping looks at the chromosomes in abnormal blood cell DNA. This test is necessary for determining which treatments best suit a particular cancer type.
An additional method of determining the correct treatment is flow cytometry immunophenotyping. This test looks in more detail at unusual substances on the blood cell surface and is important for treatment pathways that include targeted therapy.
Lymph node biopsies rule out or confirm lymphoma or cancer spread into other organs. This procedure is carried out by inserting a fine, hollow needle under ultrasound guidance. For deeper-lying lymph nodes, surgery may be required.
Bone density scans are carried out to stage blood cancer and are also prescribed if other test results are not clear.
Biomarker testing is a more recent test that gives more data concerning a cancer’s predicted behaviour in response to various treatments. This is a form of personalised medicine that means blood cancer patients are treated as individuals. Biomarker tests look for mutations in certain cells that might improve or lower the effect of a specific therapy. It is then possible to integrate a fairly new group of drugs that reduce or reverse undesired responses. These drugs are collectively known as targeted therapies.
How is blood cancer treated?
Different types of blood cancer require different types of treatment; however, nearly all treatments centre on chemotherapy. Surgery to remove the spleen (splenectomy) may be advised if the spleen is enlarged. This is due to large numbers of abnormal cells clogging up the filtering and storage systems of this organ and forcing it to reject healthy blood cells. Another surgical option is a lymphadenectomy or the removal of affected lymph nodes.
Most blood cancers are treated in three stages. The first stage - remission induction - aims to destroy immature cancerous cells in the bone marrow and improve the ratios of healthy to unhealthy cells. This stage should relieve any symptoms caused by the cancer. The second stage is consolidation that continues to destroy any remaining abnormal cells. Treatment pathways are similar to remission induction but doses are often lower and the side effects much less uncomfortable. After these initial treatments, most blood cancers require maintenance therapy that can last anywhere up to 3 years.
Chemotherapy for blood cancer
Chemotherapy is by far the most common treatment used for all types of blood cancer; however, different cancer cell types do not all respond in the same way and different combinations of chemotherapy drugs are used for the varying types of blood cancer.
Intravenous chemotherapy drugs are administered intravenously via a portacath, PICC line or central venous catheter. Lower doses can be given in pill form. Treatments last for as long as it takes for a response; some types of blood cancer will go in remission after 1 or 2 cycles. Some require 10 to 12 cycles. A cycle consists of chemotherapy and a rest period of 3 to 4 weeks. This means that treatment can go on for many months. After each cycle, further tests will show whether the cancer is gone, reduced, controlled, unaffected or re-emerging. Only then is it possible to know if another cycle is required.
Ask Remedazo for more information regarding long-term stays where all of your physical, psychological and emotional needs are catered for during this stressful time. Alternatively, we can arrange similar accommodation and familiar, trusted team members for regular returns to your clinic of choice and cater for your accompanying family members or friends. Naturally, your care will be overseen by a consulting oncologist with in-depth knowledge of the latest drug combinations and treatments for all types of blood cancer. We also help you to access skilled medical teams equipped with empathic staff, the best equipment, extensive stocks of sometimes hard to obtain pharmaceuticals, and high-quality materials.
Radiation therapy for blood cancer.
Radiation therapy has more than one role to play in the treatment of blood cancers. Although it destroys cancer cells, in most blood cancers these are scattered throughout the blood and lymph systems. However, structures that contain larger populations can be treated with radioactivity. The spleen, liver and lymph nodes are all radiation targets. In addition, where bones have become damaged from blood cancer cells, radiation therapy can treat bone pain.
Radiotherapy therapy for blood cancer is composed of two main types – external beam radiation therapy (EBRT) and stereotactic body radiation (SBRT). If blood cancer recurs after a first successful treatment, other relatively recent drugs known as radiopharmaceuticals may be advised. These are injected drugs that contain radioactive substances and settle in areas of damaged bone. Here, they emit radiation that kills cancer cells.
External beam radiation therapy focuses beams of radiation into the blood and requires short (30 minute) visits to the hospital 5 times a week for several weeks. Long-term stays with all transportation, support, accommodation and meals can be seamlessly arranged by the Remedazo team. EBRT is a painless treatment and recent technology now enables oncologists to be even more precise with dosage and range. Additional options such as three-dimensional conformal radiation therapy or 3D-CRT use computers to map the affected blood(s) and shape the radiation beams to avoid damaging non-cancerous tissues. The even more advanced intensity modulated radiation therapy (IMRT) machine moves around the patient, shapes the beams and adjusts radiation intensities. This may be done with built-in scanners (image guided radiation therapy or IGRT) or using a more rapid but not necessarily more effective technique called volumetric modulated arc therapy or VMAT. You will be able to discuss all of these alternatives with a Remedazo oncology specialist.
The side effects of radiation therapy often depend on its effects upon healthy tissues that are found close to the lymph nodes, spleen or liver. In addition, radiation treatments can make you feel tired for weeks to months. At Remedazo, all associated information will be given upon or shortly after your consultation; you can then make an informed decision regarding the types of radiotherapy available to you.
Blood cancer immunotherapy
Immunotherapy or biotherapy allows your immune system to respond to the presence of specific cancer cells and attack them. Often, this response is absent during cancer growth. It has been shown that some blood cancers respond well to immunotherapy treatment but this certainly does not apply to all. Ask about immunotherapy options during your free Second Opinion.
Four types of immunotherapy drugs that have shown extremely positive effects in the treatment of blood cancers. Most of these are intravenous treatments that require at least a 4-hour stay in a clinical setting up to 5 times a week. These treatments can continue for several weeks or even years when used as part of your maintenance therapy program.
Cytokines such as interferon and interleukin can significantly slow down cancer growth. Immunomodulators that prevent cancer cells from dividing and communicating with each other include drugs such as thalidomide. Monoclonal antibodies bind to cancer cells and allow your immune system to recognise and destroy them. Finally, CAR-T (chimeric antigen receptor T-cells) gene therapy – a recently approved treatment – has presented some extremely positive outcomes. This treatment involves the insertion of genetic material into immune-system cells in a laboratory. The insertion of new genetic information enables them to target and destroy cancer cells. Even terminal cases of lymphoma have been cured with this exciting scientific breakthrough.
The side effects of immunotherapy are many and can be serious. Those offered this type of treatment are given in-depth information regarding side effects and the detection of their early signs. Remedazo can put you in touch with one of our specialist oncologists to discuss your eligibility for immunotherapy based upon your personal medical history.
Blood cancer targeted therapy
Targeted therapies are receiving more and more interest in scientific communities and represent yet another breakthrough in the race to cure cancer. Finally, we are working towards highly personalised medical treatments based upon our genetic information and that of the abnormal cells inside us. It is an exciting time for scientists who are discovering further areas in which drugs can control, slow, temporarily halt and even permanently stop cancer growth.
While immunotherapy improves our internal immunity to help us fight cancer, targeted therapies attack cancer cells directly. They are commonly used in the treatment of blood cancers and include monoclonal antibodies, and tyrosine kinase, histone deacetylase, proteasome and hypermethylation inhibitors.
As with immunotherapies, these drugs have their own lists of associated side effects; however, their value in the treatment of blood cancer is evident. Targeted therapies are not used as a stand-alone therapy but increase the effects of chemotherapy and significantly improve outcomes. As personalised drugs, your cancer cell type must be sensitive to the action of one or more of these drugs.
Monoclonal antibodies are cloned copies of a single type of antibody. While they are classified as immunotherapy drugs for assistance with cancer cell recognition, they also block some cancer cell proteins, stopping them from multiplying. Commonly used monoclonal antibodies in the treatment of blood cancer are ipilimumab and pembrolizumab. These drugs are administered intravenously.
Tyrosine kinase inhibitors (TKIs) stop 1 or more chemicals that instruct cancer cells to multiply. Examples are imatinib mesylate and nilotinab. TKIs are oral medications that do not require a hospital stay but as with all targeted therapy drugs, their use insists upon regular monitoring by an experienced oncologist.
Histone deacetylase inhibitors (HDIs) stimulate the early and natural death of cancer cells by affecting their DNA. An example of this drug category is valproic acid. Hypermethylation inhibitors – also known as tumour suppressors – similarly change a tiny part of the DNA of the cancer cell, leading to cell death. Alternatively, bortezomib is a proteasome inhibitor often used for the treatment of multiple myeloma and some forms of lymphoma. This drug damages cancer cells; once damage has occurred, the targeted cell will die.
Stem cell transplant for blood cancer
You will find detailed information on stem cell and bone marrow transplants here. Cell transplants are well known for their many unpleasant side effects but can deliver excellent results. Particularly in the treatment of blood cancers, bone marrow transplants after initial chemotherapy can be curative. You will need to discuss your eligibility for this treatment type; it is not recommended for those in poor health due to the high physical demands of this long-term therapy.
How is leukaemia treated?
If you have been diagnosed with leukaemia, your treatment pathway depends upon the type and stage of your cancer, as well as upon your level of health. As already mentioned, blood cancer treatment is a long-term commitment and a partnership between you and your medical team that demands both psychological and emotional support.
Treatment of acute forms of leukaemia
Adult and paediatric ALL and AML are usually treated using similar therapy pathways, although children often tend to respond more rapidly and rarely undergo radiotherapy.
Remission induction therapy involves combination chemotherapy, steroid drugs, oral targeted therapy (tyrosine kinase inhibitor for Philadelphia-positive cancer), antibiotics, red blood cell and platelet transfusions, protective intrathecal (into the spine) or intravenous central nervous system therapy, and in adults only, possible radiation therapy to the brain.
Once the disease has responded to remission induction therapy, you will need to undergo further chemotherapy or a bone marrow or stem cell transplant. A successful transplant means that maintenance therapy is not required.
Maintenance therapy in the form of oral and intravenous chemotherapy (low dose) and steroids can last for 1 to 3 years and is prescribed in short cycles or blocks every 1 to 2 months. If the cancer is Philadelphia-chromosome positive, oral targeted therapy further improves outcome.
If leukaemia recurs, treatment consists of an initial course of chemotherapy or monoclonal antibody therapy before stem cell transplant. It is likely that radiation therapy and tyrosine kinase inhibitor drugs (targeted therapy) will also be prescribed.
Treatment of chronic forms of leukaemia
Chronic forms of leukaemia are usually detected in older adults and can progress extremely slowly. This is why the first step is often watchful waiting with regular blood tests and medical imaging to monitor the disease. Should abnormal blood cell populations start to increase, therapy can be initiated.
The first step in the treatment of active CML and CLL is chemotherapy using a combination of oral and intravenous cytotoxic drugs for approximately 1 month. Intravenous drugs often require an overnight hospital stay. In addition, steroids may be prescribed to help you avoid some of the side effects associated with chemotherapy drugs. Antibiotics will also be administered to reduce the risk of infection.
Another mode of treatment is the bone marrow transplant that requires an initial chemotherapy course and can be curative.
Radiotherapy is used to shrink enlarged glands or organs such as the lymph nodes and spleen, while red blood cell and platelet transfusions are often necessary to increase healthy blood cell populations. In addition, a medication known as granulocyte-colony stimulating factor or G-CSF can help to increase your white blood cell count.
Once the abnormal cells in the blood have been destroyed, maintenance therapy is necessary. This continues for approximately 2 years. Maintenance most commonly consists of a combination of chemotherapy and an immunotherapy monoclonal antibody drug such as rituximab. Targeted therapy may also be advised. As cancer-fighting drugs are constantly evolving it is important that your oncologist is up to date with the latest treatment pathways. Remedazo is proud to work with multiple consultant oncologists, all of whom possess broad knowledge of both traditional, recent and developing therapies.
MDS treatment
Myelodysplastic syndrome treatment involves supportive care that reinstates healthy populations of blood cells through red blood cell, white blood cell and/or platelet transfusions. In addition, certain drugs may be given that stimulate red blood cell production – these are known as erythropoiesis-stimulating agents or ESAs. Supportive care also means avoiding infection, for which antibiotics can be administered. For MDS types that are more likely to evolve into acute myeloid leukaemia, chemotherapy is advised.
Stem cell treatment works best when MDS is not caused by earlier cancer therapies. When this is not the case, initial chemotherapy preceding stem cell transplant can be curative.
How is lymphoma treated?
Unlike other blood cancer types, some cases of non-Hodgkin lymphoma are cured after biopsy or surgery without the need for further treatment. The level of success depends upon the stage and spread of the disease. Non-Hodgkin lymphoma treatment may also involve watchful waiting with regular blood tests and medical imaging. Should the cancer begin to grow at a more rapid rate, oral or intravenous chemotherapy, steroids and/or radiation are prescribed. Radiation works most effectively in early-stage disease and this form of treatment continues for up to 3 weeks. You will need to visit the hospital every day during this time. Protection of the central nervous system through the injection of chemotherapy drugs into the spine (intrathecal injection) may also be advised.
The latest immunotherapies and targeted therapies are now becoming standard in the treatment of a broad range of cancers, including lymphoma. You can discuss all available treatment methods with haematology and oncology specialists during your free Remedazo Second Opinion.
Hodgkin lymphoma can often be treated with great success - and cured - with a course of intravenous chemotherapy and steroids. In some cases, additional radiotherapy is prescribed. Stem cell transplants are similarly achieving positive results.
Where Hodgkin lymphoma is at a later stage, longer-term oral chemotherapy can significantly slow disease progression.
How is multiple myeloma treated?
As with chronic forms of blood cancer and non-Hodgkin lymphoma, it is possible that an initial diagnosis with multiple myeloma does not require treatment.
When regular, scheduled blood and urine tests show that cancer cells are starting to multiply, treatment is initiated with new intravenous and oral targeted therapy drugs. These include bortezomib, carfilzomib and ixazomib, or specific monoclonal antibodies. Pharmaceutical therapy is often enough to control multiple myeloma. As with other blood cancer treatment pathways, steroids can help with unpleasant side effects but also play a supportive role with various therapy types.
The combination of chemotherapy and subsequent bone marrow transplant is becoming increasingly popular due to its ability to cure many specific blood cancers, but is not always recommended in older patients as these treatments are associated with long treatment times and many side effects. At Remedazo, you can discuss your eligibility during free Second Opinion sessions with renowned cancer specialists.
Where tumours attack the bone and cause pain, radiotherapy is the treatment of choice. This treatment can target specific areas of affected bone and lower levels of discomfort or pain, as does the administration of radiopharmaceuticals.
Why do I need blood cancer treatment?
Treatment is essential for all acute forms of blood cancer. As the populations of immature blood cells increase, healthy cells are unable to compete with serious symptoms as a result. Even in early-stage chronic disease, regular monitoring is extremely important. Furthermore, many forms of blood cancer can be cured, even those in more advanced stages.
Blood cancer treatment is a long-term commitment, combining therapies that themselves cause damage to healthy cells. By consulting an empathic, knowledgeable and experienced oncologist who is extremely familiar with effective therapy pathways and up to date with current clinical trials, your treatment can be personalised to achieve the best possible outcome. A holistic approach in combination with world-renowned physicians, excellently equipped hospitals, evidence-based therapies and regular follow-ups is guaranteed at Remedazo. Our goal is to ensure your comfort during this difficult time, meaning you can concentrate on your recovery.
How do I prepare for blood cancer treatment? What can I expect?
Approximately 4 weeks before your blood cancer treatment you will be asked to supply the results of your blood and diagnostic tests and copies of any applicable imaging results (CT, MRI and/or PET). This means we can see how your blood cancer is progressing and help us to advise the best treatment options. We will also need any information regarding medication use, other illnesses or disorders and your overall state of health.
You will need to undergo an MRI or CT scan and possibly a bone scan – if these have not yet taken place - which will help us to see whether your spleen, bones or lymph nodes have been affected. In early chronic blood cancer, this is usually not the case; however, a complete diagnostic check up can help us and your doctors at home to precisely monitor any future changes.
As the majority of acute or potentially acute blood cancer treatments involve chemotherapy and often a long stay in hospital, you should arrange time off work and, where necessary, request assistance from family members and friends or employ childcare or housekeeping staff. Think about how you might spend your time in the hospital; chemotherapy can make you extremely tired but time will go by much more quickly with some distractions. Consider who you would like to accompany you if this is at all possible, and perhaps download favourite books, games and television shows on a laptop (paper versions of books and magazines are difficult to wash and could be an potential source of infection). Remedazo works together with outstanding hospitals that provide comfortable, well-equipped and private accommodation; however, it is always a good idea to bring along a personal selection of your favourite pastimes.
Try to avoid contact with people who are ill whenever possible. Maintaining your weight by eating a healthy diet will also lower your risk of infection. It is now time to put yourself into Remedazo’s attentive hands. We can arrange every aspects of your stay according to your emotional, psychological and physical preferences and requirements, as well as according to your budget. With Remedazo, all you have to think about is your recovery.
Benefits of blood cancer treatment
The benefits of blood cancer treatment very often include cure or remission, even in later-stage disease. A broad range of new, personalised, supplementary therapies are producing increasingly efficient chemotherapy results, while the many positive outcomes achieved through the combination of chemotherapy and stem cell transplants are extremely encouraging.
Remission rates for non-Hodgkin lymphoma, for example, have tripled in the past 40 years with over 60% living with or being cured of the disease 10 years after diagnosis. Furthermore, approximately 98% of children with acute lymphoblastic leukaemia go into remission within just a few weeks of starting treatment, and chronic lymphocytic leukaemia has a remission rate of over 70%. As the scientific world’s understanding of cancer deepens, so the oncologist’s choice of treatments increases and a global cure for cancer becomes reality.
Disadvantages of blood cancer treatment
The most commonly reported disadvantages of blood cancer treatment are the length and associated side effects of the various treatment pathways. While more recent breakthroughs allow doctors to use drugs that only attack cancer cells, chemotherapy is still an essential step that causes destruction not only to damaged cells but also to healthy ones.
Often, the side effects of blood cancer treatment are similar to the symptoms of more advanced blood cancer. Low immunity, anaemia, fatigue, nausea, bruising, irregular bowel movements and weakness are common experiences both before and during treatment. Many of these symptoms can be alieved with over the counter or prescribed medication; however, the negative effects of blood cancer therapy should not be underestimated.
Another disadvantage of blood cancer treatment is the length of time required for induction and maintenance. All blood cancer initial treatments last for weeks if not months and maintenance, although much less associated with side effects, can continue for years.
As already mentioned, low immunity is a side effect of both blood cancer and its various therapies. It is often necessary to remain in isolation for a period of time to avoid the risk of infection. For many, this can be an extremely lonely experience even where modern technology allows us to enjoy video-chats. A lack of human contact can make blood cancer treatment a psychologically difficult time, as well as a physically demanding one.
Blood cancer alternatives
It is possible that you have been given a choice of one or more alternative treatments or have not yet made an appointment for your free e-consult and are simply browsing the possibilities.
The accepted and current blood cancer treatment alternatives have been described in the necessary detail above. Complementary and alternative blood cancer remedies are unproven and should not take the place of accepted treatment courses.
Of course, there is no alternative for professional medical advice. Please call us to arrange your free e-consult and the opportunity to speak personally with specialist haematologists, oncologists, radiologists and paediatric oncologists to determine the best treatment type for you. You can discuss all blood cancer treatment alternatives with them, ask for second or third opinions, and take the first step towards your personalised Remedazo holistic care package.
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