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Leukemia Cancer

Leukemia Cancer

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Overview

Leukemia includes all forms of neoplasm affecting tissues that nurture blood, e.g. bone marrow, and damage the immune system. The different types of leukemia depend on how fast they run for the acute lymphoblastic, acute myeloblastic and chronic lymphocytic leukemias.

In these forms, there may be some years without significant symptoms. Acute forms, however, have signs such as long-continued moderate fever, loss of weight, and bleeding, with increased bruising.

The treatment strategy for leukemia depends on its type and how severe it is. People will usually be monitored for slow progression under active surveillance with little or no medical therapy, but cases of acute illness will usually undergo some intensive therapy with chemotherapy, possibly with adjunctive radiation therapy and stem cell transplantation.

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Types of Leukemia Cancer

This classification divides leukemia depending on the blood cell and the eventual speed with which the abnormal cells proliferate and spread. Acute leukemias appear rapidly and require immediate blood transfusion, while chronic ones are slow, progressive diseases with minimal symptomatology.

The classification has also provided subtypes of leukemia attacking either lymphocytes (type of white cell found in our blood) or myeloid cells (immature cells from which white blood cells, red blood cells, and platelets develop). Such classification is relevant to the treatment implications and prognosis.

The four major types of leukemia are:

  • Acute lymphocytic leukemia (ALL):

    Fastest growing, and most likely seen in children.

  • Acute myeloid leukemia (AML):

    Fastest growing and mostly in adult humans.

  • Chronic lymphocytic leukemia (CLL):

    Slow-growing type; mostly happens to elderly adults.

  • Chronic myeloid leukemia (CML):

    Another slow-growing type but that sometimes can show rates of growth comparable to those seen in CLL.

Risk Factors

Factors That May Increase Your Risks of Developing Some Forms of Leukemia:

  • Prior treatment for cancer:

    Those who have received chemotherapy and radiation therapy of any sort for another kind of cancer may have an increased risk of developing certain types of leukemia.

  • Genetic aberrations:

    The genetic anomalies seem to be related to the pathogenesis of leukemia. Such genetic anomalies as Down sickness are responsible for heightened risk for developing leukemia.

  • Chemical:

    Some chemical agents are known to be linked to certain forms of leukemia, benzene being one of them; this is a fraction of the component in gasoline.

  • Cigarette smoking:

    Cigarette smoking has been shown to increase risks for acute myelogenous leukemia.

  • Family history of leukemia:

    If there were people suffering from leukemia in your family, the risk of getting the disease could be increased.

Most people with known risk factors do not develop leukemia. Conversely, many people with leukemia have no known risk factors. 

Symptoms

What are the Symptoms of Leukemia Cancer?

The symptoms, in part, depend on the type of leukemia. A chronic form may not display significant symptoms or signs in the early stage. Common signs and symptoms of leukemia may include the following: 

  • Fatigue, easy tired.
  • Fever or night sweats.
  • Frequent bouts of infection.
  • Shortness of breath.
  • Paleness of skin.
  • Unexplained weight loss.
  • Bone or joint pain, tenderness.
  • Left side abdominal pain or fullness.
  • Bruising and bleeding including nosebleeds
  • Swollen lymph nodes in neck, underarm, groin or stomach, an enlarged spleen or liver.
Causes

Leukemia originates from mutations indicative of alterations/damaging changes in the DNA of a single cell found in the bone marrow. DNA is basically the "instruction code" for a cell to know when to grow, how to differentiate, and when to die. But because of that mutation, or coding error, leukemia cells keep multiplying, and all cells derived from the original mutated cell have the same mutated DNA.

What causes the undifferentiated cells to undergo mutation is still a mystery to scientists. They have pinpointed some common mutations that all the diagnosed patients with different types of leukemia possess.

Diagnosis

Routine blood tests can make your healthcare provider suspect that you may have an acute or chronic form of leukemia and recommend further diagnosis or workup on any leukemia symptoms you may have.

Here are some diagnostic exams and tests
01
Physical Exam
With a careful medical history of your symptoms, your health provider will evaluate you and might also feel for swollen lymph nodes, or for an enlarged spleen or liver; furthermore, they may inspect your gums for any significant bleeding or indentation at the margins and they might carry a few aspects where a skin rash can be considered that might associate leukemia with red coloring, purple yellow or brownish colors.
02
Complete Blood Count (CBC)
The blood test that would indicate the presence of tubular cells in blood without leukemias is alongside abnormalities within red advances potentially taking in an aspect. Leukemia would be indicated obtaining abnormally high values in the patient as far as white blood cells are concerned.
03
Blood Cell Examination
The physician might order some additional blood tests to see if there are certain markers indicating a type of leukemia, or at least the presence of cells in the patients blood, as an additional report from him to this office. Further tests might involve flow cytometry and peripheral blood smear.
04
Bone marrow biopsy (bone marrow aspiration)
If you show abnormal count of white blood cells, it would be indicated for biopsy. Generally, a long needle is introduced into your pelvic bone, drawn into your bone marrow by inserting it inside, and extracting fluid in this procedure.
05
Imaging and Other Tests
If leukemia moves into a bone organ or tissue and symptomatizes, then the physician often orders chest X-ray and CT scan or even magnetic resonance imaging (MRI) scan. The images may not reveal the leukemia cells.
06
Lumbar puncture (spinal tap)
Sample an examination of spinal fluid, which would then determine if leukemia had also spread into the spinal fluid surrounding the brain with the spinal cord.

Treatments

Such reasoning will be based on the various treatment regimens provided for leukemia cases. The specific types of leukemia, the child's age, and the child's condition would be the factors on which this therapy depends; the effect or involvement of other tissues or organs might also be counted.

  • Chemotherapy:

     is the only treatment prescribed for leukemia. It defines a process or method by using chemicals to destroy or limit the growth of cancer cells. These drugs may be taken orally, injected into a vein or under the skin, or inserted as a suppository. As a rule, two or even more agents are combined in their usage, although some can be administered as a single agent.

  • Immunotherapy:

    It is one of the methods of treating blood cancer by some medicines that promote the immune system in humans to fight leukemia. Most of the underlying principle for immunotherapies is to improve recognition by immune effectors of a specific leukemic cell and generation of additional immune effector cells that fight against this cell.

  • Radiation Therapies:

    This type of treatment is specifically directed against a protein or gene in a leukemia cell, making it possible for leukemia cells to outgrow those of normal blood cells. Targeted agents inhibit various processes in the leukemic cell during its multiplication, blood supply, or killing it directly. Unlike classical agents of chemotherapy, Radiation therapies may seldom affect normal cells. Examples of such agents are those classified under tyrosine kinase inhibitor, a type of monoclonal antibody.

  • Hematopoietic cell transplantation:

    stem cell transplantation, bone marrow transplantation- is perhaps one of the most beautiful things about transplanting blood-forming cells diseased and damaged by chemotherapy and/or radiation with a renewed red blood-cell population from healthy hematopoietic cells. It may come either from the patient's blood or bone marrow harvested before chemotherapy and radiation or can also be from a donor. It contributes to the further process of developing fresh blood through multiplying healthy cells in the marrow. These cells differentiate into red blood cells, white cells, and platelets.

  • Radiation:

    High-energy radiation or X-rays kill or stop the growth of leukemia cells. A machine focuses the radiation on very specific areas within the body where cancer cells exist or will deliver radiation throughout the body. Body-wide external irradiation may be included as part of preparatory measures for hematopoietic cell transplant.

  • Chimeric antigen receptor (CAR) T-cell therapy:

    The infection-fighting T-cells or T-cell or T-lymphocyte have been engineered to fight leukemia cells and will be pumped back into your body. This is an exciting new therapy.

Clinical trials are also under way for testing novel drugs against fresh diagnoses of cancer. Pros and cons of joining a clinical trial should be carefully discussed with healthcare providers.

What are leukemia therapy phases?

Moreover, depending on the treatment or course of action as prescribed by the physician, long-term ongoing leukemia treatments would be available, or treatment would be performed in phases. As a rule, phase treatment comprises three parts. Every phase defines a very specific goal.

Induction Therapy
In the main objective, killing most leukemia cells found in the blood and bone marrow and achieving remission is the intent. When blood cell counts are back to normal levels, leukemia cells are not found in the blood, and all signs and symptoms of the disease disappear; this condition is known as remission. In the short term, induction therapy lasts four to six weeks.
Consolidation (also termed as intensification)
Eradication of any undetected surviving leukemia cells is the goal, thus precluding the cancer from recurring. Consolidation therapy usually received will alternate in cycles for about four to six months.
Maintenance Therapy
The purpose is to kill any leukemia cells that may have survived the first two treatment phases and to prevent recurrence (relapse). This lasts for about 2 years. If leukemia returns, your healthcare provider can either return or change treatment for you.

Side Effects of Treatment

  • Chemotherapy: Fatigue, Nausea and Vomiting, Hair Loss, increased risk of infections due to low WBC, Anemia, bruising and bleeding, mouth sores, and appetite loss
  • Radiation Therapy: Skin irritation or burns, fatigue, nausea, hair loss and potentially long-term effects in fertility issues and growth problems in children.
  • Targeted Therapy: Diarrhea, swelling, muscle cramps, rashes, and liver function changes.
  • Immunotherapy: Fever and chills, fatigue, low blood pressure, breathing problems, skin rash, and risk of autoimmune reactions.
  • Bone Marrow Transplant: infections, organ damage, infertility, fatigue, and long recovery time
  • Corticosteroids: Weight gain, high blood sugar, mood changes, increased risk of infections, and bone thinning (osteoporosis)

Support

For patients living with multiple myeloma, the disease brings with it an array of physical and emotional upheavals, yet some support schemes exist to help patients deal with this condition and improve their quality of life.

Emotional-Cum-Psychological Support:
The diagnosis of leukemia is usually coupled with feelings of anxiety, fear, sadness, and uncertainty, all of which may be explored or shared in counseling or therapy with family and close friends. While in many hospitals, oncology social workers or psychologists are available for the patient and family, in-person and online support groups offer a safe and confidential environment to vent and develop a sense of community. Family members, spiritual figures, and mental health professionals could also serve as sources of comfort in trying times.
Medical Care and Palliative:
Hematologists, oncologists, nurses, and allied health professionals oversee the multidisciplinary medical team caring for the leukemia patient. Palliative care may be given at any stage during the disease process. There are many symptoms that can be attributed to the patients such as pain, poor appetite, nausea, fatigue, etc. On the other hand, physical therapy will assist with mobility, whereas occupational therapies will empower a patient to carry on with daily activities.
Nutritional Support:
Nutrition constitutes a very important aspect during the treatment of leukemia and afterwards. Symptoms of leukemia such as loss of appetite, nausea, or sores in the mouth can make eating very difficult. Registered dietitians can plan meal schedules according to individual body immune functions, weight, and energy needs. Healing takes place through hydration and balanced meals that will allow the body to help in its self-repairing healing process.
Financial Assistance and Insurance Counselling:
Expenses incurred to treat cancer can be a burden. Some programmes provided by federal or provincial governments, such as Employment Insurance (EI) Sickness Benefits, or disability supports may even offer that relief from the burden. Charities and hospital social workers can also guide one in navigation financial aid, travel grants, and drug coverage. Even to be counseled by an insurance advisor will enable a patient to learn about their coverage and get the best use of benefits.
Support to Caregiver and Family
Caregivers are the ones who assist in the entire life journey of a leukemia patient to meet medication, appointment, emotional care, and daily routine needs. There are support groups that are specifically established for caregivers, which would help in stress management and avoid burning out. By providing family members with useful information concerning the prognosis of leukemia and its treatments, an understanding environment and strong support could be created at home.
Alternative and Complementary Therapies
Patients gain some relief from such interventions as mindfulness exercises, meditation, yoga, massage therapy, or acupuncture appointments. These all can contribute to stress reduction, increased sleep quality, or symptomatic relief from pain. They should not act independently or supplant treatment in any way. Formally, they compliment the conventional treatment approach.

Prevention

Leukemia is unlike many other types of cancer in that it lacks definable preventable causes. It develops because of a complex interplay of genetic backgrounds and environmental factors, as well as some unknown factors in some cases. Nevertheless, certain risk factors or lifestyle choices have been identified as reducing leukemia incidence risk or at least promoting general well-being.

The general idea that prolonged contact with some industrial chemicals (such as benzene-from gasoline, cigarette smoke, and industrial environments) increases the risk for leukemia, particularly acute myeloid leukemia, is evidently clear. The overall preventive measure indicates avoiding or reducing possibilities of exposure during work and in the environment.

Exposure to high doses of radiation produced during cancer treatment and nuclear accidents represent well-known risk factors. While everyday medical uses such as x-rays and CT scans have very low risks, unnecessary exposure should be avoided.

Smoking is an increased risk factor for at least several types of leukemia, particularly AML. Stopping smoking and avoiding second-hand smoke will reduce this risk and probably promote overall health.

No magic diet has been proposed or proven to prevent leukemia; yet keeping immune systems healthy through balanced nutrition and healthy amounts of exercise and restful sleep contributes to general health and benefits most nutritional intake patterns. Diets high in fruits, vegetables, whole grains, and lean proteins tend to reduce inflammation and oxidative stress in the body.

HTLV-1 and EBV are viruses associated with some leukemias and lymphomas in humans. Although uncommon, maintaining a reasonable standard of hygiene and following public health measures (particularly regarding immunization) may help to prevent cancers induced by specific viruses.

According to Occupational Safety and Health Administration (OSHA) regulations in the United States as well as Health Canada, there are regulations to reduce exposure to hazardous materials especially for people working in industries like agriculture, oil and chemical production-from using protective equipment, in case of health hazards.

Most cases of leukemia are noted suddenly; however, regular checkups and blood work can sometimes indicate changes early-specially in people at high risk for the disease. The earlier the indication of the condition, the better the treatment outcome.

Current research has provided some additional understanding of risk factors and preventive modalities. Environmental impact, immunization, and healthy living are what it means to prevent a person from getting cancer in the long term.
Questions to Ask your Healthcare Provider about Leukemia Cancer

Empower yourself with all the information regarding how your cancer diagnosis may uniquely affect you and all that stuff. Take a friend along for appointments, take notes, and ask lots and lots questions.  Some examples of questions are: 

  • Q1. What kind of leukemia is it? What type of cell? Is it acute or a chronic type of cancer?
  • Q2. How early was the leukemia diagnosed?
  • Q3. What do all my treatment options look like?
  • Q4. Competition and side effects by type of treatment?
  • Q5. What would be the best treatment regimen for me? Why is that?
  • Q6. When will treatment begins?
  • Q7. How long will the treatment last (and each portion)?
  • Q8. How long is the hospitalization?
  • Q9. What will the treatment side effects be? What can be done to prevent or minimize side effects?
  • Q10. What if I want to become a mother? What fertility conservation options do I have?
  • Q11. What is the success/survival rate for this type of leukemia?
  • Q12. Should I get into a clinical trial?