Hemato Oncology (Blood Cancers): Dr. Shilpa Gupta, Consultant Haematologist.

All you need to know about Hemato Oncology (Blood Cancers): Dr. Shilpa Gupta, Consultant Haematologist

Hemato Oncology a branch of medicine dealing with blood related cancers. Blood cancers like Lymphomas, Leukaemia, Myelomas Myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN), Certain rare blood cancers are treated by haematologists. Following are some common FAQs about the Hemato Oncology diseases:

How common are these diseases?
As per the US registry data, Blood cancers account for 10 % of all cancers. Cases of lymphomas, leukaemia and myelomas combined approximately stands at 70,000 cases per year in India.

Who is at risk for blood cancers?
Reasons for blood cancer are still poorly understood. Some lifestyle related risk factors like smoking, alcohol and exposure to some chemicals like benzene (used in rubber factories) have been associated with increased risk. Prior exposure to chemotherapeutic agents and high doses of radiation increases the risk for MDS or Acute Leukaemia.

What are the symptoms?
Symptoms of blood cancers range from being incidentally detected during routine check-up (For Example: Chronic Leukaemia, Low grade MDS) to acute rapidly progressive worsening of general condition (Acute leukaemia, Burkitt’s Lymphoma).

Summary of symptoms:

  • Myeloma - Intractable back pain or bone pains, weakness, and fatigue due to anaemia, may be present with renal dysfunction.
  • Lymphoma – Swellings (lymph nodes) progressively growing in size, unexplained weight loss, fever, fatigue
  • Leukemias – Acute Leukemias usually present with unexplained fever, weakness, bleeding (skin rash or gum bleed)

 

How is blood cancer diagnosed?
Usually a Complete blood count (CBC) gives a hint towards suspected diagnosis. However, confirmation may need a bone marrow aspiration and biopsy. Some special tests like protein electrophoresis or cytometry and cytogenetics may be needed. Imaging studies like CT scan, MRI or PET CT may be needed along with targeted biopsies from lymph nodes.

How is it treated?
Chemotherapy is the only treatment of blood cancers. Combined modality treatment includes radiation therapy in certain cases. Stem cell transplant is also an important part of treatment both as frontline as well as relapse setting. Immunotherapy or CAR-T cell therapy holds promise for future.

What is Stem cell or Bone marrow transplant?
It is a procedure that infuses healthy blood forming stem cells into the body replacing the diseased marrow. It is a potentially curative treatment in various haematological cancers and non-cancerous conditions. These stem cells can be allogenic (from other person- sibling or matched unrelated donor) or autologous (patient’s own cells procured after adequate treatment).

Usually, Haemoglobin and Platelets drop in blood cancers. Is an increase in Haemoglobin and platelet also count as a symptom of blood cancer?
Yes, any unchecked growth of cells (including blood cells) warrants evaluation for cancer. Polycythaemia Vera, Essential Thrombocytosis and idiopathic myelofibrosis are relatively under-recognized blood cancers that if identified and treated timely can ensure normal life span with good quality.

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