Leukaemia now more treatable
Next month, thousands of Kiwis across the country will shave their heads to raise awareness and funds for leukaemia and other blood cancers. I love this visible show of support, and have huge admiration for those who take part every year.
In New Zealand, six people are diagnosed with a type of blood cancer every day. This includes the different forms of leukaemia, as well as other blood cancers such as myeloma and lymphoma.
Although older people are certainly affected as well, these cancers are particularly associated with younger age groups – in fact, leukaemia is the most common type of cancer in children, and lymphoma is the most common for 15-24-year-olds.
Thankfully, a diagnosis of leukaemia no longer carries quite the same fear that it used to. Many types are ‘‘curable’’ in the majority of cases, but treatment can be prolonged and carry significant side effects.
Leukaemias are cancers that arise from cells in our bone marrow. Normally, we have immature cells in our bone marrow, known as ‘‘blast’’ cells. When these blast cells mature, they turn into either white blood cells, red blood cells or platelets, and then enter the blood stream.
In leukaemia for some reason, these blast cells become abnormal, growing and multiplying in an uncontrolled way and interfering with normal blood cell production.
This is most common in developing white cells, but some forms of leukaemia affect other cells, too.
Depending on the type of cell affected, there are different subgroups of leukaemia known as ‘‘lymphocytic’’ and ‘‘myeloid’’.
These groups are further divided into either ‘‘acute’’ or ‘‘chronic’’ – acute means the cancer comes on rapidly and aggressively, whereas in chronic cases there is a much more gradual progression and it can be many months or even years before there are any impacting symptoms.
The four different types are called:
Acute lymphoblastic leukaemia (ALL)
The most common type in children, though it can also affect adolescents and adults.
Chronic lymphocytic leukaemia (CLL)
The most common of all the leukaemias, it develops very slowly and occurs almost exclusively in people over 60.
Acute myeloid leukaemia (AML)
More aggressive but much less common, AML typically affects those over 50.
Chronic myeloid leukaemia (CML)
The rarest of all the types, this can affect all ages but again is most common in older people. It develops really slowly, sometimes over years, before causing any obvious effects.
Symptoms of leukaemias depend to a degree on the type of leukaemia and the age of the person affected but can include:
❚ Pallor and tiredness (from resulting anaemia)
❚ Shortness of breath and feeling dizzy or faint
❚ Easy bruising, bleeding from the gums or nosebleeds – these all result from the leukaemia interfering with the body’s ability to clot
❚ Recurrent infections because of impaired immune response
❚ High fevers
❚ Aches and pains, especially in joints
❚ Weight loss.
Obviously in the acute forms of leukaemia, these symptoms will appear much more rapidly and tend to be more severe. In the chronic forms, symptoms may never appear or be much milder, with a very gradual onset.
No-one really knows exactly why certain people get leukaemia, but there are some associated factors that can increase your risk:
❚ Exposure to radiation (for example, people who survived the atomic bomb during the war had much higher rates of leukaemias in later life)
❚ Exposure to chemicals, especially benzene
❚ A family history – this is particularly true for the CLL type of leukaemia
❚ Previous chemotherapy treatment for cancer
❚ Certain genetic conditions, including Down syndrome (trisomy 21).
We also know that men are more at risk than women, and the likelihood of developing leukaemia increases with age – other than that, there are no specific lifestyle factors, such as drinking alcohol or obesity, that are known to have a definite association.
If you are concerned that you or your child might have symptoms that fit the list above, don’t delay – it is easy to get a simple blood test that will either reassure you, or demonstrate the need for more testing.
Leukaemia can be definitively diagnosed by getting a sample from your bone marrow – this is done under local anaesthetic by inserting a needle
into the pelvic bone (or occasionally the breastbone). A specialist then looks at the cells and can tell if leukaemia is present, and what type it is.
Other tests may be needed to assess whether the leukaemia has affected certain parts of your body – these might include a chest X-ray, scans of the liver or spleen, and sometimes samples of your spinal fluid obtained during a lumbar puncture.
As already mentioned, a diagnosis of leukaemia, although undoubtedly very serious, doesn’t carry the same awful prognosis as it used to years ago. In fact, even the acute, aggressive forms are now much more treatable than they used to be. Most children, for example, with ALL can be cured, but unfortunately the outlook for older patients who get AML is less good.
For more information about leukaemia or other cancers of the blood, or to support the ‘‘Shave for a Cure’’ campaign in March, visit leukaemia.org.nz
A diagnosis of leukaemia, although undoubtedly very serious, doesn’t carry the same awful prognosis as it used to years ago.