Blood Cancer Treatment in Delhi, India

The various types of blood cancer include leukaemia, lymphoma and myeloma.

Leukaemia

This blood cancer type is caused by the rapid production of abnormal blood cells in the bone marrow. These abnormal blood cells affect the bone marrow's ability of the production of red blood cells and platelets. Leukaemia can be further classified into the following types:

• Acute Lymphoblastic Leukaemia (ALL): Acute Lymphoblastic Leukaemia (ALL) is a rapidly progressing cancer that affects lymphoid cells.
• Chronic Lymphocytic Leukaemia (CLL): A slow-growing cancer that affects lymphoid cells and typically occurs in older adults.
• Acute Myeloid Leukaemia (AML): Acute Myeloid Leukaemia (AML) is a rapidly progressing cancer that affects myeloid cells.
• Chronic Myeloid Leukaemia (CML): A slowly progressing cancer that affects myeloid cells.

Lymphoma

This type of blood cancer affects the lymphatic system, which is responsible for the removal of excess fluids from your body and producing immune cells. Lymphocytes are a type of white blood cell that fights infection. Abnormal lymphocytes become lymphoma cells, which grow uncontrollably in your lymph nodes and other tissues. Lymphoma can be further classified into the following types:

• Hodgkin Lymphoma: Characterised by the presence of Reed-Sternberg cells. Subtypes include classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma.
• Non-Hodgkin Lymphoma (NHL): There are numerous subtypes of NHL, including:

○ Diffuse Large B-cell Lymphoma (DLBCL)

○ Follicular Lymphoma

○ Mantle Cell Lymphoma

○ Burkitt Lymphoma

○ Marginal Zone Lymphoma

○ T-cell Lymphomas

Myeloma

This type of blood cancer affects the plasma cells, which are white blood cells responsible for the production of disease-fighting antibodies in the body. Myeloma affects the production of plasma cells which results in a weak immune system.

Different types of blood cancers may present with their own set of symptoms that can vary from person to person, and some individuals with blood cancer may not initially exhibit noticeable signs. Here are common symptoms associated with various types of blood cancer:

Common Symptoms

• Fatigue: Persistent tiredness and lack of energy that doesn't improve with rest.

• Unexplained weight loss: Losing weight without trying or a significant loss of appetite.

• Frequent infections: Increased susceptibility to infections due to a weakened immune system.

• Easy bruising and bleeding: Unexplained bruising, bleeding, or prolonged bleeding from minor injuries.

• Bone or joint pain: Pain in the bones or joints, often felt in the back or limbs.

• Swollen lymph nodes: Enlarged, painless lymph nodes in the neck, armpits, or groyne.

Specific Symptoms by Blood Cancer Type

Leukaemia

• Frequent infections: Due to the abnormal production of white blood cells.

• Anaemia: Low red blood cell count, leading to fatigue and weakness.

• Petechiae: Tiny red or purple spots on the skin caused by bleeding under the skin.

Lymphoma

• Swollen lymph nodes: Painless lumps in the neck, armpits, or groyne.

• Night sweats: Profuse sweating, especially at night.

• Fever: Unexplained recurrent fever.

Myeloma

• Bone pain: Pain in the back or ribs due to bone damage.

• Frequent infections: Weakness of the immune system.

• Kidney problems: Symptoms may include increased thirst, frequent urination, or confusion.

It's important to note that these symptoms can be associated with various health conditions, and experiencing them doesn't necessarily indicate blood cancer. However, if you are concerned about your health or notice persistent symptoms, it's advisable to consult a healthcare professional for a thorough evaluation, diagnosis, and appropriate management. 

Also check different kinds of blood cancer symptoms - Acute Myeloid Leukaemia, Hodgkin’s Lymphoma, Multiple Myeloma.

Though there isn't a single, well-defined cause for blood cancers, several factors and genetic mutations have been identified as potential contributors. Factors that are associated with an increased risk of blood cancer include:

• Genetic factors: Inherited genetic mutations can increase the risk of developing blood cancers. Some individuals may have a family history of blood cancers, which can be indicative of a genetic predisposition.

• Acquired genetic mutations: Certain genetic mutations can occur spontaneously or as a result of exposure to environmental factors, radiation, or toxins. These mutations may lead to uncontrolled cell growth and the development of blood cancer.

• Age: The risk of blood cancers increases with age. Many types of blood cancers are more commonly diagnosed in adults, though some forms, such as acute lymphoblastic leukaemia, are more prevalent in children.

• Gender: Some blood cancers may have a gender predilection. For example, lymphomas are more common in males, while myelomas are more common in males and African Americans.

• Exposure to ionising radiation: Prolonged exposure to ionising radiation, whether from medical treatments (e.g., radiation therapy) or environmental sources, may increase the risk of developing certain types of blood cancers.

• Chemical exposure: Exposure to certain chemicals, such as benzene and certain pesticides, has been linked to an increased risk of developing blood cancers.

• Viral infections: Some viral infections have been associated with an increased risk of blood cancers. For example, Epstein-Barr virus (EBV) has been linked to the development of certain lymphomas.

• Immune system disorders: Conditions that weaken the immune system, such as HIV/AIDS or autoimmune disorders, may increase the risk of certain blood cancers.

• Previous cancer treatments: Individuals who have undergone certain cancer treatments, such as chemotherapy and radiation therapy, may be at an increased risk of developing secondary blood cancers.

• Chronic inflammatory conditions: Chronic inflammatory conditions, like certain autoimmune diseases, may contribute to an increased risk of blood cancers over time.

It's important to note that many people with blood cancers have no known risk factors, and the precise interplay of genetic and environmental factors leading to blood cancer is not fully understood. If you have concerns about your risk, it's advisable to discuss them with a healthcare professional or an oncologist.

The diagnosis of blood cancer involves a combination of medical history assessments, physical examinations, and various diagnostic tests. That said, diagnostic methods may vary depending on the specific type of blood cancer suspected. Here is an overview of the diagnostic process for blood cancer:

Medical history and physical examination

The doctor will inquire about the patient's symptoms, medical history, and any family history of cancer, and a physical examination is conducted to check for signs such as swollen lymph nodes, spleen, or liver.

Blood tests

• Complete Blood Count (CBC): This test measures the number of red blood cells, white blood cells, and platelets in the blood. Abnormalities may indicate the presence of blood cancer.

• Peripheral blood smear: A microscopic examination of a blood sample to check for abnormal blood cell shapes and sizes.

Bone marrow aspiration and biopsy

A bone marrow aspiration and biopsy involve taking a sample of bone marrow, usually from the hip bone. These samples are examined for the presence of cancer cells and provide information about the type and extent of the disease.

Imaging studies

• CT, MRI or/and PET scans: These imaging studies can help assess the size and location of tumours, swollen lymph nodes, or other abnormalities.

• X-rays: Used to detect bone abnormalities.

Lymph node biopsy

In cases where lymphoma is suspected, a biopsy of an enlarged lymph node may be performed to examine the cells and confirm the diagnosis.

Cytogenetic testing

The test is used to examine the chromosomes within the cancer cells to identify any abnormalities or mutations that may be indicative of specific blood cancers.

Flow cytometry

This technique is often used to analyse the characteristics of cells, particularly useful in identifying specific types of leukaemia or lymphoma.

Molecular testing

This testing is used to detect specific genetic mutations or changes in the DNA of cancer cells, providing information about prognosis and potential treatment options.

Spinal tap (lumbar puncture)

In some cases, a lumbar puncture may be performed to analyse cerebrospinal fluid for signs of leukaemia or lymphoma involving the central nervous system.

Histological examination

This involves examining tissue samples under a microscope to study the structure and characteristics of cancer cells.

Staging

Once a diagnosis is confirmed, further tests may be conducted to determine the stage of the cancer, indicating the extent of its spread.

The staging of blood cancers helps determine the extent of the disease and guides treatment decisions. Different blood cancers have specific staging systems, and each system considers factors such as the size and extent of tumours, involvement of lymph nodes or other organs, and the presence of symptoms. Here's a general overview of how blood cancers are typically staged:

Leukaemia Staging

Leukaemia is often staged differently than solid tumours. Instead of using a numbered system, it is classified as either acute (fast-growing) or chronic (slow-growing). Additionally, factors such as the presence of specific genetic abnormalities may influence the prognosis and treatment plan.

Lymphoma Staging

The staging of lymphomas, both Hodgkin lymphoma and non-Hodgkin lymphoma, is often based on the Ann Arbor staging system.

• Stage I: Cancer is found in one lymph node region or a single organ.

• Stage II: Cancer involves two or more lymph node regions on the same side of the diaphragm (Stage II) or one organ and its regional lymph nodes (Stage IIE).

• Stage III: Cancer involves lymph node regions on both sides of the diaphragm, possibly with involvement of nearby organs.

• Stage IV: Cancer has spread to one or more distant organs or tissues, such as the bone marrow or liver.

Multiple Myeloma Staging

Multiple myeloma staging often uses the International Staging System (ISS), which is based on two blood tests: beta-2 microglobulin and albumin levels.

• Stage I: Low levels of beta-2 microglobulin and albumin.

• Stage II: Intermediate levels of beta-2 microglobulin and albumin.

• Stage III: High levels of beta-2 microglobulin.

The primary objective of this treatment is the complete eradication of cancer. Several therapies are provided by blood cancer hospitals in India for this disease. At Max Hospitals, a highly specialised team of Hemato-oncologists & radiation oncologists provide treatment for a variety of cancers like lymphomas, leukaemia and multiple myelomas. A few of them are as follows:

Chemotherapy 

Chemotherapy involves the use of drugs to kill or control the growth of cancer cells. It can be administered orally or intravenously and may be used as the primary treatment or in combination with other therapies.

Radiation therapy

Radiation therapy uses high doses of radiation to target and destroy cancer cells. It is commonly used in the treatment of lymphomas, both Hodgkin and non-Hodgkin lymphoma, and may be employed as part of the primary treatment or after other therapies.

Immunotherapy

Immunotherapy, also known as biological therapy or bio therapy, aims to stimulate the body's immune system to recognize and destroy cancer cells. This includes monoclonal antibodies, CAR-T cell therapy, cytokine therapy, and checkpoint inhibitors.

Bone Marrow Transplantation

Bone marrow transplantation, also known as stem cell transplantation, involves replacing damaged or diseased bone marrow with healthy stem cells. Max Healthcare’s HEPA (High-Efficiency Particulate Air) filtered bone marrow transplant unit offers stem cell transplantation for both benign and malignant conditions in children and adults.

Targeted therapy

Targeted therapy drugs are designed to specifically target certain molecules or pathways involved in the growth of cancer cells. They are often used in cases where specific genetic or molecular abnormalities are identified in the cancer cells.

Hormone therapy

Hormone therapy is used in certain types of blood cancers, such as some forms of leukaemia and lymphoma, where hormones play a role in the growth of cancer cells. This therapy aims to block or interfere with hormone activity.

Supportive therapies

Supportive therapies, such as blood transfusions, growth factors, and antibiotics, may be used to manage symptoms and side effects of treatment, as well as to support the patient's overall well-being.

Treatment plans for leukaemia are highly individualised, and the approach may involve a combination of these modalities. The goal of treatment is often to achieve remission, manage symptoms, and improve overall quality of life. The Department of Haemato-oncology at Max Hospitals is committed to improving the outlook for patients with myeloma by developing novel therapeutic approaches based on a sound knowledge of the biology of the disease.

Blood cancer treatment cost Even the blood cancer treatment cost in India is quite affordable keeping in mind the quality medical care facilities, and world-class technologies that max healthcare provides to its patients. Max Hospital is one of the best blood cancer hospitals in India that have the best blood cancer doctors who specialise in treating blood cancer with surgery, chemotherapy, bone marrow transplant, biological therapy and haemato oncology. Book an online appointment now at the best blood cancer hospital in India.

Preventing blood cancers is challenging because many cases are not directly linked to modifiable lifestyle factors. However, there are some general health practices that may contribute to overall well-being and potentially reduce the risk of. These include:

Maintain a healthy lifestyle: Adopt a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, and engage in regular physical activity to promote overall health and a strong immune system.

Avoid tobacco and alcohol: Avoid tobacco products, as smoking has been linked to an increased risk of certain blood cancers. It is also important to limit alcohol intake, as excessive alcohol consumption may be associated with an elevated risk of certain cancers.

Protect against viral infections: Certain viral infections, such as the Epstein-Barr virus (EBV) and human T-cell lymphotropic virus (HTLV), have been linked to an increased risk of specific blood cancers. Practise safe behaviours to minimise the risk of exposure to these viruses.

Occupational and environmental exposures: Minimise exposure to harmful chemicals, radiation, and other environmental factors that may be associated with an increased risk of cancer.

Genetic counselling and testing: Individuals with a family history of blood cancers or specific genetic predispositions may benefit from genetic counselling and testing. Understanding genetic factors can help assess the risk and inform personalised prevention strategies.

Regular health check-ups: Regular medical check-ups can help detect and address health issues early. If there are concerns or symptoms, consult with a healthcare professional promptly.

While there is no foolproof way to prevent blood cancers entirely, these general practices may contribute to overall health and potentially reduce the risk of certain cancers. Additionally, some blood cancers are not preventable because they may arise due to genetic mutations or other factors beyond lifestyle choices.

Individuals with specific concerns about their risk of blood cancers should consult with healthcare professionals, especially if there is a family history of these diseases or other risk factors. Early detection through screenings and prompt medical attention can be crucial in managing and treating blood cancers effectively.

Q. Is blood cancer curable?

The prognosis varies based on the type and stage of blood cancer. Some forms are curable, while others may be managed as chronic conditions.

Q. What are survival rates for blood cancer?

Survival rates for blood cancer vary widely depending on the type, stage at diagnosis, and individual factors. Advances in treatments have improved outcomes, and survival rates

continue to improve. It's crucial to discuss specific survival statistics with healthcare professionals for accurate information based on the particular type and stage of blood cancer.

Q. Can early blood cancer be cured?

The potential for a cure in early-stage blood cancer depends on the type of cancer and other individual factors. Some blood cancers, when detected in the early stages, may be curable with appropriate and timely treatment. Early diagnosis and prompt medical intervention can significantly improve the chances of successful treatment.

Q. Is acute blood cancer curable?

Acute blood cancers, such as acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML), can be challenging to treat, but they are often responsive to intensive therapies. Some cases can achieve remission, and in some instances, a cure may be possible. Treatment approaches have improved, leading to better outcomes for certain acute blood cancers, especially when diagnosed early.

Q. What is the difference between acute and chronic blood cancer?

Acute blood cancers, such as acute myeloid leukaemia (AML) or acute lymphoblastic leukaemia (ALL), progress rapidly and require immediate treatment. Chronic blood cancers, like chronic lymphocytic leukaemia (CLL) or chronic myeloid leukaemia (CML), progress more slowly and may not require immediate intervention. Chronic blood cancers are often managed as long-term conditions.

Q. Can blood cancer be detected early?

Early detection of blood cancer is possible through various diagnostic tests, including blood tests, imaging studies, and bone marrow biopsy. Regular health check-ups and prompt medical attention for unusual symptoms can aid in early diagnosis and improve the chances of successful treatment.

Reviewed by Dr. Rayaz Ahmed, Senior Director - Cancer Care / Oncology, Bone Marrow Transplant, Hematology Oncology, Haematology (Hematology) on 13-Feb-2024.

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