Leukemia: What Do You Need to Know?
Leukemia, a type of blood cancer, isn’t rare. In fact, doctors diagnose a new case approximately every three minutes in the United States. As is the case with many common ailments, the rate of successful treatment has increased over the years. In the early 1960s, if your diagnosis was leukemia, your five-year survival rate would have been a sobering 14%. Fast-forward to a diagnosis between 2005-2011, and you would have a five-year survival rate of 62%.
What Is Leukemia?
Leukemia is a type of cancer that affects the blood-producing cells of your body. It begins in your blood stem cells, which are the cells that become various other types of cells with different functions. Blood stem cells become either myeloid stem cells (for red cells, platelets and white cells) or lymphoid stem cells (for other white cells).
Both myeloid and lymphoid stem cells become blast cells, which are blood cells that are not fully developed. If you have leukemia, your body produces too many blast cells that don’t develop properly. Eventually, the improperly formed blast cells crowd out your healthy blood cells and prevent them from functioning normally. It is these dysfunctional blast cells that are leukemia cells.
Stages and Types of Leukemia
Cancer staging is typically done based on the size of tumors and how far they have spread. Since leukemia is not characterized by tumors, clinicians measure its stages differently. They base leukemia stages on blood cell counts and the presence of leukemia cells in various locations of the body.
Leukemia is classified into types by how fast it progresses (acute or chronic) and by the type of cells affected (lymphocytic or myelogenous).
- Acute: Cells multiply rapidly, requiring aggressive treatment.
- Chronic: Cells replicate more slowly, and cancer can go undiagnosed for a long time.
- Lymphocytic affects the cells of your immune system.
- Myelogenous affects myeloid cells, which create red, white and platelet-producing cells.
The four most common types of leukemia are:
- Acute lymphocytic leukemia (ALL): The most common type of leukemia diagnosed in children.
- Acute myelogenous leukemia (AML): The most common type of acute leukemia diagnosed in adults.
- Chronic lymphocytic leukemia (CLL): Rare in people under 30, and most common between the ages of 60 and 70.
- Chronic myelogenous leukemia (CML): Most commonly diagnosed between ages 25 and 60.
Symptoms and Causes
The type of leukemia you have determines the type of symptoms you experience. Many of the same symptoms are present whether your leukemia is acute or chronic, but there are some differences.
Acute leukemia progresses quickly and is characterized by:
- Easy bruising
- Persistent fatigue even with rest
- Slow wound healing
- Tiny red dots on your skin, usually in the lower extremities, caused by burst blood vessels
- Aches and pains
- Breathing difficulty
- Night sweats
- Low white blood cell count
Chronic leukemia has symptoms that are not as severe and are often mistaken for other illnesses. See your doctor for blood work if you haven't been feeling well, as this is how chronic leukemia is usually discovered. Symptoms may include:
- Malaise (feeling "under the weather")
- Appetite loss
- Swollen lymph nodes
- Night sweats
- Enlarged spleen (your upper right abdomen may feel full or have pain)
- Weight loss
Leukemia is the result of the DNA of blood cells mutating. If the mutation is bad enough, the cell is no longer able to function properly and begins to multiply. This process causes more defective cells, which eventually become cancer.
Prevention and Risks
Genetics and environmental exposures are the two factors that cause leukemia. While you can’t change the genes that you’ve inherited, you can do something about your environmental risk factors. Avoid exposure to:
- Cigarette smoke
- Chemicals such as benzene (found in gasoline)
Other risk factors for leukemia include:
- Previous cancer treatment, such as chemo and radiation
- Family history of leukemia
- Genetic disorders such as Down Syndrome
- Other bone marrow disorders
- Advanced age
- Male gender
It’s worth noting that having risk factors doesn’t mean you will get leukemia, and many people with leukemia don’t have any risk factors.
Diagnosis and Tests
Your doctor will likely start the diagnosis process with a physical exam to check for things such as paleness or enlarged lymph nodes, liver and spleen. Next, a blood test can determine your white cell and platelet count. If these numbers are abnormal, cancer may be present.
Leukemia cells are present in bone marrow, so your doctor can schedule a procedure to remove your marrow for testing. Clinicians take marrow from your hip bone with a long, thin needle. Further analysis of the type of leukemia cells found can determine your course of treatment.
Treatment, Procedures, and Medication
As with many conditions, your leukemia journey begins with a visit to your family doctor who will assess your symptoms and requisition tests. If the patient is a child, your doctor will refer them to a pediatric oncologist, which is a doctor who treats childhood cancer. A hematologist or medical oncologist makes the diagnosis of leukemia and will also oversee your treatment.
Several factors determine the type of leukemia treatment you will receive. These include:
- Your health
- Your age
- Your leukemia type
- Whether your leukemia has spread and how far
Common treatments for leukemia include:
- Chemotherapy, or chemicals to kill cancer cells. This treatment can be one drug or several, and oral medication or intravenous.
- Radiation therapy, in which x-ray beams kill cancer cells. Clinicians may target radiation at one area, or direct it at your entire body.
- Biological therapy, which helps your immune system fight leukemia cells using drugs, proteins or antibodies that behave in a way that is similar to your immune system.
- Targeted therapy, using drugs to attack specific weaknesses found in cancer cells
- Stem cell transplant, which destroys your diseased bone marrow using chemotherapy drugs or radiation therapy, after which you receive stem cells intravenously to help you grow new, healthy marrow.
Other clinicians you may see during your treatment include:
- Palliative care specialists
- Social workers
- Occupational therapists
Healthy Lifestyle Tips
A healthy lifestyle can have a significant impact on the progression of your illness. It can strengthen your body, bolster your immune system, improve your mood and help you avoid other health complications.
Fortunately, lifestyle is a factor over which you have some control. Positive actions to take include:
- Quit smoking
- Avoid infection risk
- Sleep well
- Get support when needed
Depending on your age, overall health and history of exercise, you should consult your doctor before making a dramatic change to your level of activity. However, once your doctor clears you, try to schedule some light exercise several times per week.
Since your leukemia treatment may suppress your immune system, you should focus on food safety and avoid items that can increase your risk of infection. Examples include:
- Raw or undercooked food
- Unpeeled fruit
- Unpasteurized dairy products
Dietary modifications can be an important part of symptom management. Your dietician may recommend strategies such as:
- Eat often but in small, nutrient-dense portions to increase your energy level.
- Choose low-fat and bland foods to combat nausea.
- Increase your fiber intake and hydration to avoid constipation.
- Prepare for each treatment with a high-protein meal an hour in advance.
- Take iron and folic acid supplements to combat anemia.
Leukemia is a serious illness, but survival rates have increased significantly, and treatment options continue to improve. Many people live beyond this diagnosis and go on to enjoy long, fulfilling lives. See your doctor regularly, learn more about the type of leukemia you have, take care of your health, and don’t be afraid to make plans for the future.
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