What is leukemia?
Leukemia is a cancer of the blood and bone marrow. The bone marrow is the spongy centre of bones, and it produces blood cells: white cells, red cells, and platelets. White cells help the body fight infections. Red cells carry oxygen from the lungs to the body’s organs. Platelets help create blood clots to control bleeding. Stem cells in the bone marrow give birth to cells that mature into white cells, red cells, or platelets in the correct amounts, in a process called differentiation.
When leukemia occurs, the bone marrow begins to produce immature white cells, called ‘blasts’, that don’t serve their purpose, and outnumber the regular cells preventing them from doing their work properly.
Leukemias are classified as either myelocytic or lymphocytic depending on what type of white cell is affected. Each type further divides into chronic or acute depending on how fast the disease spreads. Chronic leukemias progress more slowly than acute ones.
There are four main types of leukemia:
Acute Lymphoblastic Leukemia (ALL)
Acute Myelogenous Leukemia (AML)
Chronic Lymphocytic Leukemia (CLL)
Chronic Myelogenous Leukemia (CML)
More info here
Leukemia is NOT contagious!
Signs and Symptoms
The most common signs of acute leukemia are easy bruising or bleeding (as a result of platelet deficiency), paleness or unjustified fatigue (as a result of anemia), recurrent minor infections or poor healing of minor cuts (because of low white cells count).
A number of people with chronic leukemia will not experience any symptom and will be diagnosed during a routine medical check.
It is important to mention that the symptoms above are common to a number of diseases and do not necessarily indicate leukemia. However, as acute leukemia progresses fast and early diagnosis is key to beating it, it is wise to schedule an appointment with a physician for a check if you are experiencing these symptoms.
The ultimate cause of leukemia remains unknown. Chronic exposure to benzene in the workplace and exposure to extraordinary doses of ionizing radiation can be the causes, although neither explains most cases.
The aim of treatment is to bring about a complete remission, that is a state in which there is no evidence of the disease and the patient returns to good health. For acute leukemia, a complete remission that lasts five years after treatment often indicates cure. Treatment centres indicate an increasing number of people who are in complete remission after at least five years from treatment.
The most common treatments used to beat leukemia are chemotherapy and radiation. Chemotherapy involves killing the abnormal cells in the blood by means of injections of drugs. However, chemotherapy is not selective and also kills the good cells (see “chemotherapy side effects” below). This is why the patient will often receive transfusions of blood components to support the therapy. Antibiotics are also used as supportive treatments to fight infections or to avoid them.
Radiation involves the use of ionizing radiation to break down the bad cells.
In many cases a bone marrow transplant will be necessary to cure leukemia. This consists of a strong chemotherapy or radiation aimed at eradicating the natural production of blood cells by the body, eliminating the disease followed by an infusion of new stem cells to resume the normal functions of the bone marrow. This may last a few months during which the patient has to stay in isolation to prevent fatal infections. When the infused stem cells come from the patient himself, the transplant is called autologous. When instead the stem cells come from a donor, the transplant is called allogeneic.
Continued research is leading to improved drugs that in certain cases can lead to a cure even without the need of a bone marrow transplant.
Chemotherapy side effects
Not only the bad cells are sensible to chemotherapy but also the healthy ones at high replication rates. This means that chemotherapy has a number of side effects that include deficiency of the immune system, anemia, low platelet count, loss of hair, nausea, diarrhea, hemorrhoids, mucositis, and temporary sterility. The side effects depend on the type of drug used, the dosage, and the patient’s conditions. Certain drugs can have specific side effects on liver, heart, or lungs, so it is important to keep these checked regularly before, during, and after the therapy.
Side effects shouldn’t last long since normal cells tend to reform after the end of the chemotherapy. It is possible to limit certain side effects (i.e. nausea) with the use of some provisions.
How to behave during chemotherapy
A. Diet: a balanced diet is paramount to ensure a proper amount of calories and reduce or avoid weight loss. In case of nausea you should refer to your physician. In case of loss of appetite it can help to eat smaller quantities of food but more often during the day. Eat more at the times of the day when you feel stronger, like at breakfast. Eating every few hours, before you get hungry, can also help with nausea, as hunger pangs can make nausea worse. It is also important to drink much water and juices to help the body eliminate the toxins of chemotherapy drugs. Ask your physician if you can drink wine or beer.
B. Hygiene: Cleaning your hands often reduces the odds of contracting infections, while a correct oral hygiene prevents mucositis.
C. Psychological aspects: If you notice changes in your body or mood you should not get scared. Talk to your physician about it.
D. Sex: It is possible to have sex during chemotherapy as long as it is protected, to avoid contracting infections and also to avoid damage to the fetus.
E. Taking other drugs: Always ask your physician to ensure compatibility and avoid interactions.
F. Work: It is possible to continue working or studying if your body allows you to, but always keep in mind that the highest priority is fighting leukemia, and you may need extra rest for that.
How to assist friends or relatives with leukemia?
Leukemia treatment can be heavy for the patient in both a physical and psychological way. Spending a long time in isolation is hard and it is easy to lose motivation. Let your friends or relatives know that you are there for them, let them know how much you miss them and that you want them back with you soon, so they never lose sight of what beautiful prize awaits them if they hold on: going back to life.
Keep in mind that leukemia patients have a higher than normal probability of getting sick, because chemotherapy lowers their white cells count (the cells that fight infections in the body), so you will have to wash your hands more often, and if you have a runny nose or a cough be sure to keep your distance. They will also be weaker than usual and they may not be able to take part to all activities. Make sure you organize or invite them to activities they are able to do.
Check out this further resource if you have teenagers with cancer.