What Is Blood Cancer?

A blood cancer is a disease in which abnormal blood cells reproduce rapidly and begin interfering with the body’s usual operations. Cancers of this type originate in the bone marrow, where red blood cells, white blood cells, and platelets are produced. There are three primary blood cancers: leukemia, lymphoma, and myeloma. More than 1.2 million Americans are currently diagnosed with a blood cancer; about 10 percent of all new cancer diagnoses every year are hematological, or blood-related. 

Blood cancers are a major health risk. In recent years, more than 50,000 persons have died annually in the U.S. from leukemia, lymphoma, myeloma, and less common forms of the disease. If you or a loved one is exhibiting blood-cancer symptoms, the oncologists and other caring professionals at Baptist Health can help. 

What Types of Blood Cancer Are There? 

The three most common types of blood cancer are:

Leukemia

Leukemia is a cancer of the white blood cells, which your body produces to fight disease. It results from the overproduction of abnormal cells, weakening your immune system and also limiting the creation of red blood cells and platelets. Leukemia cells are usually found in the bone marrow, but can also spread to the liver, lymph nodes, and spleen. There are both acute (rapidly developing) and chronic (or more slowly developing) versions of this disease. It tends to target people at both ends of the age spectrum: children under age 15 and adults older than age 55. 

Lymphoma

Lymphoma is a blood cancer that attacks the lymph nodes, which is another important part of your immune system. Healthy cells, called lymphocytes, are replaced by abnormal lymphoma cells. The buildup of cancerous cells in the lymph nodes reduces your resistance to infection and disease. The widespread distribution of lymphatic tissue means that lymphoma cells can be found just about anywhere in the body. There are two chief types of lymphoma: Hodgkin’s and Non-Hodgkin’s. The first targets mostly teenagers and young adults between the ages of 15 and 35, while the second is more common in adults older than age 60. 

Myeloma

Myeloma is a blood cancer originating in plasma cells. The latter are white blood cells that create antibodies. The spread of abnormal plasma cells lowers antibody production, while increasing susceptibility to disease. Myelomas typically form tumors in the bone marrow. The disease is sometimes classified by the number of infected sites, either single or multiple. Men are more likely to develop myelomas than women, and African-Americans have a greater risk of this condition than European-Americans. 

What Are Blood Cancer Symptoms?

Blood cancer symptoms include:

• Weakness and fatigue
• Loss of appetite
• Flu-like fevers and chills
• Joint pain
• Rashes and itchy skin
• Swollen lymph glands
• Weight loss without apparent cause (dieting, for example)
• Night sweats
• Regular infections
• Frequent bruising and bleeding
• Headaches
• Breathing difficulty
• Abdominal irritation or discomfort

There is some variation among symptoms, depending on the type of cancer. Additionally, women and children may experience some symptoms that are unique to them.

Leukemia

Symptoms of leukemia vary on the type of leukemia. Common symptoms include:

• Chronic fatigue that does not improve with rest
• Bruises easily
• Blood clotting issues
• Frequent infections and high fevers
• Unexplained weight loss
• Swollen lymph nodes (in the neck, armpits, and groin)

In children, common symptoms include:

• Anemia
• Bruising and bleeding
• Getting infections easily
• Weight loss
• Swollen lymph nodes (your child’s neck may look swollen)
• Belly pain (specifically if the liver or spleen are swollen)
• Bone pain (you may notice your child limping or avoiding walking)
• General feeling of being unwell
• Night sweats

Lymphoma

• Lumps (painless swollen glands in the neck, collar bone, armpit, or groin regions)
• Some of the swollen lymph nodes can press on organs and cause pain in your chest or belly, and trigger coughing and breathlessness
• Fever
• Unexpected weight loss
• Night sweats that soak through your clothes and sheets

Myeloma

• Nausea
• Fatigue and exhaustion
• Bone pain
• Breathlessness

Myelodysplastic syndromes (MDS)

• Anemia
• Bruising and bleeding issues
• Infections

Myeloproliferative neoplasms (MPN)

There are 3 types of myeloproliferative neoplasms. They are polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF). 

• PV. Symptoms can include headache, blurred vision, skin changes. Many people experience no symptoms and are often diagnosed only after a blood test.
• ET. Often people do not experience symptoms. However, older people with low platelet counts can experience symptoms of persistent or repeated headaches, disturbed vision, dizziness or ringing in the ears, bruising and bleeding easily, erythromelalgia, fingers or toes turning blue or feeling cold.
• MF. Symptoms may include breathlessness, difficulties fighting infections, and unusual bleeding and bruising. Additionally, you may experience fatigue, chest pain, headaches, tinnitus, belly pain, night sweats, fever, and weight loss. 

Women and blood cancer

Although men and women exhibit fairly similar symptoms with blood cancer, there are sex-specific symptoms and women’s issues that are important to know and discuss with your doctor. One of the symptoms women can have with blood cancer is heavier or irregular menstrual flows. Your period may be much heavier, or you may notice bleeding in between cycles that is usually more than just normal spotting that can happen.

Additionally, symptoms of blood cancer can look very similar to symptoms of menopause or some symptoms of pregnancy, and therefore can be easily missed by you and your doctor. It is also important to note that women who have MPN’s need to consult with their doctor before using contraceptives due to an increased risk of blood clots. Please consult with your doctor if you are experiencing any symptoms, or if you have an MPN and are needing to try a contraceptive.

What Causes Blood Cancer?

Medical researchers have yet to determine the cause or causes of blood cancers. Possible contributing factors include:

• Genetics: Leukemia appears linked to certain genetic disorders, such as Down’s Syndrome.
• Family history: The chance of developing a blood cancer increases if other family members have been diagnosed with the same or a similar condition. 
• Smoking: Smoking is correlated with an increased incidence of several cancers, not limited to the lungs. 
• Weakened immune system: Weakened immune systems are possibly both causes and effects of blood cancers.
• Exposure to certain chemicals: Coming into regular contact with industrial and other chemicals, such as benzene, appears to increase the likelihood of undergoing a blood cancer. 
• Previous cancer treatments: Some blood cancers develop as unwanted side effects to radiation and chemotherapy treatments for non-hematological forms of cancer.
• Exposure to radiation in a non-medical context: This might include both ionizing and non-ionizing forms of radiation.

Susceptibility to blood cancers is also influenced by age, sex, race, and other factors. 

How Is Blood Cancer Diagnosed?

Unlike breast and colorectal cancer, there are no screening methods for the early detection of blood cancers. They are often diagnosed based on symptoms in the context of a physical exam:

• Physical exam: Your physician will document symptoms at the time of your exam. If what you describe meets some or all of the criteria for a blood cancer, he or she will take additional steps to confirm the diagnosis. 
• Blood tests: Blood tests are essential to determining the presence of a blood cancer. One common test is called a complete blood count, or CBC. A CBC documents the relative volume of various blood components, including red blood cells, white blood cells, platelets, hemoglobin, and hematocrit, which is a ratio of red blood cells to plasma. If any of these counts or their relative proportions are outside normal guidelines, your doctor may order additional testing. Additional blood tests might involve looking at cell samples under a microscope or assessing the blood’s clotting capacity. 
• Bone-marrow exam: Another test for blood cancer involves a bone-marrow biopsy, typically conducted by needle through the pelvis. This is done because blood cancers originate where blood is produced, inside the bones. In rare cases, a lumbar puncture is performed, to see if blood cancer cells have invaded the fluid that surrounds the brain. 
• Diagnostic imaging tests, including X-rays and CT scans: Imaging technologies can provide evidence of swollen lymph nodes or the presence of cancer in the liver or spleen. 
• Lymph-node removal and analysis: Lymph nodes can be surgically removed from the body and analyzed for cancer. 
• Survival rates for blood-cancer patients have improved in recent decades. A majority of individuals with leukemia and Hodgkin’s and Non-Hodgkin’s lymphoma are now living five years or longer from the time of diagnosis.

How Is Blood Cancer Treated?

Treatment for blood cancer depends on a number of factors, including the disease involved, your age, the cancer’s stage of development, and where it has spread in the body:

• Radiation therapy: Oncologists use radiation therapy to kill cancer cells in a specific area, most commonly with lymphoma.
• Chemotherapy: Chemotherapy is an effective means of killing cancer cells that have spread from their place of origin. 
• Stem-cell transplantation: Radiation and chemotherapy destroy good cells as well as bad ones. This can be counteracted by injecting the patient with stem cells, often acquired from a cancer-free donor. These stem cells will encourage the reproduction of healthy new blood cells.
• Biological or immunotherapies: These are newer methods of fighting cancer that enlist the body’s own immune system to combat cancer. 
• Surgery: The surgical removal of cancerous organs is recommended on occasion. 

Treatment will also involve antibiotics to maintain the patient’s health while his or her immune system is depleted, and various medications for suppressing the unpleasant side effects of cancer treatments. 

Prognosis & Complications

For most types of blood cancer, the rate of survival has significantly improved over the past decade. The five-year survival rate ranges from 42% for myeloma to 85% for Hodgkin Lymphoma. However, despite the significant improvements, the five-year survival rate for most blood cancers remains much lower than other cancers. 

Your specific prognosis will be assessed and determined by your healthcare team. Doctors usually determine a prognosis by comparing with a large group of others who have had your same type of cancer and staging. General fitness and age may also be taken into account when determining a prognosis. Keep in mind that not every patient is the same in their response to treatment, and outcomes may look different among individual patients. Prognosis typically gives a general outlook after treatment, and sometimes may change as you move through your treatment plan.  

Cancer treatments typically come with some risk for side effects or complications. The biggest complication of blood cancer treatments would be the increased risk of infection. This is because treatments for blood cancer weaken your immune system, potentially causing you to develop a condition known as neutropenia. This condition develops when your body can’t make enough white blood cells, and makes you more vulnerable to infection. If you develop an infection while you have neutropenia there is a greater risk for developing neutropenic sepsis, which can be life-threatening. Additional complications from the cancer and treatment can be nausea, vomiting, mucositis, difficulties with eating and drinking, and emotional distress.