TREATMENTS AND
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Cancer care

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Blood cells are all manufactured by the bone marrow, the soft, spongy inner portion of certain bones. Normal, healthy white blood cells have a very short life span sometimes only a few hours long and are continuously replenished in the bone marrow. They proceed through their life cycles in an orderly way, and when they die they are replaced by new cells.

What is leukaemia?

Leukaemia develops when the genetic material, or DNA, of a white blood cell is altered. These diseased cells cannot mature beyond an early stage in their life cycles, so they never develop into functional cells. The diseased cells, called blasts, eventually take over the bone marrow and do not allow normal RBC, WBC and platelet development.

As the numbers of normal cells decline, patients may develop anaemia, a low level of oxygen-carrying red blood cells; infections caused by low counts of micro-organism fighting white blood cells; and bruising and bleeding, resulting from low levels of platelets. Leukemic cells may also invade the liver, spleen, lymph nodes, and other organs.

They can be classified as Acute or Chronic Leukaemia depending on the type of blood cell affected, we could also classify them as:

  • Acute Lymphocytic Leukaemia (ALL) - This is the most common type of leukaemia in young children. ALL can also occur in adults.
  • Acute Myelogenous Leukaemia (AML) - AML is a common type of leukaemia. It occurs in children and adults. AML is the most common type of acute leukaemia in adults.
  • Chronic Lymphocytic Leukaemia (CLL) - With CLL, the most common chronic adult leukaemia.
  • Chronic Myelogenous Leukaemia (CML) - This type of leukaemia mainly affects adults. A person with CML may have few or no symptoms for months or years before entering a phase in which the leukaemia cells grow more quickly.

Risk Factors

  • People who have had some types of radiation or chemotherapy for other cancers
  • People with certain genetic disorders
  • Exposure to certain chemicals like benzene
  • Smoking
  • Family history

However, most people with known risk factors don't get leukemia. And many people with leukemia have none of these risk factors.

Diagnosis

Leukaemia is diagnosed by looking for physical signs like pallor, lymph node swelling, enlargement of liver and spleen and by a complete blood count which would show abnormal levels of the blood cells. Post which a bone marrow biopsy is done to classify the disease and determine treatment options for the patient.

Treatment options: Leukaemia is treated by any of these methods or a combination of the options

  • Chemotherapy
  • Biological therapy
  • Targeted therapy- where medications are used to target specific vulnerable areas in the cancer cells. This helps in disease control
  • Radiotherapy
  • Stem cell transplant

What is a Stem cell transplant?

One of the most advanced and innovative therapies for leukemia is the Stem cell transplant, a procedure to replace the diseased bone marrow with healthy bone marrow.

Before a Stem cell transplant, high doses of chemotherapy or radiation therapy are used to destroy the diseased bone marrow. Then an infusion of blood-forming stem cells is given that help to rebuild your bone marrow.

Stem cells can come from a donor [allogeneic], or in some cases we may be able to use the patient’s own stem cells [autologous]. A Stem cell transplant is very similar to a bone marrow transplant.

Treating childhood cancers

In India, each year 150 out of every one million children are diagnosed with cancer. cancers affecting children are of a unique kind.

Leukaemia is the cancer of bone marrow and blood. It is the most common childhood cancer and accounts for about 30 % of all cancers in children. Common symptoms are bone and joint pain, fatigue, weakness, pale skin, bleeding or bruising, fever, weight loss amongst others.

Brain and central nervous system tumours account for about 26% of childhood cancers. Headaches, nausea, vomiting, dizziness, trouble walking or handling objects are common symptoms of these cancers.

Neuroblastoma affects infants, young children and starts in the early forms of nerve cells in a developing embryo or fetus.

Wilmus tumours (nephroblastoma) starts in one or rarely both kidneys. It is most often found in children between 3 to 4 years of age.

Lymphomas starts in certain cells of the immune system called lymphocytes. They can cause weight loss, fever, sweating, tiredness and swollen lymph nodes under the skin in the neck, armpit, or groin.

Rhabdomyosarcoma starts in cells that normally develop into skeletal muscles. It accounts for about 3% of childhood cancers.

Retinoblastoma is a cancer of the eye. It accounts for about 2% of childhood cancers. Primary bone cancers (cancers that start in the bones) occur most often in older children and teens, but they can develop at any age. They account for about 3% of childhood cancers.

Treatment procedure includes chemotherapy, surgery, radiotherapy or a combination of all.

In seeking treatment for a child diagnosed with cancer, do look for the following aspects while choosing the cancer care hospital:

  • Multidisciplinary medical team that works together to decide the best treatment option for the child.
  • Minimally invasive cancer surgery that reduces pain and shortens the child's stay in the hospital so that the child can return to daily routine soon.
  • Advanced radiation therapy that ensures minimal trauma due to precise targeting of the cancer.
  • Advanced pathological analysis of tumour to ensure the right dose of chemotherapy or radiation.
  • Blood bank standards that are of international quality.
  • Trained staff who are sensitive to caring for children with cancer and provide support to the family as well.