According to recent statistics, leukaemia and Non-Hodgkin’s lymphoma are both amongst the top five cancers diagnosed in both men and women within Pakistan, said Dr Uzma Zaidi, consultant clinical haematologist, transplant physician and assistant professor at the National Institute of Blood Diseases, Karachi, at a webinar organised by the Neurospinal and Cancer Care Institute on Wednesday.
“Blood cancers essentially affect the production and function of your blood cells, and most originate in the bone marrow where blood cells are produced. So far, there are 137 types of blood cancers and related disorders, including leukaemia, lymphoma and multiple myeloma,” she said.
“As the exact causes of blood cancers remain unknown, researchers believe that they are caused by faults in DNA, a substance within your cells. The DNA, which is made up of small sections known as genes, determines how the cells develop, behave and die. However, research has shown that there are various factors that can increase the risk of developing certain types of blood cancer — age, sex, ethnicity, family history, exposure to radiation and harmful chemicals, contamination of water etc.”
Moreover, viruses, including the Epstein-Barr virus, have been linked to cases of some of these cancers, and medicines can also lead to blood cancers. “These include tumour-necrosis factor (TNF) blockers used to treat rheumatoid arthritis and steroids for eczema, usually carry a black box warning to that effect,” said Dr Zaidi.
“Blood cancers are also associated with poor diet, lack of exercise, excessive use of alcohol & consumption of tobacco that is carcinogenic, so it is always recommended to avoid these and ensure a healthy lifestyle.
“The signs and symptoms can be quite variable depending upon the type of blood cancer that occurs. The common symptoms are unexplained fatigue, fever, weakness, and tiredness which can be fast developing in conditions such as acute leukaemia versus a more insidious process in chronic leukaemia. There may be bleeding manifestations, bone pains, the occurrence of swellings involving the entire body, loss of appetite, weight loss, and abdominal pain.”
Dr Zaid further said: “In general, the symptoms can be quite non-specific which could even mimic a flu-like symptom to more dramatic ones such as bleeding manifestations and severe infection. This overlap of symptoms can often lead to misdiagnosis or delay.”
As with other types of cancer, early diagnosis and getting timely treatment can improve outcomes for blood cancer patients.
There has been a lot of research in the clinical haematology space, leading to a number of novel and innovative treatments, which is good news. Often, however, these new therapies are very costly. This is a concern not only for individuals but also for society at large in terms of working towards greater equity in cancer care.
All these classes of blood cancers have different presentations, different biologies, and are treated differently ranging from intensive chemotherapy to immunotherapy to targeted therapy and bone marrow transplant or stem cell transplantation.
Earlier, Adeel Ahmed, manager marketing at the NCCI, addressing the inaugural session of the programme, thanked and appreciated Prof Tahir Shamsi for providing a platform to haematologists, oncologists and immunologist to discuss, coordinate and share their experience on a national basis.