Remarkable progress has been made in treating patients with blood cancers. Today, about 75 percent of children with acute leukemia and nearly 80 percent of children and adults with Hodgkin lymphoma are cured of their cancer.
But we have a long way to go. More than 894,000 people in the United States currently have some form of blood cancer, and an estimated 52,910 will die from one this year. George Weiner, MD, director of the Holden Comprehensive Cancer Center at the University of Iowa Hospitals and Clinics, talks about blood cancers:
Are there signs or symptoms that someone may have blood cancer?
There are no specific signs and symptoms. People with blood cancers sometimes are found to have the cancers and have no symptoms at all. Other times they may be tired or have an enlarged lymph node that is not going away. But in contrast to some types of cancers, there is no one specific thing that people can look for that might raise their suspicions that they have one of these types of cancers.
How are blood cancers diagnosed?
Leukemias are usually diagnosed based on a blood sample that's looked at under the microscope where the white blood cells will look different than the normal white blood cells. On occasion for lymphoma, lymph nodes need to be biopsied. This very often is done with a minor procedure that can be done under a local. On occasion, a bone marrow test needs to be done. So either a blood test, a lymph node biopsy, or a bone marrow test is what's necessary for diagnosis.
Are blood cancers inherited (or genetic)?
They are not inherited, although some families do have slight predisposition to developing these. We have a research program to try to understand why some families may be more prone to getting these cancers than others. They are genetic in that a blood cell or a lymph node cell has a genetic abnormality that develops spontaneously and that it's the genetic abnormality that causes the cancer. So it's genetic in the cancer, but it's not necessarily inherited from your family.
Do all blood cancers need to be treated?
No, they don't. Blood cancers are very variable on how aggressive they are. Some of them are the most aggressive cancers we know and need to be treated within days. An example would be an acute leukemia. There are other chronic leukemias, such as chronic lymphocytic leukemia, that sometimes never needs to be treated. People can live with them for 10 or 20 years without the need for treatment. So it's very variable. Some need to be treated immediately; some never need to be treated at all.
What would you recommend someone newly diagnosed with blood cancer do about finding a facility to treat their cancer?
The most important thing is to identify a facility and a doctor with a lot of experience with that particular type of cancer. We're learning more and more about the blood cancers—almost on a monthly basis. We're able to subdivide them based on the genetics of the cancer cell and other factors to determine the type of treatment that's necessary. Most important, for either for a first opinion or a second opinion, is to find a doctor who is an expert in that particular type of cancer.
Are there physicians who specialize in leukemia, lymphoma, and myeloma specifically?
Yes, generally a hematologist or an oncologist takes care of patient with these disorders. At major medical centers, there are physicians who specialize very specifically in leukemia, lymphoma, and myeloma.
Why is it important to be treated by a physician that deals specifically with the type of cancer diagnosed?
Because it's very important to know the latest as far as treatment and diagnosis go. Very sophisticated tests can now be done looking at the actual genes within the cancer cells, and this information can be helpful in determining what type of treatment is best.
What makes some forms of cancer curable, while others are not?
That's an outstanding question that we really wish we had the answer to. We don't understand why some cancers are more curable than others. What we do know is that targeted therapies—therapies that specifically go to what's abnormal about the cancer—are proving very effective; particularly in the case of the blood cancers. Some of these treatments have resulted in dramatic changes in our ability to cure diseases that just five years ago were not curable.
What is your best advice for someone recently diagnosed with leukemia, lymphoma, or myeloma?
I would suggest they first talk to their doctor about how aggressive that type of cancer is. I would also suggest seeking expertise of someone who specializes in that type of cancer. |
