HealthyCanada.com

Overview

Leukemia is a type of cancer that starts in the white blood cells. About 4000 new cases are diagnosed in Canada every year with men affected more often than women. Leukemia is the most common form of cancer in children with about 340 new cases annually but because of advances in treatment it is now one of the most curable cancers with a survival rate of nearly 80 per cent.

Common symptoms of leukemia include:

• fatigue
• pallor
• fevers or night sweats
• easy bruising or bleeding
• pain in the bones or joints
• frequent infections
• weakness
• swelling or discomfort in the abdomen
• swollen lymph nodes
• weight loss

Many of these symptoms are similar to those found in other illnesses. It is usually their persistence and progression that indicates leukemia. Your doctor can arrange for blood tests and examination of bone marrow to confirm or rule out leukemia.

In most people the body's bone marrow produces healthy white blood cells. But sometimes this process can go awry and abnormal cells are created. These leukemia cells bully their way around crowding out healthy white and red blood cells and platelets. Once they've pushed their way into the bloodstream they can move throughout the body where they play havoc with the lymph nodes liver spleen and other organs.

Not all leukemia is the same. Different types are grouped by how quickly the disease develops and progresses. If it gets worse slowly it is called chronic. If it spreads more quickly it is known as acute leukemia. Within these categories there are four common types of leukemia:

• Chronic lymphoctic or lymphoblastic leukemia primarily affects people over the age of 55.
• Chronic myeloid or myelogenous leukemia affects mainly adults.
• Acute lymphocytic or lymphoblastic leukemia is the most common type of leukemia in young children although it can also affect adults.
• Acute myeloid or myelogenous leukemia occurs in both adults and children.

There are some other rare forms of leukemia including hairy cell leukemia but these affect very few people.

No one knows why one person gets leukemia and another does not. But while there is no known cause research has shown that people with certain risk factors are more likely than others to develop leukemia. Risk factors include:

Very high levels of radiation

People exposed to very high levels of radiation are much more likely than others to develop leukemia. Medical treatment that uses radiation can be a source of high-level exposure. Radiation used for diagnosis however exposes people to much lower levels of radiation and is not linked to leukemia.

Working with certain chemicals

Exposure to high levels of benzene and formaldehyde in the workplace can put people at a greater risk of leukemia.

Chemotherapy

Cancer patients treated with certain cancer-fighting drugs sometimes later develop leukemia.

Down syndrome

Diseases caused by abnormal chromosomes may increase the risk of leukemia.

Human T-cell leukemia virus-I

This virus causes a rare type of chronic lymphocytic leukemia known as human T-cell leukemia.

Myelodysplastic syndrome

People with this blood disease are at increased risk of developing acute myeloid leukemia.

It is important to know that most people who have known risk factors do not get leukemia while others who do get the disease have none of these risk factors. While this may seem confusing the important thing to know is that there is treatment for those who do come down with the disease and where once leukemia was often fatal today the cure rate is very high.

If your doctor diagnoses leukemia you will likely be referred to a specialist for treatment which will depend on the type and extent of the disease.

Most patients with leukemia receive chemotherapy. This type of cancer treatment uses drugs to kill leukemia cells. Depending on the type of leukemia the patient may receive a single drug or a combination of two or more drugs.

Another option may be biological therapy in which an antibody is injected into a vein in an effort to improve the body's natural defenses against cancer and slow the growth of leukemia cells. There is also radiation therapy (also called radiotherapy) which uses high-energy rays to kill leukemia cells and bone marrow transplantation or other forms of stem cell transplantation.

People with acute leukemia need to be treated right away. The goal of treatment is to bring about a remission. Then when signs and symptoms disappear more therapy may be given to prevent a relapse. This type of therapy is called maintenance therapy. Many people with acute leukemia can be cured.

Chronic leukemia patients who do not have symptoms may not require immediate treatment. The doctor may suggest watchful waiting for some patients with chronic lymphocytic leukemia. This means the progression of your disease will be monitored and treatment started only if symptoms occur or worsen.

Treatment for chronic leukemia can often control the disease and its symptoms. However chronic leukemia can seldom be cured. In addition to anticancer therapy people with leukemia may have treatment to control pain and other symptoms of the cancer to relieve the side effects of therapy or to ease emotional problems.

Because cancer treatment may damage healthy cells and tissues unwanted side effects are common. Specific side effects depend on many factors including the type and extent of the treatment. Side effects may not be the same for each person and they may even change from one treatment session to the next. Before treatment starts health care providers will explain possible side effects and suggest ways to manage them.

Some people find they need help coping with the emotional and practical aspects of their disease. Support groups can help.