India sees 1 new case of blood cancer every 5 minutes; experts share solutions

In recent years, the Indian medical community has placed greater emphasis on finding treatments for blood cancer. This heightened focus is driven by several key factors. The pivotal factor being the rising incidence of these diseases: India ranks third globally in reported blood cancer cases, with a new diagnosis every five minutes and around 70,000 annual deaths, shares Dr. Aman Priya Khanna, Bariatric, and Minimal Access Surgeon, New Delhi.

Secondly, leukaemia comprises over 50 per cent of cases, alongside rising lymphoma and myeloma instances. Consequently, there is a growing understanding of the various subtypes and complexities of blood cancers. Lastly, scientific researchers have made progress in unravelling the genetic and molecular mechanisms behind these diseases, allowing for more targeted and precise treatment approaches.

Blood cancer continues to affect a substantial number of Indians including children. According to the National Institute of Health - India witnesses close to 25,000 children receiving cancer diagnosis, and among them, approximately 9,000 are afflicted with leukaemia. In honour of Blood Cancer Awareness Month in September, we delve into a comprehensive understanding and treatments available for this life-threatening illness.

Understanding blood cancer
Blood cancer is a form of cancer that impacts the blood cells within the body. Normally, our body generates various kinds of blood cells, including red blood cells, white blood cells and platelets. However, in the case of blood cancer, the production of these blood cells is disturbed, leading to the uncontrolled growth of abnormal blood cells, informs Dr Richa Bansal, a practising oncologist from Mumbai.

The disease encompasses various types, with leukaemia, lymphoma, and myeloma being the most prevalent among them. These malignancies target distinct blood cell types and can potentially spread to diverse body regions. Symptoms often encompass fatigue, weakness, fever, unexplained weight loss, and atypical bleeding or bruising.

Known types of blood cancer
Blood cancers encompass a diverse group of malignancies that originate in the blood-forming tissues. They are broadly categorised into three main types: leukaemia, lymphoma, and myeloma.

Leukaemia: Leukaemia is a blood cancer characterised by the rapid production of abnormal white blood cells, which crowd out healthy cells in the bone marrow and bloodstream.

Lymphoma: Lymphomas are cancers of the lymphatic system, which include lymph nodes, spleen and lymphocytes (a type of white blood cell).

Myeloma: Multiple myeloma, often referred to simply as myeloma, is a cancer that originates in plasma cells, a type of white blood cell responsible for producing antibodies. It primarily affects the bone marrow and bones, leading to symptoms like bone pain and anaemia. Multiple myeloma is the third major type of blood cancer.

Diagnosing Blood Cancer
Early detection is crucial for successfully treating blood cancer. Haematologist-oncologists are the specialists who conduct these tests. The process begins with a thorough medical history review and physical examination to identify potential symptoms or risk factors. If blood cancer is suspected, the following steps are typically taken to confirm the diagnosis.

Blood tests: Blood cancers often lead to abnormal blood cell counts. A complete blood count (CBC) is one of the initial tests performed. It measures the levels of red blood cells, white blood cells and platelets in the blood. Elevated or reduced counts of any of these cell types can be indicative of blood cancer. Additionally, a peripheral blood smear may be examined under a microscope to assess the shape, size and maturity of blood cells, which can provide further clues.

Bone marrow aspiration and biopsy: If blood abnormalities are detected, the next step is often a bone marrow aspiration and biopsy. In this procedure, a small sample of bone marrow and bone tissue is collected from the hip bone or breastbone. A pathologist then examines these samples under a microscope to identify the presence of cancerous cells and determine their type.

Imaging tests: Imaging studies, such as X-rays, CT scans, PET scans or MRI scans, may be conducted to evaluate the extent of the disease and identify any enlarged lymph nodes or organs affected by the cancer. These tests can help stage the cancer and guide treatment decisions.

Expert insights on treatment options for blood cancer
India offers diverse treatments based on type, stage and preferences in their renowned centres with collaborative and advanced therapies and research. Dr Khanna shares the treatment options available in India:

Chemotherapy: Chemotherapy remains a primary treatment modality for blood cancers. It involves the use of drugs to kill cancer cells or prevent their growth. The Indian medical industry has evolved to gain access to the latest chemotherapy drugs and protocols ensuring patients receive the most effective treatments.

Stem Cell Transplantation: Bone Marrow Transplantation also known as Stem Cell Transplantation, involves replacing damaged or diseased marrow with healthy stem cells. The new stem cells can come from the patient themselves (autologous transplant) or from a donor (allogeneic transplant). The procedure aims to restore the body's ability to produce new, healthy blood cells and improve overall health. Complications like graft-versus-host disease and infections can occur, but it offers hope for long-term remission or cure.

Targeted Therapies: India has embraced targeted therapies that specifically target cancer cells while minimising damage to healthy cells. Targeted therapy focuses on specific molecules that play a role in the growth and spread of cancer cells. It offers a more focused approach with potentially fewer side effects. This approach is especially beneficial in treating certain types of blood cancers, such as chronic myeloid leukaemia (CML) and some forms of lymphoma.

Immunotherapy: Immunotherapy for blood cancer utilises the body's immune system to eliminate cancer cells. It includes methods like monoclonal antibodies, immune checkpoint inhibitors, and CAR-T cell therapy. While it can lead to long-lasting responses, side effects such as fatigue and flu-like symptoms may occur.

Radiation Therapy: Radiation therapy includes external beam radiation and internal radiation. This method uses high-energy beams to destroy cancer cells or shrink tumours. Side effects include fatigue, skin changes and temporary hair loss. Advanced stereotactic body radiation therapy (SBRT) minimises harm to healthy tissue.

Clinical Trials: India actively participates in clinical trials, providing patients with access to cutting-edge therapies and experimental treatments. This involvement in research contributes to ongoing advancements in blood cancer care.

Supportive Care: Comprehensive cancer care in India includes robust supportive services such as pain management, palliative care, psychological support, and nutritional guidance. These services are essential for improving the overall quality of life for blood cancer patients.

Ayurveda treatments: Ayurvedic cancer treatments involve herbal supplements, meditation, yoga, and detoxification practices. It aims to strengthen the body's natural defences and create an environment less conducive to cancer growth. In 1997, AML was successfully treated with Ayurveda after two unsuccessful rounds of chemotherapy.

Additionally, homeopathy's role in cancer care often focuses on improving the overall quality of life, reducing stress, and managing side effects like nausea and fatigue.

Complementary Therapy: Modalities like massage, acupuncture, and meditation aid in relaxation and alleviating stress.

Wait and Watch: This approach may be adopted for some instances with slow-growing or asymptomatic blood cancers, avoiding unnecessary aggressive treatment.

Cost of Blood Cancer Treatment in India
The cost depends upon treatment type, hospital facilities and location. India is known for affordable yet high-quality medical care. The price ranges between Rs 40,000 - 10,00,000 which includes diagnostic tests, consultations, hospital stays, medications, and supportive care expenses. Health insurance coverage and government schemes can help reduce costs. Discussing treatment costs with healthcare providers and exploring financial assistance options can aid in planning expenses.

How can you help blood cancer patients
Register as a stem cell donor: One of the most impactful ways to help is by registering as a potential stem cell donor. Organisations like bone marrow registries or stem cell donor programs maintain databases of potential donors. Individuals can sign up to become donors and their tissue type information is added to the registry. If a patient in need matches their tissue type, they may be asked to donate stem cells or bone marrow.

Promote awareness: Spread awareness about the importance of stem cell donation for blood cancer treatment within your community and social networks. Encourage friends and family to register as donors, and share information about donor drives and registration events.

Participate in donor drives: Attend or organise donor drives in your local area or workplace. These events aim to recruit potential donors by collecting tissue-type information and raising awareness about the need for stem cell donations.