Understanding blood cancers

Your blood flows through every part of your body, carrying oxygen and nutrients. It also plays a role in everything from your immune system to your metabolism to your body temperature. Considering how vital your blood is, you may wonder — what happens if you are diagnosed with a blood cancer?

Blood cancers can interfere with many of your body’s functions in ways that other cancers may not. Here’s what you should know to better understand blood cancers.

What are blood cancers?

There are many different blood cancers, but most fall under one of the three main types: lymphoma, leukemia and myeloma.

"All three of these impact the way your body makes blood cells and how well your blood cells are able to do their job. Still, they have some important differences," says Deric C. Savior, MD, a medical oncologist at Lankenau Medical Center, part of Main Line Health, and co-director of Main Line Health Cancer Care.

Lymphoma

Lymphomas affect your body’s lymphocytes, which are a type of white blood cell crucial to your immune system. With lymphoma, abnormal lymphocyte cells — called lymphoma cells — build up over time (often in your lymph nodes) and weaken your immune system.

Lymphoma can cause symptoms like:

• Enlarged lymph nodes
• Fatigue
• Fever
• Sweating (especially night sweats)
• Unintentional weight loss
• Itchy skin

Under 5% of all cancer cases in the U.S. are lymphoma. While health care researchers aren’t sure what causes lymphoma, there are risk factors that make you more likely to develop the disease. For instance, males are slightly more likely to have lymphoma. Other risk factors include having a lowered immune system (due to disease or medication) and certain infections (like Epstein-Barr virus).

"In order to diagnose lymphoma, your health care provider will need to biopsy (take a small tissue sample) from your lymph node and may need to run further tests, like blood tests. If you do have lymphoma, these can tell you what type of lymphoma you have," says Dr. Savior.

The two main types of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma. Non-Hodgkin lymphomas are made up of many subtypes and are more common than Hodgkin lymphoma.

Leukemia

Blood cells are made in your bone marrow, which is the spongy tissue in the middle of most of your bones. With leukemia, your bone marrow produces abnormal blood cells (usually white blood cells) — and then it overproduces them.

Not only can these abnormal cells not perform their function, but over time, they leave little room for healthy blood cells. Without healthy cells that are able to perform their job, you could have symptoms that include:

• Fatigue and weakness
• Bleeding from your gums
• Appetite/weight loss
• Frequent infections
• Bone pain
• Easy bruising

"Leukemia can be either acute, meaning it develops quickly and needs to be treated swiftly, or chronic, meaning it progresses slowly and symptoms may take longer to show," says Dr. Savior.

While leukemia is the most commonly diagnosed cancer in children and teens, some types are more likely to occur in adults. The cause of leukemia remains unknown, but there are risk factors for certain kinds of leukemia, including having a family history of leukemia, having received previous cancer treatment, having some genetic disorders (like Down syndrome) and smoking.

If you or your health care provider suspect you might have leukemia, your health care provider will likely use blood tests like a complete blood count (CBC) and a physical exam to start. A bone marrow biopsy can then determine the type of leukemia and help guide the treatment course.

Myeloma

Myeloma (also called multiple myeloma) is a cancer of your blood’s plasma cells — a type of white blood cell that make antibodies to fight infection. With myeloma, your plasma cells don’t produce antibodies properly, meaning you can’t fight infections effectively.

"Just like with leukemia, the myeloma cells can overcrowd your normal, healthy blood cells in the bone marrow and interfere with your blood’s ability to carry out its tasks," says Dr. Savior.

Myeloma’s abnormal antibodies can cause kidney damage, bone weakness and fractures. It can also lead to symptoms like:

• Bone pain
• Frequent infections
• Fatigue
• Easy bruising
• Abnormal blood counts

Myeloma is fairly uncommon, and the lifetime risk of developing it is under 1%. Its cause is mostly unknown, but there are factors that can increase your risk of developing it, such as a family history of the disease, obesity and getting older. Black Americans are also twice as likely to develop myeloma compared to white Americans.

Diagnosing myeloma typically involves blood tests, urine tests (which can detect the kidney-damaging antibody) and bone marrow biopsy.

Preventing and treating blood cancers

As with other cancers, preventing blood cancers centers on staying healthy overall. Eating healthy, not smoking, maintaining a healthy weight and staying up-to-date with medical care all go a long way toward lowering your risk.

As for treatment for blood cancer, that can vary depending on the type of cancer, as well as other factors like your age and general health. Some common treatments include:

• Chemotherapy: Certain drugs and medicines are effective for treating some types of leukemia, lymphoma and myeloma.
• Bone marrow transplant (also called stem cell transplant): This process of replacing malfunctioning bone marrow with healthy stem cells can be used to treat leukemias and myelomas, as well as non-Hodgkin lymphoma.
• Targeted cancer therapy: This treatment uses drugs precisely developed to destroy only a specific type of cancer cell by targeting a protein in the cancer cell. It is used as a treatment for certain types of leukemia.

These treatments and more can be used alone or in conjunction with one another, depending on your situation.

Finding support if you have blood cancer

Regardless of what type of blood cancer you have and the treatment you require, it can be overwhelming to navigate this journey alone. Your care team is there to help you every step of the way, including by answering questions and providing expert guidance.

"You can also find support in counseling, education and cancer support groups, which can help you cope with the emotional and practical aspects of cancer," says Dr. Savior.

Armed with knowledge and support, you’ll be ready to take the next steps if confronted with blood cancer.

Next steps:

Learn more about Deric C. Savior, MD
Learn more about cancer care at Main Line Health
The importance of attending cancer support groups