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Blood Cancer Diagnosis and Treatment

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Procedures or Tests for Diagnosis of Blood Cancer

There are multiple testing methods available for blood cancer diagnosis. Initially, a physical examination is performed when an individual visits the doctor with blood cancer symptoms.

Based on the observations from the physical examination, different combinations of these tests are recommended for patients for a confirmed diagnosis.

The following are the different tests available for blood cancer diagnosis:

1. Complete Blood Count (CBC)

A complete blood count is an important blood cancer diagnosis test to determine various aspects of the blood, such as hematocrit value, the numbers of red blood cells, white blood cells, platelets, and other blood-related parameters. A CBC test can help detect abnormalities that indicate the presence of blood cancer. That said, a complete blood count is not a confirmatory diagnostic test for blood cancer, as various other diseases may affect the count of various blood cells.

2. Blood Chemistry Tests

Blood chemistry tests are another method for determining the presence of blood cancers. They detect the levels of various blood components, such as proteins, electrolytes, and enzymes. They help detect various blood diseases, including blood cancer. Elevated calcium levels may occur in myeloma, while abnormal liver function may suggest a metastatic state.

3. Magnetic Resonance Imaging Scan (MRI)

Magnetic resonance imaging is a blood cancer diagnosis technique, including multiple myeloma and lymphoma. Whole-body MRI is considered highly sensitive for assessing myeloma and is endorsed in several clinical guidelines. It helps in the detection and staging of myeloma. Whole-body MRI in lymphoma may be considered early in the disease. MRI is also done to assess the treatment response.

4. Computed Tomography (CT) Scan

If blood cancer, such as myeloma, is suspected after a physical examination and evaluation of the symptoms, the doctor may advise a computed tomography (CT) scan. A CT scan is a non-invasive blood cancer diagnosis technique that detects enlarged lymph nodes. It also helps detect blood cancers that may have spread to other organs. It is also done to determine the extent of the disease, guide biopsies, and monitor the treatment's efficacy. Although a CT scan is not diagnostic for blood cancer, it allows clinicians to guide further courses of action, including biopsies and developing individualized treatment plans.

5. Bone Marrow Biopsies

Bone marrow biopsies are usually the confirmatory tests for blood cancer diagnosis. They allow clinicians to evaluate the number of abnormal and normal blood cells. They also help detect any mutation that results in the development of cancerous cells and determine whether the malignancy of the bone marrow is primary or secondary. During a bone marrow biopsy, the doctor obtains a small sample of bone marrow tissue, usually from the hipbone, to evaluate the presence of abnormal cells and detect the type of mutation. The results of the bone marrow biopsy allow the oncologists to plan the treatment.

6. Positron Emission Tomography (PET) Scan

PET scans, which use radiotracer substances, are also helpful in diagnosing and staging various blood cancers, such as lymphomas. The test involves detecting the increased metabolic activity at the site of division and proliferation of cancer cells. This imaging technique assists oncologists in detecting lymph node involvement, treatment efficacy, and tumor relapse. Integrating it with a CT scan may increase its effectiveness.

7. Blood Cell Examination

A blood cell examination is usually part of a complete blood count test. It is important in diagnosing blood cancer as it allows clinicians to determine the level of various blood cells. For instance, blood cell examination may help to diagnose sickle cell anemia by detecting the sickle shape of red blood cells. Blood cell examination also involves determining the morphological abnormalities, such as the presence of atypical or immature cells that may indicate hematological malignancies.

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What are the Types of Blood Cancer Treatment?

For better health outcomes, blood cancer treatment should be personalized according to the individual needs of the patient. Some patients may show a better response to chemotherapy, while others may need chemotherapy with another treatment for better results.

Personalized treatment planning involves doctors carefully studying the case information, paying attention to the details of the genetics of cancer, its stage, and grade, and assessing the patient’s overall health before deciding which treatment suits them the best.

The following are the different approaches available for blood cancer treatment:

1. Chemotherapy

Chemotherapy for blood cancer is usually a first-line treatment for various blood cancers, including leukemias, lymphomas, and multiple myelomas. Chemotherapy for leukemia, for instance, involves the administration of chemotherapy drugs, oral or intravenous, to kill all the rapidly dividing cells in the body, such as malignant cells. Administration of chemotherapy drugs may either result in complete or partial remission. Chemotherapy may or may not be accompanied by other treatments, depending on individual case parameters.

2. Radiation Therapy

In the case of localized lymphoma, oncologists may recommend radiotherapy. Radiation therapy for blood cancer involves killing cancerous cells using high-energy radiation. As radiation therapy alone is insufficient to treat blood cancers, it is usually combined with various other blood cancer treatments, such as stem cell transplantation, chemotherapy, or immunotherapy. It may also be recommended to alleviate the symptoms of blood cancer by shrinking the size of the tumor in the spleen, lymph nodes, or liver.

3. Immunotherapy

Also known as biologic therapy, immunotherapy utilizes the patient's immune system to fight against the cancer cells. The side effects of immunotherapy are relatively fewer. Various immunotherapy options studied for blood cancer treatment are cytokine treatment, chimeric antigen receptor (CAR) T-cell therapy, monoclonal antibody therapy, and therapeutic cancer vaccines. During immunotherapy, the patient's immune system is stimulated to fight against cancer cells effectively. Immunotherapy for blood cancer also helps detect cancer cells more efficiently.

4. Targeted Therapy

Targeted therapy is also another option for blood cancer treatment. Targeted therapy is a type of precision medicine where the patient’s genomic, environmental, and lifestyle factors are taken into consideration while planning the treatment. Targeted therapy for blood cancer focuses on specific molecular targets of cancer cells, such as enzymes and various pathways vital for their growth and proliferation. It specifically targets biomolecules and biological pathways associated with cancer growth to treat the disease. As it specifically targets and attacks cancer cells, healthy cells are spared, and patients experience fewer side effects.

5. Car T-cell Therapy

Chimeric antigen receptor (CAR) T-cell therapy is an immunotherapy for blood cancer treatment. This therapy involves obtaining the T-cells from the patient's blood, re-engineering them in the laboratory for them to identify and attack cancer cells, and re-infusing them back into the patient's blood. The technique through which the T-cells are obtained is known as apheresis. Before reinfusion, the patient undergoes chemotherapy to allow the re-engineered T-cells to multiply. Some side effects of CAR T-cell therapy are immune effector cell-associated neurotoxicity syndrome and cytokine release syndrome.

6. Autologous Stem Cell Transplant

A bone marrow transplant is an effective treatment for blood cancer. During autologous stem cell transplantation, stem cells are collected from the patient’s marrow. After this, a conditioning regimen is done that involves killing the cancer cells through high-dose chemotherapy or radiation therapy. Once the cancer cells are destroyed, the stem cells collected previously are transfused back into the patient’s body. These stem cells reach the bone marrow and start producing healthy blood cells through the process called engraftment. The recovery may take 3-6 months, depending on the type of condition treated and its stage. As an effective blood cancer treatment, autologous stem cell transplant helps patients achieve long-term remission. It is often recommended when other treatments fail to show the desired response. As the stem cells are taken from the patients, there is a relatively lower risk of developing graft-versus-host disease.

7. Allogeneic Stem Cell Transplant

Allogeneic stem cell transplantation for blood cancer treatment involves healthy stem cell transfer from a compatible donor to patients with blood cancer. The donor should have a similar genetic makeup as the patient. HLA (human leukocyte antigen) typing is done to find the ideal match for stem cell transplant. Different types of donors for allogeneic transplants include matched donors (siblings), haploidentical donors (parents/children), and unrelated donors. Similar to autologous transplants, before allogeneic stem cell transplants, the patient usually undergoes high-dose chemotherapy or radiation therapy. As the stem cells are obtained from the other donor, it may carry the risk of graft-versus-host disease.

Why Choose HCG for Treatment and Diagnosis of Blood Cancer?

HCG's advantages for diagnosing and treating blood cancer include its multidisciplinary approach. It also offers advanced diagnostic tools like PET and MRI scans with personalized treatment plans. The medical oncologists, hemato oncologists, and BMT physicians at the HCG Cancer Centre specialize in diagnosing and managing different blood cancers and use innovative therapies, including immunotherapy and stem-cell transplants.

HCG Cancer Centre takes a patient-centered approach to comprehensive care and support throughout the treatment journey, improving the outcome and quality of life in patients diagnosed with blood cancer.

Conclusion

Blood cancer diagnosis involves various techniques, such as complete blood count, blood chemistry examination, and imaging techniques, such as MRI, CT scan, PET scan, and bone marrow biopsy. The treatment of blood cancer depends upon various factors, including the type of blood cancer, the stage of blood cancer diagnosis, and the overall health of the patient. Some of the treatment options include chemotherapy, radiation therapy, immunotherapy, targeted therapy, CAR T-cell therapy, and stem cell transplantation.

Frequently Asked Questions

How can you test for blood cancer?

Several methods are used to detect blood cancer. These include a complete blood count, blood chemistry tests, and imaging tests, such as MRI, CT, PET, and bone marrow biopsy.

The primary test for diagnosing blood cancer is the complete blood count, which measures the number of blood cells that have increased in the tumor. However, other tests, such as imaging tests and bone marrow biopsy, also assist oncologists in diagnosing blood cancer.

Yes, a CBC can detect blood cancer. Commonly, in blood cancer cases, levels of specific blood cells are elevated, and these elevated levels are detected in the complete blood count test.

Early blood cancer diagnosis and appropriate treatment effectively manage blood cancer. However, various other factors also affect the overall outcomes of the disease. These factors include the type of blood cancer, its aggressiveness, and the patient's overall health.

Blood cancer ranks fifth among the most common cancers in the world. About 13 lakh new cases of blood cancers were diagnosed worldwide in 2020. In India, the blood cancer incidence was about 14.6 lakh in 2022.