Understanding blood cancer

Blood cancer, also known as hematologic cancer or hematological malignancy, refers to a group of cancers that affect the production and function of blood cells.  Blood cancers involve abnormal growth and development of blood cells in the bone marrow, lymphatic system, or other parts of the body. These abnormal cells, also known as cancerous or malignant cells, interfere with the normal functioning of the immune system, circulation, and oxygen delivery to tissues and organs, leading to various symptoms and complications.

There are three main types of blood cancers:
1.  Leukemia
Leukemia affects the white blood cells which are responsible for fighting infections and diseases. Leukemia occurs when immature white blood cells, known as blasts, grow uncontrollably and interfere with the normal production of healthy blood cells. As a result, leukemia can lead to anemia, infections, bleeding, and other complications. Leukemias can be classified as acute or chronic leukemias based on rate of progression of disease.
Acute leukemias can be acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML). Chronic leukemias can be chronic lymphocytic leukemia (CLL), chronic myeloid leukemia (CML), etc.

2.  Lymphoma
Lymphomas affect the lymphatic system which is responsible for filtering out waste and toxins from the body. Lymphoma occurs when abnormal lymphocytes (a type of white blood cell), grow uncontrollably and form tumors in the lymph nodes or other parts of the body. Lymphoma can lead to swelling, fatigue, fever, night sweats, and weight loss. There are two main types of lymphoma: Hodgkin’s lymphoma and non-Hodgkin’s lymphoma.

3.  Myeloma
This type of cancer affects the plasma cells which are responsible for producing antibodies that help the body fight infections. Myeloma occurs when abnormal plasma cells grow uncontrollably and form tumors in the bone marrow, leading to weakened bones, anemia, infections, and kidney damage.

Causes and Risk Factors
The exact cause of blood cancer is unknown, but several risk factors have been identified, including:

1. Age: Blood cancers like acute lymphoblastic leukemia is more common in children than adults whereas cancers like CLL, AML, and myeloma are more common in adults.
2. Gender: Some types of blood cancer, such as ALL, CLL and Hodgkin`s lymphoma, are more common in males.
3. Genetics: There are known genetic mutations which can predispose to a specific type of cancer and have prognostic value in some type of cancers. Most of these genetic mutations are acquired during life but a few can be inherited.
4. Environmental factors: Exposure to certain chemicals, such as benzene, pesticides, radiation (such as from nuclear accidents or medical treatments), can increase the risk of developing blood cancer.
5. Weakened immune system: People with weakened immune systems, such as those with HIV/AIDS or those who have undergone organ transplants, are at an increased risk of developing blood cancer.

Symptoms
The symptoms of blood cancer vary depending on the type and stage of the disease, but may include:

1. Fatigue: Feeling tired and weak, even with enough rest. 
2. Fever: Could be a manifestation of disease itself or could reflect the underlying infection due to weakened immunity.
3. Night sweats: Experiencing excessive sweating during sleep.
4. Weight loss: significant loss of weight over a short span of time
5. Swollen lymph nodes: Having enlarged lymph nodes in the neck, armpits, or groin.
6. Bruising and bleeding: Having frequent bruising, bleeding gums, or nosebleeds.
7. Bone pain: Having pain or tenderness in the bones, especially in the back or ribs.
8. Shortness of breath: Feeling out of breath, even with mild exertion.

Treatment for blood cancer involves chemotherapy and targeted therapy. Role of radiation therapy is limited to few types of cancers like lymphomas and solitary plasmacytoma. The only curative treatment for most of the blood cancers is hematopoietic stem cell transplantation. Supportive care, such as management of infections, blood product transfusions for low hemoglobin and platelets, pain management and psychological support form an important part of treatment of patients with blood cancer.

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