Blood cancer is the third biggest cancer killer in the UK. Shockingly, despite the risk it poses, many people are unaware of the key facts surrounding the disease – who is susceptible and what are the key signs and symptoms.

Although awareness of one type of blood cancer – Leukaemia – is relatively high, beyond this knowledge and understanding of the disease as a whole is low. This leads to late diagnoses in many cases and puts many more lives at risk each year.

What is blood cancer?

Blood cancer occurs when changes typically affecting DNA occur within blood cells. This means that they don’t function as they should, for example, repairing the body and fighting off infection. The changes in the blood cells generally happen as a result of DNA in the cells of the bone marrow mutating. This causes the cells to develop incorrectly – acting abnormally and growing in an uncontrolled manner. Unfortunately we are unable to say what causes the mutations in these cells, in the vast majority of cases – it is not directly due to something we have been exposed to.

Is there more than one type of the disease?

In total there are 130 different types of blood cancer however, they sit under three key groups – Lymphoma, Myeloma and Leukaemia. There is a misconception that Leukaemia is the most common type of the disease, as this is typically the type of blood cancer that most people have heard of however, in fact it is Lymphoma which most people in the UK will be affected by.

Lymphoma – This is not only the most common type of blood cancer, but also the fifth most common type of cancer in the UK overall. It can affect people of all ages, and if caught early, is nearly always treatable. There are approximately 60 different strains of Lymphoma however, they are broadly split into Hodgkin Lymphoma and Non Hodgkin Lymphoma. The disease affects the white blood cells (lymphocytes) which fight infection in the body, causing them to grow out of control. These abnormal cells then collect in the lymph nodes (most commonly in the armpits, neck or groin) – but can also spread to deeper parts of the body such as the spleen.

Leukaemia – This type of blood cancer usually affects the white blood cells and bone marrow. Unfortunately there is no firm evidence to determine exactly what causes the disease however, age and sex do have a part to play with regards to the type of Leukaemia people are most likely to develop. Men are more susceptible to Acute Myelogenous Leukaemia, Chronic Lymphocytic Leukaemia and Chronic Myeloid Leukaemia; whereas women are more susceptible to Acute Lymphocytic Leukaemia. Apart from Acute Lymphocytic Leukaemia which predominantly affects children, the older you are, the more likely you are to develop the disease. People with Leukaemia have a large proportion of abnormal white blood cells which commandeer the bone marrow and enter the blood stream. The disease can also affect the lymph nodes, spleen, liver and skin.

Myeloma – Many people are unfamiliar with this type of blood cancer however, over 5,500 people in the UK are diagnosed with the disease every year. Typically Myeloma impacts those over the age of 65 however, there have been cases of people as young as 20 being diagnosed. Myeloma affects the plasma cells – a type of white blood cell found in the bone marrow. The disease develops when the DNA is damaged during the creation of a plasma cell. The affected cells then multiply within the bone marrow and spread. Myeloma most commonly affects where bone marrow is present in the body – the spine, pelvis, skull, rib cage and limbs causing pain and infections.

What are the causes of blood cancer?

Although we don’t know what causes the DNA to mutate to cause cancerous blood cells, we do know there are certain factors which are likely to make some groups of people more susceptible to blood cancer. The most common risk factors are:

• if you have a family history of the disease
• if you have previously been exposed to chemotherapy/radiotherapy for cancer treatment
• your age – with the exception of ALL (Acute Lymphocytic Leukaemia) your risk of developing blood cancer increases as you get older.

What are the symptoms of blood cancer?

Symptoms of blood cancer will vary based on each type of the disease, and will also broadly differ from individual to individual. However, there are several key signs and symptoms which everyone should be aware of.

Key blood cancer symptoms, which are consistent across all types of blood cancer, include extreme fatigue, sudden weight loss, and repeat infections (due to the abnormal white blood cells failing to fight off illness). However, for Lymphoma specifically people should look out for severe night sweats (which drench your night-clothes and bed sheets), swollen lymph nodes and itching all over the body.

Unexplained bruising and/or bleeding can be a sign of leukaemia, with persistent bone pain a potential sign of Myeloma.

If anyone experiences any of the above symptoms then my advice is to see your Doctor at the earliest opportunity to get checked out. The presence of one or more of these symptoms doesn’t automatically mean a blood cancer diagnosis however, it’s important that people understand the warning signs and seek medical advice quickly so that a cancer diagnosis can hopefully be ruled out.”

How is blood cancer treated?

The type of treatment offered for blood cancer patients will vary depending on the different types of the disease, and whether the disease is ‘acute’ or ‘slow growing’. Some treatment options are curative, with the aim of eradicating the cancer all together, and some are based around the management of symptoms – to reduce the cancer and keep patients in remission for as long as possible.

Generally speaking, treatment options can be split into high intensity and low intensity options. High intensity options include standard/high dose chemotherapy to destroy the impacted cells and prevent them from multiplying any further. A stem cell transplant is also a high-intensity option and would be carried out after a patient has undergone a high dose course of chemotherapy to kill off the abnormal cells in the bone marrow or lymph nodes. Radiotherapy is another type of therapy, and can be used in conjunction with chemotherapy.

In recent years, immunotherapy drugs have been increasingly used as a method for treating blood cancer, and we hope that this will be the future of treatment. This involves using therapies to enhance the body’s immune system to kill the cancerous cells.

Low intensity treatment options are more gentle forms of chemotherapy and immunotherapy. The purpose here isn’t to cure the cancer, but to manage symptoms, reduce the spread and keep control of the disease over a longer period of time.”

Dr Rakesh Popat is a Consultant Haematologist from HCA Healthcare UK at University College Hospital. HCA Healthcare UK includes London Bridge Hospital, The Portland Hospital, The Harley Street Clinic, The Lister Hospital, The Princess Grace Hospital, The Wellington Hospital, Roodlane Medical Ltd, and Blossoms Healthcare. HCA UK also partner with leading NHS Trusts to provide care at The Christie Private Care, HCA UK at University College Hospital and Private Care at Guy’s.