Blood Cancer Treatment in Mumbai, India

Overview

Blood cancer refers to the uncontrolled division and growth of blood cells in the body that interfere with the physiological functions of normal blood cells. Blood cancer usually starts in the bone marrow where all the red blood cells, white blood cells, and platelets are produced. Leukemia, lymphoma, and myeloma are blood cancers that affect various blood cells.

Alternate Name

Hematologic cancer or Leukemia.

Associated Anatomy

Bone marrow cells.

Blood Cancer Symptoms

The signs and symptoms of blood cancer differ depending on the type of cancer the person is dealing with. But often, many symptoms are common to all types of blood cancer. We’ll discuss the symptoms of leukaemia, lymphoma and myeloma in detail below.

Leukaemia

Anaemia is the common symptom of leukaemia and signs of anaemia include:
Shortness of breath
Pale skin
Tiredness and weakness
Dizziness
Chest pain
Poor blood clotting which may be accompanied by:
Bleeding gums
Heavy periods
Unusual bruising
Black bowels or bowels streaked with blood
Small red spots on the skin
Other symptoms include:
Falling ill frequently
Frequent fevers
Night sweats
Swelling of lymph nodes, liver, tonsils and spleen
Lumps in the armpit or neck
Unexplained weight loss
Bone pain
Feeling full even after eating very little

Lymphoma

Swollen lymph nodes
Lump in the armpit, neck or groin
Shortness of breath or coughing
Pain in bones, stomach or chest
Bloating or feeling full
Tiredness or weakness
Fever
Itchy skin
Night sweats

Myeloma

Long-lasting, chronic pain in the ribs or back
Weakening or thinning of bones
Damage to bones in the spine
Loss of bladder or bowel control
Tingling in arms
Weakness
Nausea and stomach pain
Constipation
Excessive thirst and urination
Loss of appetite
Confusion
Numbness and pain in legs and arms
Bleeding problems
Anaemia
Severe, recurrent or persistent infections

While the 3 types of cancer may have unique symptoms, some symptoms may be common to all types such as:

Fatigue and weakness
Persistent fever of (38°C or above)
Night sweats
Unusual bruising or bleeding
Unexplained or unexpected weight loss
Frequent infection
Bone pain
Enlarged spleen or liver
Swollen lymph nodes
Unexplained itchy skin or rashes

Symptoms can also be different because of different skin tones:

Reddish bruises which are tender to touch and turn darker over time.
Rashes that appear as petechiae (tiny small dots) or purpura (large blotches).
Unusually pale skin (pallor).

Kindly consult with an oncologist for an appropriate diagnosis.

Blood Cancer Causes

When the DNA of the blood cell changes or mutates, it causes blood cancer. The blood cells begin behaving abnormally because of DNA mutations. However, the exact reasons for the mutation are largely unknown. In most cases, the DNA changes occur because of uncontrollable factors and are not genetic faults that can be inherited. Although the exact reasons for a person developing blood cancer are not known, certain factors such as age, gender, family history, chemical or radiation exposure, family history or treatments and health conditions can be contributing factors.

In this section, we have discussed how genetic changes can cause the 3 types of blood cancers – leukaemia, lymphoma and myeloma.

Leukaemia: It is believed that genetic and environmental factors can cause changes in the DNA, which leads to leukaemia. These DNA changes are caused by alterations in chromosomes (strands of DNA). When cell division occurs and new cells are formed, the DNA strands are copied and sometimes, genes get changed between chromosomes. In the case of leukaemia, this swap can impact genes that help in cell growth and genes that repress tumours. It is believed that exposure to certain types of chemicals or high radiation levels is responsible for genetic changes causing leukaemia.
Lymphoma: Any changes in the genes in WBCs (or lymphocytes) that make them divide uncontrollably can cause lymphoma. Further, while normal lymphocytes usually die, abnormal lymphocytes do not die and keep multiplying. Although the cause of the genetic change is not really known, studies reveal the factors could be a weak immune system or certain infections.
Myeloma: Changes in the genes in the plasma cells in the bone marrow cause them to divide and grow abnormally and may be the cause of myeloma. However, research is still ongoing to find the links between changes in chromosomes affecting genes which control the growth of plasma cells and myeloma.

Blood Cancer Types

Also known as hematologic cancers, most types of blood cancers develop in the blood marrow, which produces blood cells in the human body. Blood cancer is classified into 3 major types i.e., leukaemia, lymphoma and myeloma.

Leukaemia: Leukaemia usually develops in the bone marrow and blood. The cancer is caused when the white blood cells (WBCs) grow and multiply abnormally. The increased number of abnormal WBCs in the blood cannot fight infections in the body and they also hamper the capability of the bone marrow to produce red blood cells (RBCs) and platelets. Usually, leukaemia occurs in adults; however, it is the most common type of cancer in kids and teens. There are different subtypes of leukaemia based on whether they originate in the lymphoid or myeloid stem cells and if they are acute (fast-growing) or chronic (slow-growing). Some of the leukaemia subtypes include:
Lymphoma: The lymphatic system helps produce immune cells and also eliminates the excess fluids from the body. Lymphoma is a blood cancer type that impacts the lymphatic system. Lymphocytes are WBCs that help combat infection. When the lymphocytes start growing abnormally, they turn into lymphoma cells. These multiply and begin collecting in the lymph nodes and tissues and over time, they weaken the immune system. The 2 main subtypes of lymphoma are Hodgkin and non-Hodgkin lymphoma.
Multiple Myeloma: Plasma cells are WBCs that produce antibodies that help the body fight infections and diseases. Multiple myeloma is cancer affecting the plasma cells. Myeloma cells hamper the body’s production of antibodies and weaken the immune system, making the body vulnerable to infections. The 2 main subtypes of multiple myeloma are amyloidosis and plasmacytoma.

Some other types and subtypes of blood cancer which are rarer include polycythaemia vera, essential thrombocythemia, Langerhans cell histiocytosis, Waldenstrom macroglobulinemia, follicular lymphoma, cutaneous T-cell lymphoma, Burkitt lymphoma, etc.

Blood Cancer Stages

There are different types of staging systems for different forms of blood cancer. The stage of blood cancer defines the size or extent to which the primary tumour has grown and its spread to the other parts of the body.
Typically, since blood cancer like CLL (chronic lymphocytic leukaemia) does not develop into tumours, the staging is determined by the WBC count and the collection of the WBCs in different organs in the body such as lymph nodes, spleen, liver, etc. CLL is classified according to the Rai staging system, which depends on 3 aspects i.e., the number of lymphocytes in the blood, the number of RBCs and platelets in the blood and how enlarged the lymph nodes, spleen and liver are. The stages of CLL are:
Stage 0: In this stage, although the number of lymphocytes in the blood is very high, no other symptoms of leukaemia are observed. Stage 0 of blood cancer is indolent or slow-growing. This is a low-risk stage.
Stage 1: In this stage, there is a sudden increase in the abnormal WBCs (lymphocytes
0 in the blood, which causes the lymph nodes to become enlarged. In this stage, the cancer is limited to the lymph nodes and has not metastasised (spread to other organs) or affected them. This is an intermediate risk stage.
Stage 2: In this stage, the lymphocytes grow very quickly and there is a high number of lymphocytes in the blood. There is an enlargement of the lymph nodes in this stage and the spleen (splenomegaly) or liver (hepatomegaly) may also be enlarged. In this stage, the risk is intermediate.
Stage 3: This stage is characterised by a high number of lymphocytes in the blood and the number of RBCs reduces considerably, leading to anaemia. In stage 3 also, there is an abnormal enlargement of the lymph nodes, spleen and liver. In this stage, the risk is high.
Stage 4: In stage 4, the level of platelets falls very quickly. The anaemia becomes quite severe and the cancer cells metastasize to other areas of the body including the lungs and other key organs. This is a high-risk stage.

Blood Cancer Diagnoses

Diagnosis of blood cancer is done through various procedures and tests such as a physical exam and checking the medical history of the patient and their symptoms. Blood tests and imaging procedures are then used to confirm the diagnosis. Some of the tests used for blood cancer diagnosis are:

Complete Blood Count (CBC): CBC counts and measures the blood cells in the blood. Typically, in leukaemia, the CBC will show a very high or low WBC count and the RBC and platelet counts are usually lower than normal.
Other Blood Tests: This helps to determine any changes in the appearance of the blood cells. Blood smear tests are done to identify the signs of lymphoma or leukaemia. Some other types of blood tests for blood cancer diagnosis include blood chemistry, white cell differential, FISH (fluorescence in situ hybridization), immunophenotyping, flow cytometry, polymerase chain reaction and karyotype test.
MRI (Magnetic Resonance Imaging) Scan: This is used to look for lymphoma or leukaemia complications affecting the spine.
CT (Computed Tomography) Scan: This imaging test creates 3D images of the bones and soft tissues and can be used to determine bone damage in the case of myeloma.
Bone Marrow Biopsies: This helps to determine the ratio of normal to abnormal cells in the bone marrow. The bone marrow sample may be also tested for DNA changes causing the growth of cancer. Bone marrow biopsies are used to find out If the person has blood cancer or not, to determine how advanced the disease is and to determine if the blood cancer treatment is working.
PET (Positron Emission Tomography) Scan: This imaging test is used to check the organs and tissues and detect the presence of myeloma.
Spinal Tap: This is also known as lumbar puncture, involves the testing of the fluid around the spinal cord and brain to check for the presence of blood cancer cells.

Blood Cancer Treatment Options

There is no specific blood cancer treatment that can treat all types of blood cancers. The doctor will determine the best blood cancer treatment(s) for the particular patient after considering various factors, including the patient’s age, type of blood cancer they have, side effects of the particular treatment and overall health of the patient.

Medical Interventions

Common medical interventions for blood cancer treatment include radiation therapy and chemotherapy.

Radiation Therapy: This procedure makes use of high-energy beams to destroy blood cancer cells and prevent them from growing. The radiation is directed on specific parts of the body where there is an accumulation of blood cancer cells or over the entire body. Radiation therapy may be used alone or along with some other therapy for blood cancer treatment.
Chemotherapy: A popular type of blood cancer treatment, chemotherapy uses one drug or a combination of drugs to kill the blood cancer cells to remove the cancer completely or slow down the progression of the disease.

Targeted Therapies

Targeted therapies for blood cancer treatment target the mutations or genetic changes that transform healthy cells into abnormal ones. They focus and block the abnormalities in the cancer cells and destroy them.

Stem Cell Transplantation

This is also called bone marrow transplant. The procedure replaces the unhealthy cancerous bone marrow with healthy stem cells that will help renew healthy bone marrow. Before the stem cell transplant procedure, typically, the cancerous bone marrow is destroyed using radiation therapy or chemotherapy and then a blood transfusion of blood-forming stem cells is given that help rebuild the bone marrow. For stem cell transplantation, whether the stem cells of a donor or the patient’s stem cells are used.

Clinical Trials

Experiments that are conducted to test new blood cancer treatments or newer ways of making use of existing blood cancer treatments are known as clinical trials. Although this form of treatment may offer the patient the option of getting new cancer treatments, it is uncertain whether these treatments will be beneficial for the patient or risky. So, before trying out some new experimental procedure, it is important to consult the doctor and discuss the potential pros and cons of the clinical trials.

Choosing the Right Blood Cancer Specialist

Blood cancer is a complex disease and, if not treated appropriately can lead to serious complications. Making the right decisions regarding blood cancer treatment can have a positive effect on the overall health, as well as the quality of life of the patient.

When choosing a doctor for blood cancer treatment, it is very important to:

Find the right cancer specialist or a haematologist-oncologist who is specially trained for blood cancer treatment.
Research and choose the best blood cancer specialist who can help to find the best treatment options based on the patient, the specific type of blood cancer they are suffering from, their symptoms and overall health condition.
Check the credentials and experience of the cancer specialist, as well as the cancer centre or hospital to ensure that this is the right fit for the patient.
After consulting a cancer specialist, get a second opinion on the treatment with another doctor to ensure that the patient is getting the right blood cancer treatment.
Check the patient’s insurance plan and ensure that blood cancer treatment, diagnostic tests and hospitalisation are all covered by it.

Credentials and Experience

When selecting a haematologist-oncologist for blood cancer treatment, here are a few things to keep in mind. The patient or family member:

Can get a referral for a good blood cancer specialist from their regular doctor, friends or family members.
Check the credentials of the blood cancer specialist to determine if they are board-certified in oncology. They should also check the doctors’ training, certifications, areas of expertise and experience.
Assess the experience of the oncologist specialist in the treatment of the specific form of blood cancer and check their success rates in blood cancer treatment, as well as patient outcomes like survival rates, patient satisfaction and quality of life.
Select a specialist who has access to the hospital where the patient is seeking medical treatment, from diagnostic testing to inpatient stays, etc.
Choose a cancer specialist who is conveniently located so that the patient to visit them frequently for treatment and follow-ups.
Could consult different cancer specialists and compare their credentials, experience, treatment options and bedside manner and communication to decide which doctor suits the patient the best.

Finally, it is important to do some research and choose a good and reputable hospital such as Nanavati Max Super Speciality Hospital that offers world-class blood cancer treatment in Mumbai. The multi-speciality hospital has a highly skilled team of nationally recognised medical and haematological oncology specialists and radiology, radiation oncology and pathology staff who follow a patient-focused approach to ensure that patients receive the best blood cancer treatment and care.

Blood Cancer Risk Factors

The chances of blood cancer may increase due to the below:

Genetic disorders: Inherited genetic abnormalities like Down's syndrome, Klinefelter's syndrome, and neurofibromatosis may increase the risk of blood cancer.
Cancer treatment: If you have undergone chemotherapy or radiation therapy for certain cancer, you may be at risk of suffering from leukemia.
Chemical exposure: Prolonged exposure to benzene alters the blood cell DNA leading to cancer.
Cigarette Smoking: Cigarettes usually contain formaldehyde, ammonia, benzene, nicotine, etc. that act as carcinogenic substances.
Family medical history: If any of your family members have been diagnosed with blood cancer, you may be at a greater risk of inheriting the cancerous genes.

Blood Cancer Possible Complications

Advanced cancer can cause severe complications within the body. The tumor growth can cause nerve damage, jaundice, kidney damage, blocked blood vessels, frequent and severe infections, etc. Since cancer raids the bone marrow, it can cause bone fractures and raise serum calcium levels. The complications may also arise due to intense treatment therapy sessions.

Timely diagnosis and treatment are necessary to combat the complications of blood cancer. Consult your oncologist for appropriate suggestions.

Blood Cancer Prevention

Know all the primary prevention and secondary prevention below:

Primary Prevention

The following steps help in preventing the development of blood cancer:

Avoid an unhealthy diet: Consumption of red meat consumption and junk food should be avoided.
Avoid smoking and alcohol intake: Smoking and consumption of alcohol should be avoided.
Screening: If you have a family history of cancer, kindly consult an oncologist and get a screening done.

Secondary Prevention

If you are recovering from the initial stages of blood cancer, the following steps would help prevent recurrence:

Healthy living: Eat a healthy diet, do regular exercises, and maintain healthy body weight.
Annual check-ups: Do regular follow-ups with your oncologist to keep a tab on the likely recurrence of cancer episodes.
Take timely medications: If your doctor has prescribed medicines after the treatment, take them on time. If you are in remission, do not stop the medication without consulting your doctor.

Epidemiology of Blood Cancer

India being the second most populated country in the world records nearly 8% of blood cancer cases every year. Around 20,000 new cases of childhood blood cancers are detected each year, and nearly 15,000 of these are leukemia cases.
Blood cancer can affect everyone irrespective of age, gender, and geographical location.

Prognosis of Blood Cancer

Expected Prognosis of Blood Cancer

Blood is the major connective tissue in our body. The cancer cells in the blood can circulate to all the body tissues and organs. A person detected with blood cancer has a 70% chance of survival in the next five years. With timely diagnosis and treatment, the person can go into remission.

Natural Progression of Blood Cancer

The stem cells, in the bone marrow, rapidly divide themselves and thus any mutated stem cells will produce abnormal blood cells with altered functions. The cancer cells will lodge themselves in other parts of the body and impact overall well-being.

Pathophysiology of Blood Cancer

Blood cancer occurs due to the malignant transformation of the blood stem cells. The altered blood cells cannot carry out normal functions like oxygen transportation, fight-off infections, wound healing, etc. The altered metabolism help in their proliferation and tumor growth.

Frequently Asked Questions

1. Who is The Best Hospitals for Blood Cancer Treatment in Mumbai?

Nanavati Max Hospital in Mumbai is considered one of the best hospitals for blood cancer treatment in the city, offering a range of advanced treatments and experienced specialists.

2. What are Some Treatment Options for Blood Cancer?

Blood cancer treatment strategies are tailored based on factors such as the type of cancer, its stage, the patient's age, and overall health.

Chemotherapy is a popular method that uses drugs to destroy cancer cells.
Radiation therapy makes use of high doses of radiation to eliminate cancerous cells.
Targeted therapy aims to target specific abnormalities within cancer cells.
Immunotherapy works by boosting the body's natural defences to fight cancer.
Stem cell transplant replaces diseased bone marrow with healthy stem cells.

Supportive care can help manage symptoms and side effects.

In many cases, a combination of these treatments proves most effective.

3. What are Some Side Effects of Blood Cancer Treatment?

Every individual may experience different side effects based on the treatment type. Commonly observed side effects include fatigue, nausea, hair loss, anaemia, and increased susceptibility to infections.

4. Can Blood Cancer Be Cured?

The prognosis for blood cancer varies. Some, like Hodgkin lymphoma, boast a high cure rate. In contrast, acute myeloid leukaemia might pose more challenges. However, with early detection and the right treatment, many patients lead a healthy life.

5. What is Stem Cell Transplant for Blood Cancer?

Stem cell transplant has emerged as a common treatment strategy, especially when the bone marrow stops producing healthy blood cells. There are two primary types:

Autologous: Uses the patient's own stem cells.

Allogeneic: Uses stem cells from a matched donor.

6. What is The Duration of Blood Cancer Treatment?

Treatment length varies from person to person. Factors like cancer type and stage, as well as an individual's response to the treatment, dictate the duration of the treatment. Some might require a few months, while others undergo treatment for years. An experienced haematologist and bone marrow transplant specialist will always explain the treatment duration and prognosis in detail.

7. What are The Latest Advancements in Blood Cancer Treatment?

Some of the advancements in blood cancer treatment are the use of targeted therapies, immunotherapy, CAR T-cell therapy, autologous and allogeneic stem cell transplant along with other traditional treatments such as radiation therapy and chemotherapy.

8. Are There Any Support Groups for Blood Cancer Patients in Mumbai?

Some of the support groups for blood cancer in Mumbai include Friends of Max (FOM) for CML (Chronic Myeloid Leukaemia), Cancer Patients Aid Association (CPAA), Nanavati Max Saathi, UGAM by Indian Cancer Society, V Care Foundation, ACC (Apollo Cancer Centres) Support Group, The Leukemia Lymphoma Foundation - Tata Memorial Hospital and more.

9. What is The Cost Range of Blood Cancer Treatment in Mumbai?

The cost of blood cancer treatment in Mumbai ranges between INR 45,000 and INR 20,00,000.

10. Can Blood Cancer Be Cured?

Because of the advancements in medicine and the accessibility of newer treatments and therapies, blood cancer is highly curable. However, early detection, timely medical treatment and proper care can increase the chances of a cure. Some of the other factors that can affect the cure for blood cancer include type, stage and grade of blood cancer, if it is chronic or acute, molecular factors, age, health condition if there are any comorbidities, if it has affected any other organ or part of the body and if the blood cancer has developed newly or if it has recurred after being cured previously.

11. What Role Does Stem Cell Transplantation Play in Treating Blood Cancer?

Stem cell transplantation is a popular blood cancer treatment, where healthy stem cells are transplanted into the patient’s body to aid the production of healthy blood cells after the therapy that is used to kill the cancerous blood cells.

12. Is Immunotherapy a Viable Option for Blood Cancer Patients?

Yes, immunotherapy is a viable treatment for blood cancer, where body’s immune system is used to combat the disease. Some types of immunotherapies include CAR T-cell therapy and monoclonal antibodies, which boost the immune system by altering the chemical environment of the blood cancer.

13. How Long Can You Live with Blood Cancer?

The outcomes for people suffering from blood cancers have improved significantly over the years. Around 66% of people with leukaemia live 5 years or more. The survival rates for other types of blood cancers are around 75% for non-Hodgkin lymphoma, 89% for Hodgkin lymphoma and about 60% for myeloma.

14. Is Blood Cancer Very Serious?

Blood cancer is a very serious disease, accounting for about 10% of all types of cancers diagnosed in the US each year and causes around 3% of all deaths related to cancer.

15. How Do Doctors Determine The Best Treatment Plan?

The doctors will determine the best blood cancer treatment plan after evaluating various factors including the type, subtype, stage, grade and spread of the cancer and overall health conditions, blood cell counts, genetic testing results and symptoms of the patient.

16. Does Insurance Cover The Cost of Blood Cancer Treatment?

Yes, most of the insurance companies in India cover the cost of blood cancer treatment, but the coverage provided will vary depending on the insurance company and type of insurance policy.

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