ABU DHABI // Most people are well versed in the signs and symptoms of cancer when it strikes the breast, colon or lungs – but when it occurs in the blood, it is a different story.
Leukaemia, a cancer of the white blood cells, can be fatal but many people are not aware of what to look out for, experts have said.
“There’s generally a low awareness of the condition because the condition tends to present with general symptoms, such as fever, sweating and weight loss,” said Dr Mahir Al Hilali, a consultant haematologist at Mediclinic City Hospital, in Dubai.
“This is normally taken as, for example, an infection or as a viral infection or something similar, rather than something serious.”
Patients, therefore, tend to seek medical attention late, only when they develop specific symptoms, explained the Briton.
These include bleeding from the skin and mucous membrane in the mouth and nose.
“When these specific signs occur, they tend to be quite alarming and the patient tends to attend hospital as an emergency,” he added.
If people knew more about the disease they may potentially take the initial signs more seriously, said Dr Al Hilali, who added that a lack of awareness was a global issue.
“People who tend to have these symptoms will need to see their doctor earlier as we can offer them a better treatment and a better chance of cure from this disease,” he said.
Leukaemia can be classified into two major groups – acute or chronic – and then subdivided further, depending on the type of white blood cells involved.
The incidence of acute leukaemia is between one to four per 100,000 people worldwide, as a general figure, said Dr Al Hilali. The chronic form is more common, particularly in the elderly population, he said, and is in the region of 20 to 25 per 100,000. Varying figures were provided by other doctors.
Worldwide, leukaemia was diagnosed in about 350,000 people with in 2008, according to Cancer Research UK.
“Both of them [chronic and acute] are curable and we have a huge success rate in children and a good result in adults,” explained Dr Al Hilali.
“Lymphoma and leukaemia has become more and more common recently.”
Factors that contribute to the increase include exposure to toxins and low-level radiation, as well as recurrent viral infections. There is also a genetic predisposition, he added.
Dr Mohammed Burney, a consultant in clinical pathology at Abu Dhabi’s Burjeel Hospital, agreed that the general population has a low awareness of leukaemia, as compared to other cancers, such as breast cancer.
The problem is that there are no specific symptoms, continued Dr Burney, who is from India.
“There might be general tiredness and shortness of breath or having some infections,” he said.
“Sometimes they go unnoticed for months or the patient doesn’t bother much because the symptoms are going at a very slow speed.”
The doctor also spoke of the importance for parents to be able to spot any potential signs in their children.
“For example, acute lymphoblastic leukaemia is most common in children and now there is about an 80 to 85 per cent cure rate,” he said.
While there are no specific symptoms, signs of acute leukaemia can include increased bleeding, such as from the nose, mouth or a cut, a pale face, fever, swollen glands, a feeling of heaviness in the abdomen and a rash, explained Dr Burney.
In the chronic form, signs include infections, swollen glands, discomfort in the stomach, on and off mild to moderate fever and tiredness.
Dr Mohammed Barr Ali, a specialist in haematology at Abu Dhabi’s Al Noor Hospital, said: “In the 1950s a diagnosis of leukaemia was considered as a death sentence but, today, approximately 85 per cent of children can be cured and about 50 to 60 per cent of adults.”
Medical advances in diagnosis and treatment have improved the outcomes but so has better nutrition, the use of antibiotics and improved blood banks, which are able to separate blood components, said Dr Ali.
Treatment can include chemotherapy, radiotherapy and a bone marrow transplant, depending on the type.
A blood transfusion is important to help support the patient, particularly those with acute leukaemia, but it can also be necessary in chronic cases.