A diagnosis of leukemia can strike fear into the heart, especially if it is in conjunction with a child. There are so many different varieties of leukemia, that it can all be a bit confusing. Like with any form of cancer, it is important to know and understand the specifics of your particular situation so that the best choices can be made regarding managing and treating the illness. Let’s take a look at what is known about leukemia and see if we can eliminate some of the confusion and fear often associated with this illness.
What is Leukemia?
Leukemia is a cancer of the organs that are responsible for forming blood in your body, mainly the bone marrow and lymphatic system. Taken from the Greek, the word “leukemia” literally means “white blood,” which is appropriate because most types of this cancer begin in the white blood cells. There are many types and subtypes of leukemia, but the broadest classification for leukemia is acute (fast-growing) and chronic (leukemias that progress more slowly, sometimes taking years to develop). The majority of childhood leukemia is of the acute variety, but there are far more adults that suffer from leukemia than children.
Leukemia is a complex disease that can be difficult to treat and manage simply because of its association with the lymphatic system, a network of “highways” within the body that is an integral part of the immune system. Unlike some cancers that are localized to one organ or part of the body, the lymphatic, circulatory, and bone marrow systems are spread throughout the body and thus leukemia can form and spread just about anywhere, and the cancer is usually found at multiple locations throughout the body. Therefore, leukemia can be tougher than some other types of cancer to pinpoint and knock out with common treatments such as surgery, chemotherapy, and radiation.
Overall, leukemias account for about 2% of all cancers in the United States. Often mistakenly thought of as primarily a childhood disease, leukemia affects nine times as many adults as it does children. However, leukemia is the most common type of childhood cancer in the U.S. Approximately 30,000 new cases are diagnosed annually in this country, with about 50% of them occurring in folks over the age of 60.
Perhaps a bit of background information on the basics of the lymphatic and bone marrow systems will help us understand the workings of leukemia better. When leukemia strikes, the bone marrow, which normally produces several different types of blood cells, continues to make white blood cells, but many of them are abnormal in both quantity and function. These renegade cells eventually crowd out the normal white blood cells and interfere with their ability to fight disease and infections. These cancerous cells also affect other types of blood cells, such as red blood cells (RBCs) that transport oxygen and nutrients throughout the body, and platelets, which are involved in the blood clotting process.
Bone marrow is spongy tissue located inside the larger bones of the body. The lymphatic system is composed of lymph vessels (a circulatory system for transporting “lymph,” composed of a milky, white liquid made up mostly of “lymphocytes,” or white blood cells responsible for fighting disease in the body.) In addition, pea shaped organs called lymph “nodes” are located at various points along the network of lymph vessels that run throughout the body. These nodes are responsible for producing and storing lymphocytes until the immune system calls for them to fight an invader. Certain parts of the body have greater concentrations of lymph nodes including the abdomen, neck, armpits, chest, and pelvis. Other organs included in the lymphatic system include the spleen, adenoids, and tonsils.
White blood cells are classified into three major types: granulocytes, monocytes, and lymphocytes:
- Granulocytes contain small particles (granules) of specialized enzymes (proteins) and some other substances that have the ability to tear down and destroy invaders such as harmful bacteria and chemicals that pose a threat to our health.
- Monocytes are kind of like the computer game “Pacman.” They peruse the bloodstream ingesting harmful antigens, and often settle in different organs throughout the body where they mature into other types of immune system cells.
- Lymphocytes are the workhorses of the immune system. They are also the most common and numerous types of white blood cells. They come in two major types: B cells, and T cells. B cells function by producing specialized proteins known as “antibodies” that attach themselves to bacteria and viruses and “flag” them as enemy invaders. The antibodies trigger the release of other cells in the immune system which then seek and destroy these antigens. T cells, on the other hand, are more direct in their warfare. They mostly go after viruses, and some cancer cells as well. When a virus invades a healthy cell, certain proteins are produced which identify them as harmful microorganisms that the T cells are designed to go after and destroy by making chemicals that attack and break down the viruses.
When the lymphatic, bone marrow, and immune systems are working properly and efficiently, they do a wonderful job of protecting us and keeping us healthy. However, when leukemia strikes, the white blood cells are initially affected, and this eventually triggers a break down of the entire blood producing system and the immune system. Because of these results, leukemia is a particularly destructive type of cancer that can be difficult to treat as well.
What Are the Symptoms of Leukemia?
In the earliest stages, there are often no discernable symptoms for leukemia. In fact, many times they can be mistaken for influenza or other common illnesses. Signs and symptoms will vary depending on the particular type, but there are some typical ones that often occur. These include:
- Fatigue and persistent weakness
- Loss of appetite
- Unexplained weight loss
- Swollen lymph nodes, often initially painless
- Enlarged liver or spleen
- Frequent infections
- Uncharacteristically easy bruising or bleeding
- Shortness of breath, especially when exerting yourself
- Bone pain or tenderness
- Petechiae (tiny red marks on your skin)
- Excessive perspiration
- Night sweats
- Bleeding from gums or nose
The degree of symptoms is defined mostly by the amount of abnormal blood cells generated by the leukemia and the part(s) of the body where they accumulate, as well as the specific type of leukemia.
How Are Leukemias Classified?
The first major classification is based on the speed of progression of the leukemia:
- Acute leukemia involves rapidly multiplying immature blood cells (“blasts”). They never progress to the point where they can be functional to the immune system, and there large numbers interfere with healthy cells. Acute leukemia is the most common type of childhood leukemia.
- Chronic leukemia occurs via more mature blood cells. They reproduce more slowly, and are able to perform their functions normally for a while before they begin to deteriorate. They also interfere with healthy cells less than those associated with acute leukemia do.
The second factor in classification of leukemias is related to the type of white blood cells that are attacked by the disease:
- Lymphocytic leukemia: This form affects the cells of the body’s lymphatic system. They are key components of the immune system, and are located system wide.
- Myelogenous leukemia: This type affects the myeloid cells. Some of these types of cells will later become RBCs, platelets, and white blood cells.
Armed with this basic information, we can now better understand the four major types of leukemia:
- Acute myelogenous leukemia (AML): This most common form of leukemia afflicts both children and adults. It is also known as acute nonlymphocytic leukemia.
- Acute lymphocytic leukemia (ALL): The most common form of childhood leukemia, accounting for about 80% of all juvenile leukemia cases.
- Chronic Lymphocytic leukemia (CLL): This slowly progressing type of leukemia is very common amongst adults, especially Jews of Russian or Eastern European descent. It is extremely rare in children.
- Chronic myelogenous leukemia (CML): Affecting mainly adults, this type is associated with a chromosome abnormality known as the Philadelphia chromosome. It involves a mutant gene called BCR-ABL. This mutation produces a protein called tyrosine kinase that researchers believe triggers abnormal cell behavior that results in leukemia.
What Causes Leukemia?
Acute leukemia is thought to be triggered by a few, or even one, white blood cell that has lost or damaged DNA information. These cells remain immature, multiply profusely, and crowd out the ability of healthy white blood cells to function normally. Chronic leukemia is a slower, but just as potentially deadly, process. Eventually, the immune system and blood production system becomes unable to function properly, and most fatalities from chronic leukemia occur due to uncontrollable bleeding or opportunistic infections.
Why these changes in the blood producing and immune systems begin to occur is not known for certain, but certain risk factors have been identified:
- Genetic disorders: Certain genetic abnormalities that produce other problems in the body also seem to increase one’s risk for developing leukemia. The one that has the most evidence behind this link is Down syndrome. Clinical studies have shown a strong connection between Down syndrome and risk for leukemia.
- Previous cancer treatments: Individuals who have been treated for cancer with certain types of radiation and/or chemotherapy have a greater statistical chance of developing leukemia later in life.
- Environmental exposures: Survivors of an atomic bomb blast, such as those in Hiroshima when the bomb was dropped during World War II, have an increased risk for leukemia. The same holds true for some individuals who have been exposed to nuclear reactor accidents, such as Chernobyl in Russia. Another toxin that has been clinically linked to risk of leukemia is benzene, a solvent used in industry and an ingredient in unleaded gasoline and cigarette smoke.
What Treatments Are Available for Leukemia?
As with all cancers, treatment options are considered based on the type of leukemia, the stage of advancement, and the general health of the patient.
In most cases, surgery is not an option as most leukemias are widespread throughout the bone marrow and lymphatic systems, and not locally contained. This can also make it difficult to use radiation, but it is sometimes recommended, often requiring radiation of the entire body. Chemotherapy, typically with a combination of drugs determined by the specifics of the leukemia, is the most common form of treatment used on leukemia.
Needless to say, the side effects of chemotherapy, radiation therapy, or both can be very unpleasant and dangerous, especially in children. Learn as much as you can about the specifics of your situation before submitting to any therapeutic regimen. Study the risks and benefits for yourself, as you are the one who ultimately has to deal with the outcome, not your doctors or anyone else. It is advisable to gain the advice and expertise of a naturopath or MD sensitive to natural forms of cancer support therapy that can be used in conjunction with traditional allopathic medicine. This can help protect you from some of the negative side effects, and also help your body to pursue wellness naturally as it is designed to do.