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Leukaemia is a cancer of the white blood cells, with several different types.
Doctors do not know the exact causes of leukaemia. But some risk factors may increase the chance of developing it. Different types of leukaemia have various risk factors. Having one or more risk factors does not mean you will get leukaemia.
Different types of leukaemia are named according to:
- The type of blood cell which is affected
- Whether the leukaemia is acute (faster growing) or chronic (slower growing)
The main types of leukaemia are:
- Acute myeloid leukaemia (AML)
- Acute lymphoblastic leukaemia (ALL)
- Chronic lymphocytic leukaemia (CLL)
- Chronic myeloid leukaemia (CML)
Another type of leukaemia is the less common hairy cell leukaemia.
*Information provided by Macmillan Cancer Support
What are the signs and symptoms?
Leukaemia symptoms commonly include fatigue, breathlessness, infections, and bruising or bleeding more easily. Leukaemia symptoms vary depending on the type of leukaemia. Not everyone gets the same symptoms, and you won’t necessarily have all of the symptoms.
Most people with these symptoms won’t have leukaemia. But some people will; the earlier it’s diagnosed, the higher the chance of successful treatment.
Even if you only have one symptom, if it’s unexplained, goes on for a long time, or is unusual for you, you should contact your GP.
Do I need any tests to confirm the diagnosis?
There are several common tests for leukaemia, and they can be:
- Blood tests
- Scans: The range of imaging includes X-Rays, Ultrasound, Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Nuclear Medicine imaging, including PET-CT (positron emission tomography CT). Each test varies in whether radiation is being used.
- Bone marrow biopsy: when a thick needle is used to take samples of bone marrow, the soft jelly-like tissue is found in the hollow centre of large bones. Bone marrow biopsies are usually taken from the top of the pelvic bone, just below your waist. You’ll usually have a local anaesthetic to numb the area, and you may also be given a sedative to help you relax and cope with any discomfort or anxiety.
What treatments are available?
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT). Your treatment will depend on different things, such as your leukaemia type and general health. You may have a combination of treatments.
These are some common treatments. You might have these treatments on their own or in combination:
Watch and wait: Some people with slow-developing blood cancers don’t need treatment immediately – this is called ‘watch and wait’. You’ll be carefully monitored and only start treatment if and when required. “Watch and wait” doesn’t mean you can’t be treated. It’s offered when your doctor believes there’s no added benefit to starting treatment immediately.
Chemotherapy: Chemotherapy uses drugs to kill cancer cells or stop them from growing. You can have chemotherapy through a drip into a vein, as a tablet you swallow or by injection under the skin. Some people with leukaemia will need high doses or high-intensity chemotherapy, which can cause more side effects. Lower dose or low-intensity chemotherapy is usually gentler and causes fewer side effects.
Other drug therapies: Other drug therapies can be used on their own or with chemotherapy. Targeted therapies are drugs that target proteins or genetic changes that cancer cells have, which normal cells don’t have. They are also sometimes called biological therapies or immunotherapy. Examples used for leukaemia are drugs called rituximab and tyrosine kinase inhibitors (TKIs), but there are others.
Stem cell transplant: Blood stem cells are blood cells at their earliest stage of development. A stem cell transplant involves having high doses of chemotherapy to kill the abnormal cells in your bone marrow or lymph nodes and then receiving new blood stem cells (either your own or from a donor) through a drip. The aim is for these new stem cells to start producing healthy blood cells.
Your doctor or specialist nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions.
*Information provided by Blood Cancer UK
What happens if I do not get treatment?
It will depend on your type of leukaemia. Please discuss this with your doctor and cancer nurse specialist.
What is Personalised Cancer Care?
Personalised Cancer Care means your team will support you to take an active role in your cancer care by giving choices and control based on what matters most.
Together with your key workers’ team, like your Clinical Nurse Specialist and Macmillan Support worker, we will aim to help you access the care and support that meets your individual needs from the moment you receive your cancer diagnosis so that you can live as full, healthy and active a life as possible.
You will be invited to complete a Holistic Needs Assessment (HNA) to identify any concerns you may have when you have been diagnosed with cancer. These concerns may be physical, emotional, practical, financial and spiritual.
You will answer a simple set of questions or fill in a checklist about all areas of your life. It is to find out about the concerns you may have. You are often asked to rate how important these concerns are to you. It could help you decide what to discuss first during the assessment.
Once you have completed the assessment, your Clinical Nurse Specialist will discuss your needs, maybe face-to-face in a clinic or over the phone. During the discussion, you and your Clinical Nurse Specialist will agree on the best ways to manage your needs and concerns. They will write down what you have decided in a document called a care plan. They may write it during the discussion. Or they may make notes and send them to you afterwards. Your care plan will record the following:
- The main concerns you talked about
- Suggestions and actions to help you manage your concerns
- Services that may be able to support you, and any referrals that are made
- What is already being done to help – for example, the services you are already using
- Information about who to contact if you need more help
- The details of other health or social care professionals with whom you have agreed to share the information.
You may not wish to complete the holistic needs assessment at this time. The care you receive will not be affected in any way, and we will be happy to discuss this again in the future
Health and wellbeing information and support also include:
- Access to the Macmillan Information & Support Centre to find out what support is available in the community, e.g., practical, financial, and how to access it
- Help with understanding cancer and its treatment and how to manage its impact through videos and workshops run by healthcare professionals at St George’s and in the community.
- Attend wellbeing activities which are great opportunities for you and your carers to get together with others affected by cancer