Being told you have “leukaemia” is a terrifying experience. A stream of horrible thoughts – chemotherapy, hair loss, isolation, the sinking feeling that everything you’ve taken for granted up to then, even whether you’ll be alive next weekend – takes over. It’s the often last word you hear the doctor say in your first consultation. Thankfully, for many, the event is very different from the initial expectation.
In fact there are many kinds of leukaemia. The “acute” leukaemias move quickly. They need intensive chemotherapy and often several months in hospital with only very occasional breaks of a few days between treatment courses. The chemotherapy isn’t as bad as many people imagine but it’s a tough time physically and emotionally and you’ll never be more grateful for the positive support of your family and close friends. “Chronic” leukaemias are completely different. Many people with these don’t feel at all unwell. You may be diagnosed incidentally through a routine blood count, having been walking around with it for years. These leukaemias usually change slowly.
Chronic lymphocytic leukaemia (CLL)
Some with this will remain well for decades, never requiring treatment. In others it will grow in the bone marrow, slowly or more quickly, crowding it out and preventing it from making healthy blood. This leads to anaemia, infections and bleeding. Treatment for CLL can be tablets or injections, but most people are treated as daycases or in clinic rather than in a hospital bed. This won’t cure the disease but can be very effective at returning the bone marrow to normal activity, remissions often lasting years before more treatment needs to be considered.
Chronic myeloid leukaemia (“CML”)
CML is a good example of how modern treatments are revolutionising cancer care in general. This leukaemia is caused by a specific genetic accident, effectively jamming a growth signal on. A new class of designer drugs fits like a key into the faulty signal molecule, turning it off. Formerly CML was an invariably fatal disease with an outlook of around 5 years. Nearly everyone now, taking the new tablets, has almost undetectable levels of CML 10 years after diagnosis and still counting!
Myeloma is a form of blood cancer which can cause bone pain, fractures and kidney damage if uncontrolled. For the most part it is incurable as yet but treatment has greatly improved over the past decade thanks to new classes of drugs such as Velcade, and the rediscovery of some surprising older ones such as thalidomide. The outlook for patients with myeloma is much better today than it was a few years ago.