Leukaemia and other blood cancers: causes, symptoms and treatment

Leukaemia, lymphoma and other blood cancers can affect everyone from young children to older adults. Thankfully, there are often ways to treat blood cancer.

Blood cancers like leukaemia, lymphoma and myeloma are the second-most common cause of cancer-related deaths, according to the Leukaemia Foundation.

These cancers affect both adults and children. In fact, blood cancers are the most commonly diagnosed childhood cancer in Australia, accounting for about 40% of all diagnoses. According to the Leukemia Foundation, these numbers are also on the rise.

Staying in tune with changes to your health and acting on these by taking yourself for screenings can help with early diagnosis and treatment.

Blood cancer types

Unlike cancerous tumours that originate in one part of the body, like the bowel or breast, blood cancers develop when abnormal blood cells start growing out of control. These abnormal blood cells affect the way the body works and can spread to the lymph glands, spleen, liver, lungs and kidneys.

Blood cancers are a group of cancers rather than one single disease, explains Kathryn Huntley from the Leukaemia Foundation.

“There are over 150 different subtypes of cancer that can occur in our blood, and it all comes down to which type of blood cell is impacted by the cancerous change.”

There are three main groups of blood cancer: leukaemia, lymphoma and myeloma.

Leukaemia develops in your bone marrow and usually involves the white blood cells, which help your body fight infection. In people with leukaemia, your body produces too many abnormal white blood cells, which don’t work properly to fight infection. They also weaken the bone marrow’s ability to produce red blood cells, which carry oxygen around your body, and platelets, which help your body to form blood clots that allow wounds to heal.

Leukaemia can be either acute and fast developing or chronic, which progresses more slowly. Kathryn says acute lymphoblastic leukaemia (ALL) is the most common blood cancer diagnosed in children.

Lymphoma develops in the lymphatic system – a network of vessels that branch out into all your body tissues – from cells called lymphocytes, which are another type of white blood cell that help fight infection. There are two main types of lymphoma: Hodgkin lymphoma, sometimes called Hodgkin’s disease and named after the first doctor who described this cancer, and non-Hodgkin lymphoma. With both types of lymphoma, the abnormal blood cells that develop prevent the immune system from effectively fighting infection.

One of the differences between Hodgkin lymphoma and non-Hodgkin lymphoma is how they progress through the body. Hodgkin lymphoma occurs slowly, starting in one group of lymph nodes before moving onto the next. This means it is often diagnosed before it reaches an advanced stage. As non-Hodgkin lymphoma spreads more quickly, it is often more advanced before it is detected.

“The most common type of blood cancer among adults is lymphoma,” says Kathryn.

Myeloma develops from white blood cells in your bone marrow called plasma cells. It impacts your immunity as well as your bone strength.

It’s unclear what causes blood cancers, says Kathryn. “There are no specific linkages or causes that increase someone’s likelihood of blood cancer, like lifestyle choices or a family connection.”

Blood cancer symptoms

The symptoms for each of these types of blood cancers are different:

• Leukaemia symptoms usually occur quite suddenly and can include feeling weak, tired, bleeding easily – for example, having nose bleeds – and looking pale and washed out.
• Swelling of the lymph nodes in your neck is the most common symptom of lymphoma.
• Myeloma may cause bone pain, easily broken bones and tiredness but often there are no symptoms in the early stages.

The symptoms of blood cancers are often hard to differentiate from colds, flu and general fatigue – and there are no screening programs. Kathryn says it’s important to see your GP if you're concerned about other symptoms, like bruising easily, bleeding that takes a long time to stop or taking much longer than usual to fight even the mildest of colds. Your GP may do a blood test to check for signs of blood cancer.

“Maintain a good relationship with your GP and create a habit of being aware of what’s going on in your body because the symptoms of blood cancer can be subtle,” Kathryn says.

Blood cancer treatments

Because there are so many different types of blood cancer, treatments can vary.

“With some acute leukaemias, you’ll get a phone call from the GP and you’ll be presenting within an hour at the emergency department to start treatment quickly,” Kathryn says.

“Whereas with some chronic forms of leukemia it’s what we call ‘watch and wait’, where people are observed by their specialists every six months with a blood test.”

For the majority of people with blood cancer, treatment may include:

• chemotherapy
• radiotherapy
• steroids
• immunotherapy, which helps your immune system fight cancer
• stem cell transplants.

Thankfully, most children and many adults with leukaemia can be cured or, for chronic forms of the disease, successfully managed for long periods of time. Treatment for Hodgkin lymphoma is often very successful, and non-Hodgkin lymphoma is also curable. Myeloma isn’t curable but it can often be managed.

“What we’ve been really fortunate to see in Australia is a lot of advances in treatment,” Kathryn says.

If you or someone you know is diagnosed with a blood cancer, the Leukaemia Foundation can provide information and support. Always speak to your health care professional if you are experiencing symptoms or are concerned about your health.

Words by Angela Tuvfesson
First published September 2021