Leukemia

Leukemia can refer to several different types of cancer of the bone marrow and blood. Although leukemia occurs more often in adults over age 55, it is the most common type of cancer in children.

Researchers have found a link between these types of cancer and exposure to smoking and some dangerous chemicals, but there is also the possibility of a genetic component. Certain blood disorders may make a person more likely to develop leukemia.

A significant step in your cancer treatment is to understand what type of cancer you have. That, along with other factors we’ll mention below, are what determines the treatment your cancer doctor recommends.

Different Types of Leukemia

The type of leukemia you have depends on two factors:

  • What type of cell is affected — Cancer begins growing in the bone marrow cells that become either myeloid cells or lymphocyte cells.
  • The growth rate of the cancer cells — The acute type of leukemia is faster-growing than the chronic type of leukemia.

This means there are four different types of leukemia:

  • Acute lymphocytic leukemia (ALL)
  • Acute myelogenous leukemia (AML)
  • Chronic lymphocytic leukemia (CLL)
  • Chronic myelogenous leukemia (CML)

The faster growing, acute leukemia requires immediate and aggressive treatment. Chronic leukemia is slower growing, but it still must be treated.

To determine what type of leukemia you have, doctors rely on a complete blood count, liver and renal function studies, bone marrow examination, and a “flow cytometry” blood test. They also use cytogenetics (the relation of chromosomes to cell behavior) to help identify the leukemia type.

Factors that Determine Your Cancer Treatment

You likely know of someone who has been treated for cancer with radiation or chemotherapy – or perhaps both. You may feel apprehensive and worry about the cancer treatment you’ll receive, but it’s important to know that your cancer treatment may differ greatly from someone else who has cancer.

Your cancer doctor takes other factors into consideration before recommending a course of treatment. Besides the type of cancer you have and the presence (or lack of) certain biomarkers, other significant factors include:

  • Your age
  • Acute myelogenous leukemia (AML)
  • Your general health
  • Stage of cancer

In general, the younger you are when cancer is diagnosed, the more aggressive the cancer, which requires an aggressive cancer treatment. When you are diagnosed with cancer later in life, the cancer is slower-growing and there is often time to examine various treatment options.

Your current state of health (for example, physical fitness or the presence of other medical conditions) is important in determining how aggressively your cancer can be treated and what treatments can be used. You should also discuss any past health issues with your oncologist so that he or she can determine if it’s a factor in your cancer treatment.

When compared to other cancers, the staging of leukemia is different because the cancer cells begin growing in the bone marrow (i.e., there is no originating tumor). The different leukemia types (ALL, AML, CLL, CML) require different staging systems. Other variables doctors use (besides your age and health) when staging the cancer can include:

  • Number and size of the cancerous cells
  • Sub-type of the cancer (applies only to ALL and AML)
  • Where else the cancerous cells are located (lymph nodes, thymus, spleen, etc.)

Treatment for leukemia may include:

  • Chemotherapy — Anti-cancer drugs taken intravenously or by mouth.
  • Stem cell transplant — Cancer cells are destroyed with chemotherapy and replaced with healthy stem cells.
  • Radiation — Radiation is sometimes used after chemotherapy.

Your Treatment Team

A medical oncologist, with the assistance of nurses and staff, will treat your cancer in addition to any cancer-related conditions. The medical oncologist has the role of treating your cancer using chemotherapy or other medications, if appropriate.

The oncologist also works with other types of healthcare professionals to treat your cancer:

Hematologists
A doctor who specializes in diseases and conditions of the blood.

Radiation oncologists
Treats cancer using radiation therapy.

Genetic counselor
Evaluates the results of genetic tests to provide further information about your cancer.

Your oncologist consults extensively with the other doctors to determine what type of treatment will result in the best outcome for you. Although you might receive treatment from any of the doctors on your cancer team, your oncologist is the “quarterback” who coordinates the treatment.

You can read more about your cancer doctor’s background and experience on the About page.

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