Haemato - Oncology
Hematology, or Haematology, is the medicinal branch that deals with blood related diseases. The cause of such diseases are studied, it is then followed by the prognosis, the treatment and prevention of such blood related diseases. And Oncology is the branch of medicine which deals with the diagnosis, treatment and prevention of cancer. The person who deals with it is an Oncologist. Haemato Oncology is related to all kinds of blood cancers that amount upto one tenth of global cancers. The person who deals with such cases is known as a Haemato Oncologist. Diseases like leukemia, hemophilia, anemia, lymphomas, thalassemias and cancer of other organs come under Haemato Oncology. The abbreviated term for it is hem-onc.
Haemato oncology is the study of blood-related cancers. Blood-related cancers account for approximately 10% of all cancers. Our hospitals can diagnose and treat a wide range of blood cancers:
- Lymphoma (Hodgkin and non-Hodgkin)
- Chronic lymphocytic leukaemia and related disorders
- Chronic myeloid leukaemia and related disorders
- Acute lymphoblastic leukaemia
- Acute myeloid leukaemia and myelodysplastic syndrome
- Multiple myeloma
Owing to the reputation of the effective diagnosis, Narayana super-speciality hospital is regarded as the best blood cancer hospital in India.
Diagnosis & Treatment
These tests can include:
- PET and MRI scans to stage many lymphomas and myelomas
- Molecular tests to look for mutations
- Cytogenetics to look for chromosomal changes in cancer cells
- Histopathology to look at tissue biopsies at the microscopic level
The treatment will be guided by our doctors and it will depend on the type of blood cancer, health condition of the patient at the time of the treatment, and how they wish to receive the treatments. Some need a single type of treatment and some may need several. Strong treatments are not for everyone, these tend to be taxing on the body and are not recommended unless absolutely necessary. Gentler treatment options appeal to many as it supports a good quality of life, even if it fails to cure blood cancer.
Everyone is different, so the treatment is classified in several sections that suits individual needs.
Intensive treatment: Intensive treatments are strong treatments and require the use of strong drugs to stop the spread of cancer cells. Primary examples of intensive treatment are as follows:
- Heavy dose chemotherapy: In this procedure, heavy dosage of drugs are used to kill the cancer cells.
- Standard chemotherapy dose: The use of cancer cell-killing drugs that stops the infected cells from multiplying.
- Stem cell transplantation: High doses of cancer killing drug, chemo is used to kill the affected cells from the bone marrow or lymph nodes. Then new stem cells from a donor or from yourself are introduced to the body through a drip. The new stem cells will then be producing fresh blood cells.
- Radiotherapy: It is the use of radioactive rays to kill cancer cells from a certain area of a body part. (Primary treatment for lymphoma).
- Surgery: Surgery is a rare occurrence. Splenectomy, the removal of spleen is performed if required.
Be it short or long term, all these treatments are linked with a number of side effects.
Non intensive treatment: Lower dose chemotherapy is an example of non intensive treatment. Such treatments are much more gentle on the body and have fewer side effects. Such cases usually don't kill the cancer but may help in keeping the cells in remission and in maintaining physical stability for a certain length of time. Some examples of non intensive treatments are as follows:
- Lower dose chemotherapy: Lower dose of chemotherapy drugs are used to kill cancerous cells and to prevent them from multiplying.
- Immunotherapy or bio therapy: Drugs that boost your immune system so that your body fights against the cancerous cells and keeps it in check.
- Curative treatment: If the doctors feel that you may not be able to cope with strong treatments due to certain compatibility issues then you are given some low risk treatments that may not essentially kill all cancer cells, but can keep it in check for extended periods of time. Lower number of side effects and low risk are the pros of such a treatment.
- Non curative treatments: Such treatments can be very strong or much gentle. It can maintain remission and manage your symptoms but it doesn't aim to cure cancer. It is more of a maintenance program.
- Wait and watch: A certain treatment for people who have a very slowly developing cancer situation in their body is called 'wait and watch' or 'active surveillance'. Here, you will be having a number of tests from time to time to observe the symptoms of the slowly spreading cancer. Even when the treatment starts, it will start from a very low dose.
- Supportive care: Supportive care along with non intensive or intensive care is a necessity. Such treatments don't directly fight the cancer cells, but helps in better management of symptoms and makes the experience a bit easier.
- Palliative care: Such care can help you cope with symptoms. It helps you in maintaining a quality through all the adversities.
- Follow up care: Here, signs of complications and relapse are observed. To make sure you have received the right treatment.
A wider range of treatments are required for patients with lymphomas or myeloma, including
Bone marrow transplantation
Patients with certain forms of cancer like leukaemia and lymphoma can be benefited from bone marrow transplantation. Stem cells transplants from the bone marrow or other sources are widely considered for cancer treatments as they can help in replenishing the healthy cells and bone marrow, destroyed from chemotherapy and radiation.
Following a successful transplant, the bone marrow will begin producing oxygen-carrying red blood cells, infection-fighting white blood cells and clot-forming platelets.
Enzyme inhibiting drugs
In cancer treatment, enzyme inhibiting drugs are used to block specific enzymes that cancer cells depend for their growth. Some of the drugs include:
- Histone Deacetylase Inhibitors – They target the proteins that support the DNA in the cell nucleus.
- Hormones (Corticosteroids) – Corticosteroids are hormones that can kill malignant lymphocytes by blocking cell metabolism.
- JAK or Janus-Associated Kinase Inhibitors – They block JAK1, JAK2, JAK3 and tyrosine kinase 2 enzymes, which are responsible for inflammatory and immune responses in certain diseases.
- Proteasome inhibitors – Proteasome are cell structures that need to function properly to keep a cell alive. Proteasome inhibitors can be used to limit the functionality of proteasome in cancer cells.
- Tyrosine Kinase Inhibitors – A tyrosine kinase inhibitor blocks the action of a certain abnormal protein that signals the cancer cells to grow.
Immunotherapy uses the patient’s own immune system to attack and fight cancer. Also known as biological therapy, it has fewer short-term side effects than chemotherapy. Few immunotherapies used to treat blood cancer include chimeric antigen receptor T-cell therapy, cytokine treatment, donor lymphocyte infusion, monoclonal antibody therapy, radioimmunotherapy, etc.
In cytotoxic chemotherapy, cytotoxic drugs are used to inhibit cell division, and thereby destroy cancer cells. They are also capable of killing small tumours that initial tests couldn’t identify. Cytotoxic drugs affect healthy tissues as well, but cancer cells are sensitive to these drugs as they divide faster than normal cells.
Responses and side effects have varying effects on individuals. There are some short term side effects that one gets during the treatment or immediately after the treatment. Then there are the long term side effects, which may last for months, years or even a lifetime.
Even if two patients are receiving the same kind of treatments, the side effects that both the patients display can be different as it varies from patient to patient. There are cases where people have shown little to no side effects during and after the treatment.
This is the aim of most blood cancer treatments, if not all. Remission is when your cancer cells cease to multiply and have successfully left the body.
A number of tests are performed after the treatment to determine if remission has been achieved. The tests that are done show the amount of remaining cancer cells, if any, and whether the cancer cells have completely or partially left the body. It all depends on how well your body has responded to the treatment. Once remission is achieved doctors may describe you as 'cured'.
the hospital to ensure no chances or relapses are present. Relapses occur due to several factors. One major factor is your own health condition, age, and the stage of cancer at which you were diagnosed. There are options for further treatment available to restore remission. The longer you stay in remission the better is the overall outlook.
Massage, acupuncture, meditation along with your cancer treatment goes a long way in relieving all the stress and tension and ensures you have a clear mind and are feeling good during the treatment. There is no medical evidence that such therapies help with blood cancer, but even if it isn't helping directly, it has its own effects. With complementary therapies, patients will be more relaxed, calm, and receptive during the treatment. And this will go a long way in maintaining your overall well being.
Haemato - Oncology FAQs
A haematologist-oncologist is a doctor who has expertise in diagnosing and treating blood cancers and diseases, such as haemophilia, iron-deficiency anaemia, sickle-cell disease, leukaemia and lymphoma. Apart from treating blood cancers, such as multiple myelomas and Hodgkins and non-Hodgkins lymphomas, they may also be involved in the management of solid tumours.
Haematologist-oncologists usually work with professionals from other departments for the treatment and management of blood related diseases, some of which may include pathology, surgery, radiation-oncology, radiology, etc.
A general physician may recommend someone to consult a haematologist-oncologist if they have some of the following blood disorders:
- Heavy menstruation
- Frequent nosebleeds
- Easy bruising
- Bleeding into joints
- Delayed blood clotting after wound, injury or surgery
- Bloody urine
- Shortness of breath
- Swollen lymph nodes
- Decreased platelets
- Low red blood cell and white blood cell count
- Petechiae or pinpoint skin rashes caused due to low platelet counts
Although these abnormalities dont necessarily point out to a serious disease, they may indicate serious blood disorders as well. So, it is better to get them checked by a specialist.
The consultation process generally starts by looking at the patients existing records, such as medical history, recent laboratory tests, blood test results, etc. The doctor will ask the patients about their symptoms and any unusual blood-related problems. During the consultation, the patients must give as much details as possible about their condition to help the haematologist arrive at a conclusive diagnosis.
Sometimes, the initial tests may not be enough to arrive at a conclusion. So, the haematologist may request for further tests like complete blood count, platelet aggregation tests and bleeding time measurement.
These tests may either be ordered during the same visit or may be scheduled at a later time. If you are looking for the best cancer treatment in India, you can schedule a visit to your nearest Narayana Health Hospital.