Bone marrow cancer occurs when the cells in the marrow start to grow uncontrollably, and form an abnormal mass. This kind of cancer is referred to as bone marrow cancer or blood cancer. There are some types of cancer that can spread from other parts of the body (where cancer originated) to the bones and bone marrow, but this is not referred to as bone marrow cancer.
Bone marrow is the spongy fatty material inside some bones of the body. The marrow contains certain type stem cells, known as haematopoietic stem cell, that can give rise to all kinds of blood cells, including red blood cells, white blood cells, and platelets. The cancer may cause the marrow to not produce enough blood cells, leading to a variety of health problems.
Types of bone marrow cancer
There are many different types of blood and marrow cancers, but mainly:
Leukemia is the cancer that affects the white blood cells. It causes the marrow to produce abnormal blood cells that don’t die off when they should. As the number of these abnormal cells grow, they crowd out the normal blood cells (white blood cells, red blood cells, and platelets). This may result in interfering with their ability to function properly. Leukemia can be acute or chronic. Acute leukemia includes production of immature blood cells, called blasts, and symptoms progress rapidly. While, chronic leukemia includes more mature blood cells and symptoms progress slowly. The signs of cancer appear mild at first and patients may not even know if they have it for years.
The basic difference between the two is that the acute leukemias are fast progressing cancers, while chronic leukemias grows slowly. There can be different types of leukemia:
- Acute lymphocytic leukemia (ALL): This leukemia is found more commonly amongst children than in adults.
- Acute myeloid leukemia (AML): This type of blood cancer is most common in older adults. However, children can also develop AML.
- Chronic lymphocytic leukemia (CLL): It is a slow growing leukemia that originates in the white blood cell, called lymphocytes. CLL is more commonly found in older adults.
- Chronic myeloid leukemia (CML): This is a rare type of leukemia that starts in the bone marrow. CML can then spread to the blood and other body tissues.
- Chronic myelomonocytic leukemia (CMML): It is type of leukemia that grows in the kind of bone marrow cells that produce other blood cells. CMML primarily affects older adults mostly.
Lymphoma are cancers that start in the lymph nodes or the bone marrow. There are mainly two types of lymphoma: Hodgkin’s lymphoma, which starts in B lymphocyte, and non-Hodgkin’s lymphoma, which starts in B or T cells. There are several subtypes under these two categories.
Hodgkin lymphoma: This type of lymphoma is a cancer that affects certain kind of B lymphocytes. It can be differentiated from non-Hodgkin lymphoma with the presence of a specific type of abnormal cell, known as a Reed-Sternberg cell.
Non-Hodgkin lymphoma: This cancer can occur in any part of the body. It may affect different types of lymphocyte (kind of white blood cell).
Lymphoma involves the abnormal growth of lymphocytes, resulting in tumors and making it difficult for immune system to fight infections.
Multiple myeloma is the most common type of cancer of bone marrow and it begins in the plasma cells. These are the type of blood cells that make antibodies to attack the foreign particles in the body. The cancer develops when the body starts to produce plasma cells. The uncontrolled growth of abnormal cells (tumors) can lead to bone loss and a reduced ability to fight infections.
Symptoms of bone marrow cancer
Some symptoms of leukemia include:
- Frequent infections
- Unexplained loss of weight
- Swelling in the lymph nodes
- Enlargement of liver or spleen
- Bruising or bleeding easily, usually as frequent nosebleeds
- Small red dots on the skin
- Excessive sweating and night sweats
- Bone pain
Some signs of lymphoma are:
- Swollen neck, underarm, arm, leg, or groin
- Enlargement of lymph nodes
- Neurological symptoms: nerve pain, numbness, tingling sensation
- Unexplained weight loss
- Fever, chills and night sweats
- Pain in chest or lower back
Signs of multiple myeloma are:
- Weakness and fatigue
- Anemia due to shortage of red blood cells
- Bleeding and bruising due to reduced blood platelets count (condition called thrombocytopenia)
- Frequent infections caused by shortage of normal white blood cells (called as leukopenia)
- Excessive thirst and dehydration
- Frequent urination
- Pain in the abdominal region
- Lack of appetite
- Confusion resulting from high calcium levels in the blood (hypercalcemia)
- Bone pain or weakness of the bones
- Kidney damage (may lead to kidney failure)
- Peripheral neuropathy (itching), or tingling sensations, due to nerve damage
Treatment for bone marrow cancer
The treatment for blood and marrow cancer is a personalized process and the doctors will suggest a plan based on the type and stage of cancer when diagnosed, along with several other health considerations. The type of treatment recommended will affect the cost of treatment, outlook, and survival. The BMT treatment cost in India is comparatively lower than several other countries, but with equally good quality of clinical services. This is an advantage for international patients, as they can save a significant amount of money, even after including travel, accommodation and other expenses.
The following are the main treatment options for bone marrow cancer:
Chemotherapy: It is a systemic treatment that involves the use of anticancer drugs to destroy the cancer cells in the body. A combination of drugs can be used based on the type of cancer the patient has.
Stem cell transplant: A stem cell or bone marrow transplant is a medical procedure in which the damaged bone marrow is replaced using a healthy marrow cells. The treatment may include high-dose chemotherapy and radiation therapy before transplanting the new stem cells.
Radiation therapy: This therapy involves use of high-energy radiation delivered to a targeted area. The radiation may kill the cancer cells, reduce tumour size, and relieve some symptoms such as pain.
Biological therapy: In this therapy, patient’s own immune system is used to destroy cancer cells.
Targeted therapy drugs: It involves use of drugs that attack specific types of cancer cells. Unlike chemotherapy, this type of treatment prevents damage to healthy cells.