Seventy-year-old Don Wright doesn’t believe in giving up without a fight. Since being diagnosed with multiple myeloma (MM), also known as myeloma, eight years ago, he has become a beacon of light for patients battling the crippling cancer of the plasma cells in bone marrow. While no exact cause has been found to lead to this disease, it does primarily affect elderly folks. the median age of diagnosis is roughly 70 years.

A picture of health, the retired American lawyer has used his passion for running marathons to keep physically fit, controlling the cancer with a clinical trial drug called pomalidomide to give himself a new lease of life. He has been on this drug since March 2008, with positive results. Prior drugs gave him little to no relief.

Wright spoke to Life following his speech at the 53rd American Society of Hematology (ASH) conference in San Diego late last year, where medical experts congregated to promulgate and analyse new treatments for myeloma suffers. He spoke candidly to the audience about how encouraged he was to see fresh developments taking place in the treatments for MM patients. a trial drug has worked wonders for him, he said with enthusiasm, offering him a life he would not have imagined a few years ago.

“I want patients around the world to be emotionally and physically strong to fight this disease,” said Wright. “Trial drugs might not be easily accessible to the masses and might not always work, but that should not put people off from looking after themselves both physically and emotionally.

”Pomalidomide, the trial drug, is working for me. It will not cure the myeloma but it keeps it stable. I want people in my shoes to be encouraged to live and celebrate life. I have a disease but despite that I have a wonderful life. Despite the odds, it is pivotal to have hope. At the conference, doctors talked about a cornucopia of treatments, which are at trial stage, so there is a lot of hope for new cures on the horizon. Life is there to be lived to the fullest despite the impact the disease has had on us both mentally and physically.”

Afterwards, he took time out to run a mini-marathon with a small group. He has competed in 55 marathons in 37 states, while his goal is to compete in 50 states. Wright was diagnosed with myeloma two weeks after running his first marathon in 2003. His doctor_ who gave him a five-year survival estimate _ was always supportive of his running which he believed would strengthen his bones. He decided to continue for the sheer enjoyment of pushing his physical limits to the next level. Admitting that with advancing age and the sickness, he is simply content with reaching the finish line.

Adhering to a healthy lifestyle is a must to boost your chances of fighting the disease, he said. Smoking, obesity and fast food should be kept at bay. Nutritious food is a must, organic is most advised. Exercise of all forms can lift people from depression and stress, he enthused with a twinkle in his eyes. Wright credits good emotional health to a supportive family, a wife and daughter that also participate in marathons with him.

The well-toned athlete calls them his pillar of emotional support. Wright concluded on a poignant note: ”I do realise that I don’t know just when the cancer might deteriorate. But for the meantime, my family and I are relishing the extra time that we have been given to be together. To make the most of it, we have been travelling and doing these running events together to celebrate life.”

Meanwhile, Dr Weerasak Nawarawong, president of the Thai Myeloma Working Group, who also attended the ASH meetings, said that while the experimental drug pomalidomide is not available in Thailand, it is important for Thai patients not to lose hope because many new treatments are being tested to find suitable cures. Judging from all the positive developments that are taking place in the field of blood cancer studies, there is reason to be optimistic about the future.

Despite being diagnosed with multiple myeloma, a treatable yet incurable cancer, Don Wright (foreground, right) has fought tooth and nail to keep it under control through a positive attitude and healthy lifestyle.

He said a number of updates were shared at the American Society of Hematology conference about the treatment of multiple myeloma. one which includes the next generation immunomodulatory drugs pomalidomide, proteasome inhibitors and carfilzomib. Patients taking these drugs, in addition to other experimental medication, tested in no increased toxicity.

In Thailand he said most MM patients are in the age bracket of 60-70 years old. Annually, there are approximately 150 new cases in comparison to 15,000 in the US. Dr Weerasak noted that while myeloma is treatable it yet remains incurable. important treatment advances, however, have developed in higher rates of remission and lengthier survival than were seen in the past. As experts attain a better understanding of the development and progression of this disease, targeted treatment strategies are generating further benefits.

He said that a routine blood screening can catch a number of myeloma cases while it is still in an asymptomatic state. the symptom at the onset of the disease for most Thai patients is bone pain. In those who have pathologic fractures especially fractures of the thoracic and lumbar vertebral bodies, it usually results in severe spasms and back pain. the anaemia, which may be quite severe, is the most common cause of weakness in patients with MM.

Dr Weerasak admitted that while Thailand has kept statistics of the number of myeloma patients through the years, it had not made an epidemiologic study of the disease as such. Due to lack of awareness physicians under-diagnose their patients, he noted. Epidemiologic studies in countries such as China and Korea have given him reason to believe that the number of patients with multiple myeloma in Thailand is increasing steadily.

To raise awareness the Thai Myeloma Working Group organises several functions to educate both physicians and patients on the disease. they also have a website (thaimyeloma.org/th) for patients to obtain information about multiple myeloma. He also hopes that in the near future, they will be able to set up supportive groups for myeloma patients to receive counselling.

Thai myeloma patients can expect medication that is approved worldwide.

”All the anti-myeloma drugs that have been approved for treating multiple myeloma are available in Thailand,” noted the veteran medical expert. ”The success of the treatment is as good as you would find in Western countries if only we can get access to novel drugs, which don’t come cheap. There are numerous determining factors that influence the positive outcome of the treatment. Few examples include age, the advancement of the symptoms and the duration of time that has elapsed before the patient gets the anti-myeloma therapy.

”Novel drugs also have no guarantee and can be expensive. so Thai myeloma patients’ biggest setback can be the ability to purchase these drugs. the government does not also have a big enough budget to cover the expense.”

Dr Weerasak said doctors are looking for appropriate drugs that can be used to maintain the status of remission which is quite successful in some of the sufferers.

He explained that clinical trials are research studies of new treatment methods. Even if you are newly diagnosed with multiple myeloma, he said you might be offered a clinical trial drug. the early phases I and II of the clinical trials focus mainly on a safe dosage level, side effects and type of cancer to ascertain

that the new drugs are working. the phase III trials then determine if the patient is making better progress from the currently available treatment they have undergone. Patients might have to take some risks, such as suffering from adverse effects, so it is up to them to continue or discontinue with the treatment.

Asked to share common causes and symptoms of myeloma, Dr Weerasak explained that as there is no exact cause of MM, there are several risk factors that could lead to the disease. Repeated exposure to chemicals such as pesticides, benzene and spraypaints have been proposed as potential causes.

”Most people with MM have no known risk factors other than age,” he said. ”Scientists have identified a few risk factors for instance, obesity, exposure to radiation or chemicals. Not everyone with risk factors gets multiple myeloma. Myeloma is slightly more common in men than women, and most people are diagnosed in their sixties.

”Symptoms could include frequent low back pain. the pain could nonetheless occur in other areas like ribs, arms, legs and pelvis.

”For patients that develop anaemia, they will have paleness, dizziness, weakness, fatigue and shortness of breath. Infections such as pneumonia, sinusitis are frequent. Weakness or numbness in your legs might be the result of spinal cord compression. Unexplained weight loss is common. High calcium levels cause excessive thirst, nausea, constipation, loss of appetite and confusion. Swelling, especially in the legs, along with weakness are symptoms of kidney failure.”

Best prevention methods are to keep healthy through having a good diet, exercise to enhance your physique, observe good personal hygiene to prevent infection and avoiding smoking and alcohol. Exposure to toxic chemicals and radiation is believed to increase the risk of multiple myeloma and other cancers, so keep this in mind and avoid being around these substances for long periods of time. Regular medical examinations for early detection and timely treatment is always advisable.

Photojournalist Ed Kashi captures the lives of patients suffering myelodysplastic syndromes, a group of closely related but diverse blood cancers, which also affect the aged.

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Kidney is one of the most vital organs in the human body and plays a major role in filtering and removing waste products from the body. if the kidneys fail to work properly, it causes various health problems. Acute kidney failure and chronic kidney failure are the main two types of kidney failure. Chronic kidney failure, also called as chronic renal failure, allows building up waste products and fluids in the body in dangerous levels. Chronic kidney failure symptoms start to appear after a period of years.

Shortness of breath

Shortness of breath is one of the common chronic kidney failure symptoms. it happens in people due to extra fluid in the lungs. Accumulation of toxins in the blood may also cause shortness of breath. The toxin accumulation can decrease the oxygen carrying capacity of the blood.

Decreased urine output

The most common and important sign of chronic renal failure is decreased urine output. The patient experiences decrease in urine output because of the malfunctioning of the kidney. This results in improper absorption of waste and water from the bloodstream.

Generalized weakness

People, who suffer from chronic renal failure, may experience generalized weakness. In normal situation, the kidneys produce a protein hormone called erythropoietin (EPO). Its function is to stimulate bone marrow to increase red blood cell count. if the kidneys are failed, the production of erythropoietin becomes insufficient to stimulate bone marrow. it leads to the decrease in the red blood cell count resulting generalized weakness.

Anemia

Anemia is also caused by the lower level of erythropoietin due to a kidney failure. Regulating red blood cell production is the function of EPO. as chronic kidney failure decreases the red blood cell count, the patient becomes anemic. Loss of nutrients such as iron and folic acid that are important components of red blood cells may also cause anemia.

Loss of appetite

Chronic renal failure may cause a constant foul taste in the mouth of the patient. This can lead to the loss of appetite.

Bone disease

Chronic kidney failure symptoms include several bone diseases. Regulating the balance of substances such as calcium, vitamin D and phosphate are one of the main functions of the kidney. Failure of the kidney may result in abnormal levels of these substances that may lead to bone diseases. The bones can become thin and weak that may be associated with pain. Patients, who suffer from renal bone disease, are at a higher risk of bone fractures and osteoporosis.

Swelling

Swelling of the lower limbs and abdomen is commonly associated with chronic kidney failure symptoms. The failure of kidney causes buildup of fluid in the body. Increased fluid in the blood vessels may accumulate in various spaces of the body such as tissues in the lower limbs and abdomen with ensuring swelling.

Depression

Chronic kidney failure may affect the nervous system of the people in some cases. The patient may have a depressed mood. Toxic metabolite buildup due to kidney failure can result in general malaise, altered mood, weakness and decreased mental function.

Uremia buildup

Uremia is one of the toxins found in the blood stream. Normal functioning kidneys can remove this toxin from the body. if the kidneys fail, uremia may accumulate in the body with many effects. Uremia is toxic to the platelet cells in the blood and platelet cell dysfunction may make the body to bruise and bleed. Increased uremia can inflame the pericardium with symptoms of discomfort and chest pain. Uremia toxin also affects the brain and nervous system that may cause various symptoms such as lethargy, decreased mental acuity, loss of reflexes, impaired sensation and even coma. Constant itching also occurs due to uremia buildup.

Chronic kidney failure symptoms may often become life-threatening and it is advisable to consult a doctor when any of such symptoms are exhibited.

Related Tags: kidney disease and decrease in mental function, renal failure and mood, situation of kidneys

Bone cancers are uncommon varieties of cancer which will have an effect on any bone inside the body. two varieties of bone cancer are quite a few myeloma and bone sarcomas. Bone cancers also can take location when tumors that start in other organs, as an example breasts, lung, and prostate, metastasize (spread) towards the bone. quite a few myeloma is going to be probably the most prevalent sort of bone cancer.

Regular information about Bone cancer symptoms and therapy. Blood tests, X-rays, CT scans, MIRs and ultrasound can all be utilized inside the diagnosis of bone cancer and cancer of the bone marrow. Ultimately nevertheless, only a bone biopsy can supply a definitive diagnosis. by examining a sample of tissue, a Pathologist can choose regardless of no matter whether cancer is present and how speedily it can be growing, crucial information in determining probably the most powerful course of therapy. Varieties of Bone Cancer: Osteosarcoma could possibly be probably the most widespread bone cancer. it hardly ever occurs in adults older than 25 years old.

Osteosarcoma is generally identified inside the bones of the arms, legs and pelvis, and in bones that develop speedily, like the shoulders and knees. Ewing’s sarcoma is generally discovered in youngsters ages four to 15, and is uncommon in adults older than 30. it genuinely is an aggressive cancer generally identified inside the center of the lengthy bones of the arms and legs. Chondrosarcoma is observed in cartilage cells and accounts for about 25 percent of bone tumors, producing it the second most widespread type. Unlike most other bone cancers, it is most widespread in men and girls older than 40.

It is generally discovered inside the enormous bones of the hips and pelvis. Bone Cancer Symptoms: Discomfort Swelling or tenderness of the joints fractures Fatigue, fever, weight reduction, anemia Bone dysplasia with medullary fibrosarcoma Eosinophilic granuloma quite a few Myeloma The symptoms of bone cancer differ from 1 certain individual to yet one more based on the location and size of the bone cancer. Discomfort is amongst probably the most typical bone cancer symptoms. Generally, there’s a gradual strengthen inside the severity of the symptoms with time.

At initial, the discomfort could only be felt with activity or at evening. These are typical sorts of Bone Cancer Treatment: Surgery How bone cancer is treated depends upon the selection of tumor, how aggressive it genuinely is, the location of the tumor and regardless of no matter whether or not the cancer has spread to other locations of the body. Alternatives incorporate surgery, radiation and chemotherapy, or a mixture of the three.

Risks contain infection, harm to surrounding muscles, nerves and blood vessels, and recurrence of the cancer. Patients are generally prescribed a course of physical therapy following surgery to assist them regain full use and strength inside the limb specifically where the tumor was removed.

Blood Cancer Treatment in India available at ISO approved hospitals

Blood Cancer Treatment in India is available at various corporate hospitals that are JCI accredited, ISO certified or in the process of achieving these seals. various corporate hospitals in India are specially designed according to the needs of international patients. over the last two decades, the economic boom in India has led to the building of medical facilities & infrastructure that rival the very best that western medical care has to offer. Blood Cancer Treatment in India is available at various corporate hospitals that facilitate world class, high quality and affordable medical treatment and healthcare tourism in India.

About Blood Cancer

Blood Cancer or Leukemia refers to a group of cancers of the blood cells. in blood cancer, white blood cells become abnormal, and divide and grow in an uncontrolled way.

White blood cells and blood cancer

White blood cells are made in your bone marrow, which is the soft spongy centre of your bones. Your bone marrow makes the most basic type of cells (called stem cells), and they can develop further into three types of cells –

white blood cells – protect your body from infectionred blood cells – carry oxygen around your bodyplatelets – important for normal blood clotting

Once these cells are made, they enter your bloodstream. White blood cells are involved in your body’s immune system, a defense system that protects you from infections. there are two main types of white blood cells – myeloid cells and lymphocytes.

In blood cancer, some of the white blood cells don’t grow properly. They stay in the bone marrow and keep reproducing in an uncontrolled way. these abnormal white blood cells fill up the bone marrow and prevent it from making healthy white blood cells. This means the body is less able to fight off infections. The abnormal white blood cells also prevent bone marrow from making enough red blood cells and platelets. a lack of red blood cells leads to less oxygen being delivered to the organs and tissues of your body. This is called anemia, and it can make you feel tired and breathless. a lack of platelets can lead to problems with the blood-clotting system, and results in bleeding and bruising much more easily than usual.

Causes of Blood Cancer

The exact cause of blood cancer is unknown, although there are some factors that increase the chance of developing it.

a weakened immune system – this may be a result of medicines that suppress the immune system (eg medicines to prevent rejection of organ transplants), high doses of radiation (eg radiotherapy or chemotherapy for another cancer), or diseases that affect the immune system (eg HIV)age – chronic leukemia is more common in people who are over 40gender – slightly more men than women are affected by leukemiasmokingcertain genetic conditions, such as Down’s syndromeother blood disorders, such as aplastic anemia, a rare condition where the bone marrow fails to produce blood cells correctlycontact with a chemical called benzene, one of the chemicals in petrol and a solvent used in the rubber and plastics industry

Types of Blood Cancer / Leukemia

There are several types of blood cancer. They are named according to the type of white blood cells (myeloid cells or lymphocytes) that are affected and how quickly the disease develops. only the common types are discussed here. The two main types of blood cancer are acute and chronic.

Acute blood cancer

In acute blood cancer, symptoms develop rapidly and the cancer can quickly become life-threatening if it’s not treated. The most common form of acute blood cancer affects lymphocytes. This is called acute lymphocytic leukemia (ALL). another type of acute blood cancer is acute myeloid leukemia (AML).

Chronic blood cancer

In chronic blood cancer, symptoms develop slowly and the white blood cells are almost fully grown and normal when they leave the bone marrow and enter the bloodstream. They can function, but not as well as they should do. one type of blood cancer, called chronic myeloid leukemia (CML), affects a particular type of white blood cells called myeloid cells. it has two phases, a chronic phase that can last for several years, during which symptoms develop slowly, followed by a more aggressive phase (accelerated phase), where symptoms quickly get worse.

Symptoms

The symptoms of blood cancer vary, depending on the exact type of disease and how advanced it is. there may be no symptoms in the early stages, especially in people with chronic blood cancer. Many symptoms are vague, such as fever, headaches, weight loss and night sweats.

Symptoms of blood cancer include –

tiredness, breathlessness and pale skin (due to anemia, a reduction in number of red cells in the blood)frequent infections that do not get betterincreased bruisingabnormal bleeding from gums and cutsheavier periods in womennosebleedsbone pain (due to the pressure of a build-up of cells in the bone marrow)swollen lymph glands (glands in the neck, groin and under the arms)abdominal pain (due to an enlarged spleen or liver)swollen gums, and occasionally, swollen testiclesheadaches and vision problems

Treatment for Blood Cancer

The effectiveness of treatment for blood cancer depends on the type and stage of the disease. Acute blood cancer or acute leukemia often goes into remission (the symptoms go away; the disease is under control but not necessarily cured). but many people with acute blood cancer have a relapse (the disease returns).

Treatment includes –

chemotherapyradiotherapybone marrow or stem cell transplantmonoclonal antibodiesbiological therapy (which may be in the form of tablets)steroids

Why consider India?

Blood Cancer Treatment in India is available at various hospitals of Mumbai, Bangalore, Hyderabad, Chennai and new Delhi at an affordable price. various corporate hospitals in India use latest technology to perform complex medical treatments and procedures. Most state of the art equipment is imported from countries like USA, UK, Germany, Japan etc. While the treatment in Indian private hospitals are at par with the hospitals in USA and UK, the cost for such treatment in India is actually a fraction of what it would cost in western countries.

For more details visit our website – forerunnershealthcare.com Or you can email your queries at . Or call us at 00919371136499

December 15, 2010, 9:24 pm

* Thalassaemia is a genetically transmitted disease

* It affects the haemoglobin component of red blood cells and leads to early destruction of the affected cells.

* there is a wide spectrum of presentations depending on the type of involvement of the genes

* Severely affected children need regular blood transfusions.

* Iron overloading is a major problem that leads to life-threatening complications

* Newer modalities of treatment hold a lot of promise.

* the disease can be prevented by detecting carriers of the genes involved.

The red blood cells in the normal human being perform the important function of transporting and providing oxygen to the tissues of the body. for this important function to be performed the normal haemoglobin plays a crucial role and the normal amount of haemoglobin in the blood is scrupulously regulated in the human body. the normal red cells have a finite life span of around 120 days and there is a dynamic process of old red cells being destroyed in the body followed by replenishment of the destroyed red cells by new cells formed in the bone marrow. there is a very specific chemical structure of normal human haemoglobin and any alteration of this structure makes the cells more susceptible for destruction and in such instances they are destroyed well before their normal life span of 120 days.

Thalassaemias are inherited genetic disorders that involve decreased and defective production of haemoglobin which is the molecule found inside all red blood cells which play a part in the transportation of oxygen throughout the body. Normal human hemoglobin contains two different kinds of protein chains named alpha and beta chains. there are two types of thalassaemia, alpha-thalassaemia and beta-thalassaemia. Their names describe which part of the hemoglobin molecule is affected, namely the alpha or the beta chain. any deficiency in these chains causes abnormalities in the formation, size and shape of the red blood cells. This process makes these cells to be more susceptible to destruction by the normal regulatory processes of the body. As a result, people with thalassaemia often have a reduced number of red cells in the bloodstream which leads to anaemia which can affect the transportation of oxygen to body tissues. In addition, thalassemia can cause the red cells to be smaller than normal or drop the haemoglobin content in them to below-normal levels. Depending on the type of thalassaemia and the degree to which they are affected, children with this disease may exhibit an array of the illness ranging from very mild inconsequential disease to a very severe life-threatening format. In other words, some only have mild anaemia with little or no effects while others require frequent serious medical treatment.

Thalassaemia is always inherited and passed on from parents to children through their genes. A child usually does not develop severe symptoms unless both parents carry a thalassaemia gene. these parents, who are reasonably normal to all intents and purposes, are known as "carriers" of the disease. if only one parent passes a gene for thalassaemia on to the child, then the child is said to have the thalassaemia trait. such a thalassemia trait will not develop into the full-blown disease and no medical treatment is usually necessary. many families have thalassaemia carriers, but the trait often goes undiagnosed because it produces none or very few symptoms. Frequently, thalassaemia is not diagnosed in a family until a baby is born with a severe form of the disease. at one time it was believed that the disease affected only people of Italian or Greek descent, but it is now known that many people with thalassaemia also come from or are descended from Africa, Malaysia, China and many parts of South East Asia. Because of a recent pattern of migration from Southeast Asia, there has been an increase in the past decade of thalassaemia in Europe and the USA.

Children with alpha-thalassaemia trait do not have thalassaemia disease. People normally have four genes for alpha globin, two inherited from each parent. if one or two of these four genes are affected, the child is said to have alpha-thalassemia trait. A specific blood test called a hemoglobin electrophoresis is used to screen for alpha-thalassaemia trait and can be done in infancy. often, results of the haemoglobin electrophoresis test are normal in people who have alpha-thalassaemia trait and a diagnosis of alpha-thalassaemia is made only after other conditions are ruled out and after the parents are screened. the disease can be harder to detect in older children and adults. those who have the alpha-thalassaemia trait usually have no significant health problems except mild anaemia which can cause slight fatigue. Alpha-thalassaemia trait is often mistaken for iron deficiency anaemia because the red cells appear small when viewed under a microscope. Other cases can cause more severe anaemia where three genes are affected. People with this form of alpha-thalassaemia may require occasional blood transfusions during times of physical stress, like fevers or other illnesses or when the anaemia is severe enough to cause symptoms such as fatigue. the most severe form of the disorder is called alpha-thalassaemia major. This type is extremely rare and women carrying fetuses with this form of thalassaemia have a high incidence of miscarriage because the fetuses cannot survive.

Beta-thalassaemia, the most common form of the disorder seen, is grouped into three categories such as beta-thalassemia minor (trait), intermedia, and major. A person who carries a beta-thalassemia gene has a 25 per cent or 1 in 4 chance of having a child with the disease if his or her partner also carries the trait. Beta-thalassaemia minor often goes undiagnosed because children with the condition have no real symptoms other than mild anaemia and small red blood cells. It is often suspected on routine blood tests such as a complete blood count and can be confirmed with a haemoglobin electrophoresis. No treatment is usually needed. As with alpha-thalassaemia trait, the anaemia associated with this condition may be misdiagnosed as an iron deficiency. Children with beta-thalassaemia intermedia have varying effects from the disease. Mild anaemia might be their only symptom or some might require regular blood transfusions. the most common complaint is fatigue or shortness of breath. Some of them also experience heart palpitations which is also due to the anaemia and mild jaundice which is caused by the destruction of abnormal red blood cells that result from the disease. the liver and spleen may be enlarged, which can feel uncomfortable for a child. Severe anaemia can also affect growth. another symptom of beta-thalassaemia intermedia can be bone abnormalities. Because the bone marrow is working overtime to make more red cells to counteract the anaemia, these children can experience enlargement of their cheekbones, foreheads, and other bones. Gallstones are a frequent complication because of abnormalities in bile production that involve the liver and the gallbladder. Some of them with beta thalassaemia intermedia may require a blood transfusion only occasionally. They will always have anaemia, but may not need transfusions except during illnesses, medical complications or later on during pregnancy. Other children with this form of the disease require regular blood transfusions. In them, low or falling haemoglobin levels greatly reduce the blood’s ability to carry oxygen to the body, resulting in extreme fatigue, poor growth, and facial abnormalities. Regular transfusions can help alleviate these problems. Beta-thalassaemia intermedia is often diagnosed in the first year of life. Doctors may be prompted to test for it when a child has chronic anaemia or a family history of the condition. As long as it is diagnosed while the child is still doing well and has not experienced any serious complications, it can be successfully treated and managed.

Beta-thalassaemia major, also called Cooley’s anemia, is a severe condition in which regular blood transfusions are necessary for the child to survive. although multiple lifelong transfusions save lives, they also cause a serious side effect. That is the overloading of iron in the bodies of thalassaemia patients. Over time, people with thalassaemia accumulate deposits of iron, especially in the liver, heart, and endocrine hormone-producing glands. the excessive iron deposits eventually can affect the normal functioning of these organs and in many cases, premature deaths are due to complications arising as a result of malfunctioning of these organs.

To minimize iron deposits, children need to undergo chelation or iron-removing therapy. This can be done by taking daily medication by mouth or by subcutaneous or intravenous administration. Daily chelation therapy when given regularly has been proven to prevent liver and heart damage from iron overload, allow for normal growth and sexual development and increase the life span. Iron concentrations are monitored every few months. Sometimes liver biopsies are needed to get a more accurate picture of the bodyiron load. Children on regular transfusions are monitored closely for iron levels and complications of iron overload even when they are on the chelation medications. Other risks associated with chronic blood transfusions for thalassemia major include blood-borne diseases like hepatitis B and C. Blood banks screen for such infections, in addition to rarer infections such as HIV. In addition, those who have many transfusions can develop allergic reactions that can prevent further transfusions and cause serious illnesses.

For children and teens with thalassemia, adolescence can be a difficult time, particularly because of the amount of time required for transfusions and chelation therapy. Over the last few decades, some severely affected children in other countries have successfully undergone bone marrow transplants to treat thalassaemia major. It is however considered only in cases of very severely disabling thalassaemia disease. there is considerable risk to bone marrow transplants as the procedure involves the destruction of all of the blood-forming cells in the bone marrow and repopulating the marrow space with donor cells that must match perfectly with the tissues of the patient. the closest match is usually from a sibling. the procedure is usually undertaken in children younger than 16 years of age who have no existing evidence of liver scarring or serious liver disease. Results have been encouraging so far, with disease-free survival in many patients. Blood-forming stem cells taken from umbilical cord blood have also been successfully transplanted and research using this technique is expected to increase in the future. currently bone marrow transplantation treatment and stem cell transplant techniques are the only known "cure" for the disease.

In the Sri Lankan scenario, thalassaemia, especially the severe forms of the disease cause many problems for the health service and the families of affected children. there are areas in the country such as the North Central province, Central province, Uva province and the Southern province where there are considerable numbers of affected children. the prevalence of the disease is increased in communities where there is inter-marriage, marriage between close relatives and consanguinity. This is simply because of the fact that the chance of two carriers marrying is that much increased in these situations. With time, many carriers are produced in the community and they may not even be related. In such a scenario, even unrelated marriages could produce siblings with the severe form of the disease.

The National Health Service of Sri Lanka spends a very large amount of money for regular medical treatment, follow-up, blood transfusions and iron chelation therapy for these children. Some of these patients are from very poor communities in very remote areas of the country. the necessity for regular travelling for medical treatment and follow-up leads to many problems for these families most of whom have major social and economic problems. They go through untold suffering in their quest to keep these unfortunate children alive and relatively healthy. the resources of the hospitals in these areas are also taxed to the maximum in trying to cope with the problem which has become a never-ending type of predicament.

The authorities have now established a National Thalassaemia Centre in Kurunegala and also provided the North Colombo Teaching Hospital at Ragama with several facilities for ultra-modern testing for these diseases. the ultimate aim is to detect carriers and prevent marriages between them. This will be a very potent arm in preventing the severe form of the disease and in that context thalassaemia, at least the severe form of it, is one of the eminently preventable diseases. In addition, continuing research into the disease has produced several potent chelating agents that can prevent the long term consequences of iron overload for those requiring regular multiple blood transfusions. In time to come even bone marrow and stem cell transplantation may become real possibilities in the country.

As frightening as thalassaemias can be, the future outlook is somewhat encouraging. In the past few decades, new techniques and advanced forms of therapies have greatly improved the quality of life and life expectancy for children who have these diseases. Modern methods of screening for carrier states hold a golden promise and a window of great opportunities for prevention of the more severely affected cases in the future. one hopes that, even in our country, we would be able to make life that much better for these unfortunate affected families and await the light at the end of the tunnel as a result of effective prevention of the disease in the future.

The writer would appreciate feedback from the readers. Please e-mail him at

are u sore in your bones? are they tender? Feel weak? feverish? only a dr. can say for sure. they test the bone marrow and see for sure.

Blood Cancer Treatment in India available at ISO approved hospitals

Blood Cancer Treatment in India is available at various corporate hospitals that are JCI accredited, ISO certified or in the process of achieving these seals. various corporate hospitals in India are specially designed according to the needs of international patients. over the last two decades, the economic boom in India has led to the building of medical facilities & infrastructure that rival the very best that western medical care has to offer. Blood Cancer Treatment in India is available at various corporate hospitals that facilitate world class, high quality and affordable medical treatment and healthcare tourism in India.

About Blood Cancer

Blood Cancer or Leukemia refers to a group of cancers of the blood cells. in blood cancer, white blood cells become abnormal, and divide and grow in an uncontrolled way.

White blood cells and blood cancer

White blood cells are made in your bone marrow, which is the soft spongy centre of your bones. Your bone marrow makes the most basic type of cells (called stem cells), and they can develop further into three types of cells –

white blood cells – protect your body from infection red blood cells – carry oxygen around your body platelets – important for normal blood clotting

Once these cells are made, they enter your bloodstream. White blood cells are involved in your body’s immune system, a defense system that protects you from infections. There are two main types of white blood cells – myeloid cells and lymphocytes.

In blood cancer, some of the white blood cells don’t grow properly. They stay in the bone marrow and keep reproducing in an uncontrolled way. These abnormal white blood cells fill up the bone marrow and prevent it from making healthy white blood cells. this means the body is less able to fight off infections. the abnormal white blood cells also prevent bone marrow from making enough red blood cells and platelets. a lack of red blood cells leads to less oxygen being delivered to the organs and tissues of your body. this is called anemia, and it can make you feel tired and breathless. a lack of platelets can lead to problems with the blood-clotting system, and results in bleeding and bruising much more easily than usual.

Causes of Blood Cancer

The exact cause of blood cancer is unknown, although there are some factors that increase the chance of developing it.

a weakened immune system – this may be a result of medicines that suppress the immune system (eg medicines to prevent rejection of organ transplants), high doses of radiation (eg radiotherapy or chemotherapy for another cancer), or diseases that affect the immune system (eg HIV) age – chronic leukemia is more common in people who are over 40 gender – slightly more men than women are affected by leukemia smoking certain genetic conditions, such as Down’s syndrome other blood disorders, such as aplastic anemia, a rare condition where the bone marrow fails to produce blood cells correctly contact with a chemical called benzene, one of the chemicals in petrol and a solvent used in the rubber and plastics industry

Types of Blood Cancer / Leukemia

There are several types of blood cancer. They are named according to the type of white blood cells (myeloid cells or lymphocytes) that are affected and how quickly the disease develops. Only the common types are discussed here. the two main types of blood cancer are acute and chronic.

Acute blood cancer

In acute blood cancer, symptoms develop rapidly and the cancer can quickly become life-threatening if it’s not treated. the most common form of acute blood cancer affects lymphocytes. this is called acute lymphocytic leukemia (ALL). another type of acute blood cancer is acute myeloid leukemia (AML).

Chronic blood cancer

In chronic blood cancer, symptoms develop slowly and the white blood cells are almost fully grown and normal when they leave the bone marrow and enter the bloodstream. They can function, but not as well as they should do. one type of blood cancer, called chronic myeloid leukemia (CML), affects a particular type of white blood cells called myeloid cells. It has two phases, a chronic phase that can last for several years, during which symptoms develop slowly, followed by a more aggressive phase (accelerated phase), where symptoms quickly get worse.

Symptoms

The symptoms of blood cancer vary, depending on the exact type of disease and how advanced it is. There may be no symptoms in the early stages, especially in people with chronic blood cancer. many symptoms are vague, such as fever, headaches, weight loss and night sweats.

Symptoms of blood cancer include –

tiredness, breathlessness and pale skin (due to anemia, a reduction in number of red cells in the blood) frequent infections that do not get better increased bruising abnormal bleeding from gums and cuts heavier periods in women nosebleeds bone pain (due to the pressure of a build-up of cells in the bone marrow) swollen lymph glands (glands in the neck, groin and under the arms) abdominal pain (due to an enlarged spleen or liver) swollen gums, and occasionally, swollen testicles headaches and vision problems

Treatment for Blood Cancer

The effectiveness of treatment for blood cancer depends on the type and stage of the disease. Acute blood cancer or acute leukemia often goes into remission (the symptoms go away; the disease is under control but not necessarily cured). But many people with acute blood cancer have a relapse (the disease returns).

Treatment includes –

chemotherapy radiotherapy bone marrow or stem cell transplant monoclonal antibodies biological therapy (which may be in the form of tablets) steroids

Why consider India?

Blood Cancer Treatment in India is available at various hospitals of Mumbai, Bangalore, Hyderabad, Chennai and New Delhi at an affordable price. various corporate hospitals in India use latest technology to perform complex medical treatments and procedures. most state of the art equipment is imported from countries like USA, UK, Germany, Japan etc. while the treatment in Indian private hospitals are at par with the hospitals in USA and UK, the cost for such treatment in India is actually a fraction of what it would cost in western countries.

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