Thursday, February 17, 2005
ALL ABOUT Leukemia disease (CML) - III
Like all blood cells, leukemia cells travel through the body. Depending on the number of abnormal cells and where these cells collect, patients with leukemia may have a number of symptoms.
Common symptoms of leukemia may include:
Fevers or night sweats
Frequent infections
Feeling weak or tired
Headache
Bleeding and bruising easily (bleeding gums, purplish patches in the skin, or tiny red spots under the skin)
Pain in the bones or joints
Swelling or discomfort in the abdomen (from an enlarged spleen)
Swollen lymph nodes, especially in the neck or armpit
Weight loss
Such symptoms are not sure signs of leukemia. An infection or another problem also could cause these symptoms. Anyone with these symptoms should see a doctor as soon as possible. Only a doctor can diagnose and treat the problem.
In the early stages of chronic leukemia, the leukemia cells function almost normally. Symptoms may not appear for a long time. Doctors often find chronic leukemia during a routine checkup?before there are any symptoms. When symptoms do appear, they generally are mild at first and get worse gradually.
In acute leukemia, symptoms appear and get worse quickly. People with this disease go to their doctor because they feel sick. Other symptoms of acute leukemia are vomiting, confusion, loss of muscle control, and seizures. Leukemia cells also can collect in the testicles and cause swelling. Also, some patients develop sores in the eyes or on the skin. Leukemia also can affect the digestive tract, kidneys, lungs, or other parts of the body.
Diagnosis
If a person has symptoms that suggest leukemia, the doctor may do a physical exam and ask about the patient's personal and family medical history. The doctor also may order laboratory tests, especially blood tests.
The exams and tests may include the following:
Physical exam?The doctor checks for swelling of the lymph nodes, spleen, and liver.
Blood tests?The lab checks the level of blood cells. Leukemia causes a very high level of white blood cells. It also causes low levels of platelets and hemoglobin, which is found inside red blood cells. The lab also may check the blood for signs that leukemia has affected the liver and kidneys.
Biopsy?The doctor removes some bone marrow from the hipbone or another large bone. A pathologist examines the sample under a microscope. The removal of tissue to look for cancer cells is called a biopsy. A biopsy is the only sure way to know whether leukemia cells are in the bone marrow.
There are two ways the doctor can obtain bone marrow. Some patients will have both procedures:
Bone marrow aspiration: The doctor uses a needle to remove samples of bone marrow.
Bone marrow biopsy: The doctor uses a very thick needle to remove a small piece of bone and bone marrow.
Local anesthesia helps to make the patient more comfortable.
Cytogenetics?The lab looks at the chromosomes of cells from samples of peripheral blood, bone marrow, or lymph nodes.
Spinal tap?The doctor removes some of the cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord). The doctor uses a long, thin needle to remove fluid from the spinal column. The procedure takes about 30 minutes and is performed with local anesthesia. The patient must lie flat for several hours afterward to keep from getting a headache. The lab checks the fluid for leukemia cells or other signs of problems.
Chest x-ray?The x-ray can reveal signs of disease in the chest.
A person who needs a bone marrow aspiration or bone marrow biopsy may want to ask the doctor the following questions:
Will you remove the sample of bone marrow from the hip or from another bone?
How long will the procedure take? Will I be awake? Will it hurt?
How soon will you have the results? Who will explain them to me?
If I do have leukemia, who will talk to me about treatment? When?
Many people with leukemia want to take an active part in making decisions about their medical care. They want to learn all they can about their disease and their treatment choices. However, the shock and stress after a diagnosis of cancer can make it hard to think of everything to ask the doctor. Often it helps to make a list of questions before an appointment. To help remember what the doctor says, patients may take notes or ask whether they may use a tape recorder. Some also want to have a family member or friend with them when they talk to the doctor?to take part in the discussion, to take notes, or just to listen.
The doctor may refer patients to doctors who specialize in treating leukemia, or patients may ask for a referral. Specialists who treat leukemia include hematologists, medical oncologists, and radiation oncologists. Pediatric oncologists and hematologists treat childhood leukemia.
Whenever possible, patients should be treated at a medical center that has doctors experienced in treating leukemia. If this is not possible, the patient?s doctor may discuss the treatment plan with a specialist at such a center.
