“I’m happy to tell my patients that the odds are in their favor.”
Getting a blood cancer diagnosis is an undoubtedly scary and overwhelming experience. Your mind is likely a sea of unknowns, flooded with questions: What will my life be like from now on? Can I enjoy the same things I used to? Can I be cured?
Even though a cancer diagnosis can fill you with feelings of uncertainty, asking the right questions about blood cancer treatment and learning everything you can about your options may help put you at ease—and give you the best treatment outcome.
“The advances in the treatment of blood cancer over the last 30 years have been quite impressive,” says Ruthee-lu Bayer, MD, director of stem cell transplantation at Northwell Health. “I am happy in this day and age to tell my patients that the odds are in their favor with the respect of long-term survival and cure.”
Blood Cancer Treatment Options
Blood diseases are very complex, so to get the best treatment possible, it’s important to be evaluated by hematologist-oncologist who specializes in treating your specific condition. “The treatment of the blood cancer depends on the type of blood cancer that the patient has and the goals of care for that specific patient,” says Dr. Bayer.
Watch and wait. With this method, doctors closely monitor the patient without giving treatment until their condition changes or new symptoms appear. “Immediate treatment may not be necessary, but the patient is monitored with scans and blood work. At the time where the patient is meeting certain criteria for treatment, that’s when the patient will be treated,” says Dr. Bayer. This approach is usually recommended for patients in early stages of indolent (slow-growing) or chronic forms of blood cancers.
Chemotherapy and other drug therapies. Chemotherapy is one of the mainstays of blood cancer treatment. Chemotherapy works by slowing down or stopping the rapid divide of cancer cells, but it can also affect healthy cells as well. “The white blood cell count can drop down, the red blood cells can drop down, and the platelets can drop down as well,” says Dr. Bayer. “[Patients undergoing chemotherapy] will often require transfusions of red blood cells and platelets.”
A blood transfusion uses blood cells donated by healthy volunteers to replace red cells, platelets and other blood components.
Radiation therapy can be used to treat leukemia, lymphoma, myeloma, and myelodysplastic syndromes. “The radiation therapy will damage the DNA in the cells and prevent them from growing,” says Dr. Bayer.
The radiation used for radiation therapy is the same kind that’s used for diagnostic X-rays, but at higher doses. “I often tell my patients to think of radiation as a special X-ray,” says Dr. Bayer.
Immunotherapy. “Immunotherapy is where we’re trying to harness the patient’s own immune system to help fight off the blood cancer,” says Dr. Bayer. Immunotherapies generally have fewer short-term side effects than chemotherapy. (Learn more about the difference between immunotherapy and chemotherapy here.)
Types of immunotherapy being used or studied to treat blood cancer include:
- Chimeric antigen receptor (CAR) T-cell therapy
- Donor lymphocyte infusion
- Monoclonal antibody therapy
- Reduced-intensity allogeneic stem cell transplantation
- Therapeutic cancer vaccines
“One of the main [immunotherapy] treatments for patients with high-risk blood cancer is stem cell transplantation,” says Dr. Bayer.
Stem cell transplantation can be autologous or allogeneic. Allogeneic means the doctors will use a donors stem cells to jumpstart a blood cancer patient’s immune system to fight the cancer.
With an autologous stem cell transplant, the goal is to give the patient a higher dose of chemotherapy. “We collect that patient’s stem cells, we freeze them, and we rescue that patient back with their own stem cells to repopulate their bone marrow [with healthy cells],” says Dr. Bayer.
Clinical trials. Clinical trials are carefully controlled research studies conducted by doctors to improve the care and treatment of people with certain conditions, including cancer. “Patients with a blood cancer who have failed first- and second-line treatments may consider treatment on a clinical trial,” says Dr. Bayer.
“I try to remind patients that there are many newer treatments for these diseases, and I try to remind them that in this day and age, the odds are in their favor,” says Dr. Bayer.
Ruthee-lu Bayer, MD is the director of stem cell transplantation at Monter Cancer Center, Northwell Health.
00:00:00,446 --> 00:00:03,237
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The advances in the treatment
of blood cancer over
00:00:07,703 --> 00:00:12,073
the last 30 years have
been quite impressive.
00:00:12,073 --> 00:00:17,215
And I am happy in this day and
age to tell my patients that the odds
00:00:17,215 --> 00:00:22,563
are in their favor with respect
to long-term survival and cure.
00:00:22,563 --> 00:00:28,263
00:00:28,263 --> 00:00:32,729
The treatment of a blood cancer depends on
00:00:32,729 --> 00:00:37,833
the type of blood cancer
that the patient has and
00:00:37,833 --> 00:00:42,960
the goals of care for
that specific patient.
00:00:42,960 --> 00:00:47,762
In a rare patient with
a less aggressive lymphoma,
00:00:47,762 --> 00:00:51,780
a watch-and-wait method of
treatment may be utilized.
00:00:51,780 --> 00:00:54,726
Immediate treatment may not be necessary,
00:00:54,726 --> 00:00:57,969
the patient is monitored with scans and
00:00:57,969 --> 00:01:02,049
At the time where the patient
is meeting certain criteria for
00:01:02,049 --> 00:01:06,280
treatment, that's when
the patient would be treated.
00:01:06,280 --> 00:01:07,850
One of the mainstays for
00:01:07,850 --> 00:01:12,470
treatment of patients with
blood cancer is chemotherapy.
00:01:12,470 --> 00:01:17,360
Chemotherapy affects cells
that are dividing rapidly.
00:01:17,360 --> 00:01:21,700
Cancer cells are dividing rapidly and
that's why they
00:01:21,700 --> 00:01:26,720
are most affected by
the chemotherapy agents that we use.
00:01:28,340 --> 00:01:31,380
But also the cells of
the bone marrow are affected.
00:01:31,380 --> 00:01:35,210
The white blood cell count can drop down,
00:01:35,210 --> 00:01:41,050
the red blood cells can drop down, and
the platelets can drop down as well.
00:01:41,050 --> 00:01:47,030
They will often require transfusions
of red blood cells and platelets.
00:01:47,030 --> 00:01:52,000
I often tell my patients that think
of radiation as a special X-ray.
00:01:52,000 --> 00:01:56,130
The radiation therapy will damage
the DNA within the cells and
00:01:56,130 --> 00:01:59,290
prevent them from growing.
00:01:59,290 --> 00:02:04,503
Immunotherapy is where we
are trying to harness the patient's
00:02:04,503 --> 00:02:08,940
own immune system to help
fight off the blood cancer.
00:02:08,940 --> 00:02:11,367
One of the main treatments for
00:02:11,367 --> 00:02:18,040
patients with high-risk blood cancers
is stem cell transplantation.
00:02:18,040 --> 00:02:24,062
Stem cell transplantation can
be autologous or allogeneic.
00:02:24,062 --> 00:02:27,100
In an allogeneic stem cell transplant,
00:02:27,100 --> 00:02:33,110
we are literally trying to grow
the donor's bone marrow in the patient.
00:02:33,110 --> 00:02:38,530
The donor's immune system will take
over the patient's immune system,
00:02:38,530 --> 00:02:41,740
and that's how you can cure the disease.
00:02:41,740 --> 00:02:45,280
When we're doing an autologous
stem cell transplant,
00:02:45,280 --> 00:02:50,300
the goal is to be able to give
a much higher dose of chemotherapy.
00:02:50,300 --> 00:02:56,910
So that's why we have to, ahead of time,
collect that patient's stem cells and
00:02:56,910 --> 00:03:01,590
we freeze them, and
then we rescue the patient back
00:03:01,590 --> 00:03:06,590
with their own stem cells to
repopulate their bone marrow.
00:03:06,590 --> 00:03:11,697
CAR-T therapy (chimeric antigen
receptor therapy) is for
00:03:11,697 --> 00:03:16,040
certain patients with
refractory blood cancer.
00:03:16,040 --> 00:03:19,680
White blood cells are collected
from the patient.
00:03:19,680 --> 00:03:26,680
Through viral manipulation they
target the cancer proteins.
00:03:26,680 --> 00:03:29,495
Patients with a blood cancer
who have failed first- and
00:03:29,495 --> 00:03:35,530
second-line treatments may consider
treatment on a clinical trial.
00:03:35,530 --> 00:03:42,620
I try to remind patients that there
are many newer treatments for
00:03:42,620 --> 00:03:48,696
these diseases and
I try to remind them that in this day and
00:03:48,696 --> 00:03:52,131
age the odds are in their favor.
00:03:52,131 --> 00:03:56,884
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