Being diagnosed with cancer is a challenge. Promise us, you'll always remember: you are BRAVER than you believe, STRONGER than you seem, SMARTER than you think, and twice as beautiful as you'd ever imaged.
The State of Kuwait has been targeting to eliminate cancer, and it shows in our commitment to enhance cancer care service and comprehensive educational programs to enable our patients & their families to join the fight to end cancer.
The State of Kuwait stressed the importance of developing awareness on the environmental causes of some cancers, and strategic interventions within national action plans to address the harmful effects on health. Kuwait has successfully implemented the National Program for Early Diagnosis of Colorectal Cancer and the early diagnosis program for breast cancer among women.
The Ministry Of Health in the State of Kuwait collaborates with other entities to provide clinical expertise to Kuwait Cancer Control Center (KCCC) and strengthen cancer service delivery at the KCCC. Through this collaboration, KCCC offers our patients an access to the best internationally-certified cancer services, while ensuring continuous improvement of cancer care in Kuwait. We also focus on improving nursing and physician education, health administration and information technology. We continue to expand our experience internationally while developing systems and innovative approaches that would benefit our patients.
Doctor's Guide will show all medical oncologists what to look for in a practice, how to provide a high class medical service, and how to integrate the decision support tools into the daily practice.
Leukemia is cancer of the blood or bone marrow. Leukemia is a cancer that starts in the stem cells of the bone marrow that make blood cells. Bone marrow is the soft, spongy material that fills the center of most bones (where blood cells are made).
Leukemia develops when the blood stem cells in the bone marrow make abnormal blood cells. These abnormal cells are called leukemia cells. Over time, the leukemia cells crowd out normal blood cells. This makes it hard for the white blood cells, red blood cells and platelets to do their jobs.
There are several different types of leukemia. The types of leukemia are first
divided according to the type of stem cell they developed from:
Cancer is caused by changes or mistakes in our DNA, which is our genetic material. A mistake may be caused by a genetic predisposition or a physical or chemical agent, known as a carcinogen. Environmental and other influences can also affect the DNA. There is no single cause of leukemia, but some factors increase the risk of developing it.
Symptoms start to appear as the number of leukemia cells grow and your bone marrow can no longer make the normal blood cells your body needs. Having too few normal white blood cells, red blood cells or platelets can cause a number of symptoms. In acute leukemia, symptoms appear and get worse quickly.
Acute leukemia can cause you to have too few normal white blood cells (a condition called neutropenia). You will not be able to fight infection very well. If you have too few red blood cells (anemia), you may feel very tired, be short of breath or look pale. Too few platelets (thrombocytopenia) can lead to unusual bleeding. You may bruise easily or notice small purple or red spots on your skin, especially on your arms and legs. Other general symptoms of acute leukemia may include:
After taking your medical history and completing a physical examination, your doctor may suspect you have leukemia. To confirm the diagnosis, your doctor will arrange special tests. These tests may also be used to classify the leukemia. You may have one or more of the following tests.
Blood Tests
Blood is taken and studied to see if the different types of blood cells are normal in number and appearance. The results can also show how well your kidneys, liver and other organs are working. These tests may suggest whether or not you have leukemia.
Imaging Studies
Imaging studies allow tissues, organs and bones to be looked at in more detail. Using X-rays, ultrasounds, CT scans or MRIs, your healthcare team can get a picture of where the cancer is and see if it involves your organs, such as the spleen, liver or lymph nodes. These tests are usually painless and do not require an anesthetic.
Bone Marrow Biopsy Study
A biopsy is usually necessary to make a definite diagnosis of leukemia. To diagnose leukemia, cells are removed from the bone marrow, usually from the back of the hip bone. The cells are checked under a microscope. If leukemia cells are found in the bone marrow, they will be studied further to see how fast they are growing. There are two ways to get a bone marrow sample.
It is important to note that treatment options differ based on the type of leukemia, cytogenetics, age, and health status of each patient.
Chemotherapy
Chemotherapy may be given as pills or by injection. Chemotherapy drugs interfere with the ability of cancer cells to grow and spread, but they also damage healthy cells. Although healthy cells can recover over time, you may experience side effects from your treatment like nausea, vomiting, loss of appetite, fatigue, hair loss and an increased risk of infection.
Stem Cell Transplant
Sometimes high doses of chemotherapy are used to treat leukemia that has come back or if there is a high risk that it may come back. High-dose chemotherapy destroys the bone marrow cells as well as the leukemia cells, so the bone marrow will need to be replaced with a transplant of stem cells. All blood cells develop from stem cells found in the bone marrow and in the bloodstream.
Before high-dose chemotherapy is given, stem cells will be taken from you or from a donor whose bone marrow is a close match to your own. Soon after the chemotherapy treatment, the stem cells are put back into your blood. Within a few weeks, the new stem cells will start to make blood cells.
A stem cell transplant is a complex procedure. For this reason, stem cell transplants are done in specialized transplant centres or hospitals by a team of highly trained healthcare professionals. Side effects can be very serious and may even be life-threatening. You will be watched very closely after a stem cell transplant and carefully followed up for a period of time after leaving the hospital. It may take several months to fully recover after a stem cell transplant.
Radiation Therapy
In external beam radiation therapy, a large machine is used to carefully aim a beam of radiation. The radiation damages the cells in the path of the beam – normal cells as well as cancer cells. Radiation side effects will be different depending on what part of the body receives the radiation. You may feel more tired than usual, have some diarrhea, or notice changes to the skin (it may be red or tender) where the treatment was given.
Radiation may be used for some types of leukemia to treat the disease or prevent it from spreading. If you need a stem cell transplant, you may also be given radiation to the whole body to destroy the bone marrow cells. This is called Total Body Irradiation (TBI).
Biological Therapy
Biological therapy uses your immune system to fight cancer or to help control side effects of other cancer treatments. Natural body substances or drugs made from natural body substances are used to boost the body’s own defenses against illness.
There are two forms of biological therapy used to treat leukemia: monoclonal antibodies and interferon alfa. Both are given by injection. Monoclonal antibodies are sometimes used to treat people with CLL, ALL and AML. Interferon Alfa may also be used for CML (although people with CML are more likely to be treated with cancer growth inhibitors). Side effects of these drugs often cause flu-like symptoms, such as chills, fever, muscle aches, weakness and nausea. More serious side effects are rare. Some people may have a severe skin rash, breathing problems or low blood pressure.
The side effects usually disappear once treatment is finished. Be sure to discuss the risks and benefits of this treatment with your healthcare team.
Targeted Therapy
Targeted therapies use drugs that attack specific types of cancer cells without damaging healthy cells. Cancer growth inhibitors are a type of targeted therapy. They interfere with a cancer cell’s ability to grow and divide. Some cancer growth inhibitors can be used to treat people with CML, ALL and AML. These drugs are taken by pill or capsule. Side effects are most likely to occur during the first few months of treatment. Side effects may get better as treatment continues.
Watchful Waiting
Watchful waiting is a treatment option that may be offered to people with CLL who have no symptoms. Watchful waiting means your healthcare team will watch the leukemia closely. You will visit your doctor regularly for a physical examination. Other tests may be done from time to time. Active treatment, such as chemotherapy or radiation, may be considered if signs of leukemia appear or change. Once the symptoms are controlled, you and your doctor may decide to return to a watchful waiting program.
Surgery
Surgery is rarely used to treat chronic leukemia, but some people with chronic leukemia will need to have their spleen removed. The spleen is located in the abdomen and is adjacent to the stomach, left kidney and colon. In chronic leukemia, the spleen may become enlarged. An enlarged spleen can cause discomfort and pain. It also destroys red blood cells and platelets, causing anemia and bleeding. If chemotherapy or radiation doesn't shrink the spleen, then it may be removed by surgery. Surgery to remove the spleen is called splenectomy. It is done under general anesthetic (you will be unconscious).
After surgery you may have some pain or bleeding. These side effects are temporary, and can usually be controlled. Without a spleen, you may be more at risk of infections.
If you have any questions, please speak to your treating physician.