Most of us tend to associate blood disorders with conditions such as anaemia or clotting problems. But some blood abnormalities may be the first symptoms of an underlying cancer, a cancer that originates from blood and bone marrow. Additionally, some blood disorders can arise out of autoimmune diseases, and these diseases and cancer share a rather complex relationship, wherein one can sometimes increase the risk of the other.

Cancer rates are increasing around the world, and this makes understanding the connection between blood disorders, autoimmune blood diseases have and cancer, important. Early recognition of warning signs can significantly improve outcomes, and in many cases, saves lives.

Understanding blood disorders

Blood disorders are conditions that affect one or more components of the blood such as the red blood cells that carry oxygen, white blood cells which fight infections, platelets that help with the clotting of blood, and plasma, the liquid component of blood.

While some blood disorders are inherited, some tend to develop later in life, and this could be due to infections, autoimmune diseases, medications or cancers.

Unlike the solid tumours that develop in organs such as the colon, breast or lungs, blood cancers originate in the bone marrow, and the lymphatic system. The major types of blood cancers include leukaemia, lymphoma, multiple myeloma and myelodysplastic syndromes.

Autoimmune diseases-cancer link

The major link between autoimmune diseases and cancer is that certain autoimmune disorders increase the risk of developing blood cancers such as lymphoma. There are several factors that contribute to this:

• Chronic inflammation such as inflammation can damage DNA; this tends to create an environment that promotes cancer development.
• Dysregulation in the immune system can cause it to function abnormally, and hence the ability to identify and destroy cancer cells can be impaired.
• Immunosuppressive therapy that is used to treat autoimmune diseases suppresses immune function and can also slightly raise the risk of specific cancers.
• Genetic pathways also contribute to the development of autoimmune diseases and malignancies.

Signs and symptoms

Early signs of cancer can be in the form of blood disorders, and this is often identified during routine screening or testing.

Persistent anaemia is not always due to iron deficiency; unexplained anemia also happens due to blood cancers and bone marrow disorders. Gastrointestinal cancers also cause hidden bleeding. A low platelet count may be associated with leukaemia, lymphoma and bone marrow failure syndromes. Infections commonly cause elevated white blood cells and constant high counts may warrant evaluation for either leukaemia or other haematological cancers.

Abnormal clotting and enlarged lymph nodes are not to be ignored especially younger individuals without obvious risk factors as they can be linked to underlying cancers.

Some warning signs to never be ignored are persistent fatigue, constant infections, easy bruising or bleeding that includes nose bleeds, heavy menstrual bleeding and bleeding gums. Unexplained weight loss and night sweats are also not to be taken lightly when they occur over a long period of time, since these may be signs of malignancies and could be associated with lymphoma.

Bone pain, especially near the spine, pelvis and long bones, and enlarged lymph nodes near the neck, armpit and groin are other symptoms that should be assessed immediately.

Risk, and its prevention

Individuals who are aged 60 and above, those with autoimmune diseases and those with a history of family history of blood cancers are at a higher risk than others. Smokers, previous cancer survivors and patients who have been exposed to radiation or industrial chemicals also fall under the risk categories.

Some preventive methods to keep in mind are to completely avoid tobacco use, exercise regularly, , manage autoimmune diseases well, maintain a healthy lifestyle and attend regular health checkups in general.

Since blood cancer are silent, it is important to be able to recognise their symptoms. Persistent blood abnormalities and unexplained symptoms must never be ignored since seeking medical care at the initial stages can make help detect disease early and can go a long way towards improving treatment outcomes.

(Dr. M. Gopinathan is a consultant, haemato-oncologist (BMT) at MGM Cancer Institute, Chennai. gopinathan.m@mgmcancerinstitute.in)