Blood cancer Q&A

Two of our leading specialists answer common questions on blood cancer including signs and symptoms, early diagnosis and effective treatments.

Prem Mahendra
Blood cancers are cancers that arise from the bone marrow or lymphatic system.


Gerard Robbins
This is a general term covering many different types of cancers affecting the blood, bone marrow and immune system.

Prem Mahendra
Leukaemia, Lymphoma and Myeloma.


Gerard Robbins
We currently recognise around 150 specific types. Leukaemia, lymphoma, myeloma, chronic myeloproliferative diseases and myelodysplastic disoorders are the most common groups.

Prem Mahendra
Patients usually present with tiredness, bruising, bleeding, infections, enlarged lymph glands or bone pain. However these are no specific symptoms and there are other reasons for these symptoms and it is important to see your GP if these symptoms persist.


Gerard Robbins
Symptoms vary but may include extreme tiredness, fevers, drenching night sweats, unexplained weight loss, persistent (more than 4 weeks) swelling of lymph nodes, excessive bruising or bleeding, bone pain, new or different backache, recurrent or unusual infection. It is important to remember that all of these symptoms can have entirely ‘benign’ causes. Talk to your GP if you are concerned.

Prem Mahendra
Despite major advances in the treatment of blood cancers we still don’t know what causes it.


Gerard Robbins
In many cases the short answer is “We don’t know.” In a few types a specific cause has been identified. In many cases we know of multiple factors which increase the risk including age, genetic factors, chronic infection or inflammation, suppression of the immune system, previous exposure to chemotherapy and radiation, and pre-existing blood disorders (including other blood cancers). Lifestyle factors do not play a large role in the cause, but are extremely important through their impact on coping with the cancer and its treatment.

Prem Mahendra
Blood cancers can affect patients of all ages, but older patients and men tend to have a higher risk.


Gerard Robbins
This very much depends on the individual type of blood cancer. With the exception of acute lymphoblastic leukaemia which is one of the commonest cancers in children, in general the risk of developing blood cancer increases with increasing age. Men are slightly more affected than women. There are some differences between different racial groups which might be due to both genetic and environmental factors.

Prem Mahendra
Usually on the basis of a blood tests, bone marrow biopsy and CT or PET scans.


Gerard Robbins
It is important to take a full medical history and carry out a physical examination. Blood tests, bone marrow biopsy and scans are often required. Biopsy of an affected lymph node or organ is sometimes necessary especially in suspected lymphoma. We are able to arrange very sophisticated investigations such as molecular profiling. Haematology has been a pathfinder for use of these tests. 

Prem Mahendra
Treatment usually involves chemotherapy (which maybe given in a drip or tablets), some patients may need radiotherapy and some may also require a stem cell transplant.


Gerard Robbins
We are very fortunate that there has been huge progress in the treatment of blood cancers in the last 50 years. For some it is best to simply monitor for a period (sometimes years) before starting treatment. Many cancers are highly treatable with a variety of drugs including chemotherapy. Radiotherapy can be extremely helpful in specific situations.  Unfortunately in spite of all this progress many blood cancers remain incurable at present. Rarely very high dose chemotherapy followed by stem cell transplantation will be appropriate. This will entail a referral to one of the national bone marrow transplant centres such as the Royal Marsden Hospital in Sutton.

Prem Mahendra
It’s in my blood! Seriously though I am 3rd generation doctor (both my parents and both grandfathers are/were doctors) and I knew I wanted to be a doctor from the age of 6. I decided on haematology, after having worked in a haematology laboratory in my 2nd year at medical school.


Gerard Robbins
I was always interested in science and biology. As an idealistic teenager I wanted to do something useful for other people. Medicine seemed a good choice.

Prem Mahendra
Setting up the stem cell transplant unit at the Queen Elizabeth Hospital in 1998. When I started I was the sole consultant, we are now a team of 6 and one of the largest in the UK.


Gerard Robbins
One of my most challenging and rewarding cases was an unfortunate young woman who developed an aggressive type of leukaemia during pregnancy. This posed considerable threat to her life and that of her unborn child. Fortunately with a fantastic hospital team and availability of modern drugs, we were able to successfully treat mum and deliver a healthy baby! This was over five years ago so we are very confident she is cured.

Working as a programme director for training of haematologists in our region I was able to help doctors progress in their profession. As medical director for the Royal Surrey County Hospital I had the privilege of getting involved with so many parts of the hospital outside my normal day to day work. A very challenging role but I hope I was able to help the hospital deliver better patient care.

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