Do I need to get my blood checked?

In his latest online article, renowned consultant haemato-oncologist Dr Varun Mehra explains when you should consider getting your blood checked by a specialist. He delves into the different possible conditions that can be detected in the blood, the signs of blood cancer and the different treatments available.

What are possible health problems related to blood?

As with most other health problems, the first sign of a problem can appear in our blood system. The field of haematology or ‘study of blood’ is very broad and significantly overlaps with many other specialities. The field involves the diagnosis and treatment of patients with a wide range of benign and malignant disorders of blood and bone marrow, as well as disorders affecting the coagulation system in adults and children.

Most haematologists can provide care for a multitude of these disorders and also help advise community physicians (GP), pharmacists as well other specialists where a blood problem may affect care of their other underlying health problems. Some haematologists are more specialised with expertise in areas of coagulation disorders, blood transfusion, disorders of haemoglobin such as sickle cell disease or specialists in stem cell/bone marrow transplantation and cellular immune therapies.

Do you need to see a haematologist?

A blood test provides your physician with the ideal means of examining the physiological and pathological conditions of your health, whether they are diagnosing or treating an ailment. It serves as our body's primary source of protection and regulation, housing essential immune cells and acting as a carrier of nutrients and oxygen.

Almost all organ-related conditions begin with a blood test for diagnosis. Abnormal levels of red blood cells, haemoglobin, or haematocrit may be a sign of anaemia, heart disease, too little iron or lack of vitamin b12/folate levels in your body. Low white cell count may be a sign of an autoimmune disorder, infection, bone marrow disorder, or cancer. A high white cell count may be a sign of an infection, a reaction to medicine or a bone marrow disorder.

If any of your levels are abnormal, it does not always mean you have a medical condition that needs treatment. Diet, activity level, medicines, a menstrual period, not drinking enough water, and other factors can affect the results. However, if the results remain abnormal without explanation or if your symptoms are progressively worse, you should consider asking for a referral to a haematologist.

Signs of blood cancer

If you develop a range of these new symptoms, then an urgent assessment with your GP for a blood test and/or a referral to a haematologist should be considered.

• weight loss that's unexplained
• bruising or bleeding that's unexplained
• persistent/increasing lumps or swellings
• increasing shortness of breath (breathlessness)
• drenching night sweats
• infections that are persistent, recurrent or severe
• recurrent fever (37.5°C or above) that is unexplained

Type of blood cancers:

There are different types of blood cancer, including:

• leukaemia
• lymphoma
• myeloma
• myelodysplastic syndromes (MDS)
• myeloproliferative neoplasms (MPN)

Blood cancers are sometimes described as acute or chronic. Acute means fast-growing and chronic means slower growing. They each have different symptoms, treatments and prognoses.

We don’t normally know the exact cause of developing blood cancer, but often this is acquired from a possible genetic mistake in the blood stem cells or related precursor cells, which may trigger further genomic instability and the development of an uncontrolled increase of the cancerous cells. This can be influenced by your age, gender, ethnicity, family history, lifestyle choices, radiation or chemical exposure, other health conditions and previous treatments.

Blood cancer treatments

The field of haematology is advancing at a rapid pace with a huge amount of research being undertaken for advancing our understanding of blood cancers like leukaemia, lymphoma or myeloma, as well as developing exciting targeted biological therapies like CAR-T (an advanced novel biological therapy that involves re-engineering of your immune cells to recognise and kill cancer cells) and other cellular immunotherapies.

If you have a slow-growing blood cancer, you may not need treatment straight away, and some people never need it. However, if you have an aggressive or advanced form of blood cancer, you will require rapid specialist input from an expert in this area, working alongside an experienced multi-disciplinary team comprised of specialist-trained nurses, pharmacists and other allied health care professionals.

With ongoing advanced research, increasingly newer treatment options including clinical trials are helping make many blood cancers treatable with significant improvement in long-term survival. The treatments can be toxic with many side effects, but the team will guide the patient through all risks and benefits while providing excellent support & care.

Dr Mehra is a leading consultant haematologist, who works in a centre of excellence at King’s College Hospital, London with a special interest in myelodysplastic syndromes, acute leukaemia, low blood counts and bone marrow failure syndromes. He has specific expertise in all forms of Stem cell transplantation and CAR-T based immunotherapies. If you would like to book a consultation with Dr Mehra, you can do so via his Top Doctors profile.