Blood cancer care at HonorHealth

HonorHealth blood cancer experts are as passionate about not only treating patients with blood cancer, but also pursuing innovative treatments. In fact, researchers are testing drugs and treatments that can slow the growth of cancer cells and shrink tumors with remarkable accuracy through blood cancer clinical trials.

If you have questions about clinical trials, contact the Clinical Research Coordinator at 480-323-1973 or via email.

HonorHealth is one of the few health systems that treat adult blood cancers in Arizona. In fact, the blood cancer program at HonorHealth Cancer Care draws patients from across the Southwest for the diagnosis and treatment of adult blood cancers and related disorders.

Annually, HonorHealth blood cancer experts perform approximately 200 stem cell (bone marrow) transplants as well as diagnostic tests and other treatments.

If you have acute leukemia, you'll be treated in a dedicated unit at the HonorHealth Cancer Transplant Institute in central Scottsdale. The unit also provides inpatient care for patients with other blood cancers, such as lymphoma and multiple myeloma.

An outpatient infusion therapy center is open both weekdays and weekends for chemotherapy.

What is blood cancer?

Blood cancers typically begin with abnormal cells produced in your bone marrow, the spongy center of the bones where different types of blood cells form. The three main types of cells produced are:

1. Red blood cells that carry oxygen
2. White blood cells that help prevent bacterial diseases and infections
3. Platelets that prevent bleeding

Numerous abnormalities and types of cancer can occur at any step in the development of these cells.

Unlike solid tumors, such as those found with breast or colon cancer, blood cancer cells are called liquid tumors because they literally move around in your body. Their ability to travel through the body means they can be seen in more than one area. As a result, staging blood cancer is different than staging solid-tumor cancers.

Types of blood cancers

The most common blood cancers include:

• Lymphomas: Both Hodgkin's and non-Hodgkin's lymphomas
• Leukemias: Usually divided into acute and chronic leukemias
• Multiple myelomas: Cancer formed by malignant plasma cells

While they may all be blood cancers, each has different effects on the body. Each type requires different and highly specialized clinical care.

Within the three main classifications of blood cancer — leukemias, lymphomas and myelomas — are dozens of subtypes. Some are acute, aggressive cancers while others are chronic and slow growing.

Leukemia

There are four main types of leukemia:

• Acute lymphocytic leukemia
• Acute myeloid leukemia, also known as acute myelogenous leukemia
• Chronic lymphocytic leukemia
• Chronic myeloid leukemia, also known as chronic myelogenous leukemia

Leukemias are distinguished by the type of white blood cells they affect and the level of maturity when those cells become cancerous.

In general, acute forms of leukemia require aggressive chemotherapy. They can grow rapidly if not treated appropriately. Even with treatment, you might not always respond as well as hoped, necessitating other treatments.

Chronic leukemia treatment signifies a major success in blood cancer treatment. Most chronic myeloid leukemia patients can keep the disease under control with prescription medications specifically designed to address the chromosomal abnormality that leads to the condition.

Meanwhile, medical researchers continue to search for other changes or markers that might lead to medication therapies for other types of blood cancer.

Because there are many subtypes of blood cells, there are many other subtypes of leukemia. Similarly, there are various other diseases related to bone marrow dysfunction that do not fit the classification of leukemia, but are closely related. Topping that list are:

• Aplastic anemia: When the bone marrow stops producing blood cells altogether, greatly increasing your risk of bleeding and/or infection
• Myelodysplastic disorders: When bone marrow cells don't grow properly, causing an array of blood-related health complications
• Myeloproliferative disorders: When the bone marrow cells grow excessively and overwhelm other cells

While rare, these conditions require specialized medical care from blood cancer experts. Your HonorHealth team of experts will carefully explain the specifics of your blood disorder and the treatment options available to you.

Lymphoma

There are two main types of lymphoma:

1. Hodgkin's lymphoma: A relatively rare and highly treatable disease that's most common among young adults.
2. Non-Hodgkin's lymphoma: The most common type of blood cancer, there are dozens of non-Hodgkin's lymphoma subtypes specific to the white blood cells they affect. Because they usually target more mature lymphocytes (a type of white blood cell), they often appear as swelling in the lymph glands instead of problems with the blood. Thankfully, most non-Hodgkin's lymphomas are treatable.

Myeloma

Myeloma is another common type of blood cancer. There have been more medical advances in the treatment of myeloma than any other cancer type in the last 10 years, greatly increasing survival rates.

In myeloma, you're often anemic (having low red blood cell counts), causing fatigue. However, infection is the most common side effect since the disease targets the plasma cells. This subtype of white blood cells, called lymphocytes, is responsible for producing the antibodies you need to prevent or fight infection. When the lymphocytes are compromised, infection occurs. Kidney problems and fragile bones that break more easily are also common in myeloma.

Causes of blood cancers

While the cause of blood cancers is largely unknown, physicians and medical researchers continue to study the disease.

Evidence suggests that previous chemotherapy treatment or radiation exposure may trigger your body to develop blood cancer. Genetics may also be the reason, with family history a known risk factor, particularly for some forms of leukemia. If you have a family history of leukemia or another form of blood cancer, you may benefit from genetic counseling through HonorHealth Cancer Care.

Blood cancer symptoms and diagnosis

Blood cancers often are detected when a routine physical exam uncovers an abnormal blood count. Your HonorHealth experts in blood cancer will order additional tests such as blood tests, X-rays and biopsies to confirm the disease.

Symptoms of blood cancer, which aren't always noticeable, include weakness, dizziness, fatigue, pale complexion, bleeding and/or bruising, or repeated infections. Depending on the specific type of blood cancer, you may also experience other symptoms such as swollen lymph nodes, bone pain or unexplained kidney issues.

Blood cancer treatment

Each type of blood cancer has its own treatment options, which vary based on the stage of your disease and your overall health status.

HonorHealth's hematologists, oncologists, pathologists and other blood cancer experts accurately diagnose and treat your blood cancer using state-of-the-art techniques that include:

• Chemotherapy
• Radiation
• Immunotherapy
• Highly specialized targeted therapies
• Stem cell transplantation, also sometimes called bone marrow transplantation
• Clinical trials at the HonorHealth Research Center offer another way to treat blood cancers

What is stem cell transplantation?

There are two types of stem cell transplants:

1. Autologous transplants, using your own stem cells.
2. Allogeneic transplants, using donor stem cells, which may come from a related or unrelated donor.

The majority of stem cell transplants use your own blood stem cells instead of donor cells. Your specialist will determine which transplant is right for you based on your cancer type, stage and overall response to initial treatments.

HonorHealth's stem cell/bone marrow transplant program is accredited by the Foundation for the Accreditation of Cellular Therapy for adult transplants. The program also is accredited by the National Marrow Transplant Program, a prestigious program boasting 11 million donors and organizations around the world. To learn more, contact HonorHealth's stem cell/bone marrow transplant coordinator at 480-323-4590.

To continue advancing the field of blood cancer diagnosis, care and treatment, the HonorHealth Research Institute conducts clinical trials specific to various types of blood cancer. Ask your doctor if you may be eligible to participate in a clinical research study.

Patient and family support

With a blood cancer diagnosis comes countless questions related to care, treatment, community resources, financial support and more. At HonorHealth, a care coordinator will guide you and your loved ones through each step of your blood cancer journey. If you're undergoing treatment for leukemia, you'll receive one-on-one support and guidance from a dedicated leukemia coordinator.

Your coordinator will work directly with your physicians and other members of your care team to ensure that you understand and have the resources to successfully move through the care process. This includes mapping out every phase of your care, explaining in detail what will take place so you know what to do and what to expect.

If and when you're in the hospital for a test, treatment or other procedure, your coordinator will physically walk with and guide you through the experience. That level of personal care and support continues even after treatment, ensuring that you have a trusted resource for years to come.

Classes and support

Caring for a loved one with blood cancer can take a toll on family members and friends. Monthly caregiver group sessions are a great way to prepare caregivers for what's to come.

Led by a licensed clinical social worker and registered nurse, classes outline expectations for caregivers, provide an overview of the journey ahead, and confirm that they have the tools and materials necessary to support the patient.

Classes are open to caregivers and family members of all ages.

Social worker support

In addition to a transplant coordinator, a licensed clinical social worker works exclusively with blood cancer patients and serves as an invaluable member of your care team.

Your social worker will meet with you and your family caregivers to make certain you have the support you need for a successful journey. Among your social worker's many duties are:

• Helping you coordinate lodging and transportation if you're not from the area
• Discharge planning to help ensure a smooth transition after treatment
• Working with your caregivers and other family members so they know how best to care for you prior to, during and after treatment

Financial counseling and support

Finances can weigh heavy on those undergoing treatment for blood cancer and their families. HonorHealth offers comprehensive financial counseling services specifically for blood cancer patients.

Your transplant coordinator will serve as a single point of contact for all your billing and financial needs. He or she will:

• Answer questions about the cost of care and treatment
• Review your insurance benefits
• Evaluate the long-term costs of care and life after transplantation
• Apply for grant monies

Survivorship

Once you complete treatment, a post-transplant coordinator will lead you into the next phase of your journey: survivorship. You'll always be able to call your transplant coordinator to help answer any questions related to treatment, follow-up care or community resources.