WORDS LIM TECK CHOON
| This article is part two of a special series on leukemia with Dr Habibah Abdul Halim. If you have missed the first part, click here to read it. |
 FEATURED EXPERTDR HABIBAH ABDUL HALIM Consultant Internal Medicine Physician & Haematologist Columbia Asia Hospital Bukit Rimau |
HOW CAN THE DOCTOR CONFIRM THAT ONE HAS LEUKEMIA?
Dr Habibah explains that the doctor may have a suspicion when their patient’s clinical history suggests the possibility of leukemia.
Blood tests may also reveal the possibility of leukemia.
Even if the results are negative, bone marrow aspiration and trephine biopsy may still uncover the presence of this cancer.
What Are Bone Marrow Aspiration & Trephine Biopsy Like?
“This is a bedside procedure,” says Dr Habibah, explaining the diagnostic procedure.
- This procedure involves removal of tissues from the right hip area.
- For bone marrow aspiration, a thin needle will be used to obtain a sample of fluid.
- For trephine biopsy, a small piece of bone tissue will be obtained using another type of needle (see image above).
“This is a safe procedure that can be done under local anaesthesia,” Dr Habibah further explains.
The samples are sent to a laboratory for analysis.
Advanced Gene Investigative Technology
“These days, there are advanced technologies that complement standard investigation procedures, such as next generation sequencing or NGS to identify mutations in a gene that give rise to the patient’s leukemia,” Dr Habibah adds.
Other Investigative Tests
She further mentions that in addition to these tests, the doctor will also assess the function of all the patient’s organs.
This usually involves:
- Blood tests to check the patient’s kidney and liver function
- Electrocardiogram (ECG) and echocardiogram to assess the patient’s heart function.
“The results of these tests will help the doctor come up with an appropriate management plan for the patient’s leukaemia,” says Dr Habibah.
HOW IS LEUKEMIA TREATED?
“There are different types of leukemia, and each one needs a specific treatment,” Dr Habibah points out.
Furthermore, treatment options also depend on factors such as the mutation involved in giving rise to leukemia, the patient’s overall organ function, and more.
This is also complicated by how different patients tend to respond differently to the same treatment.
Hence, Dr Habibah shares that treatment tends to be tailored to each patient, so there is no ‘one treatment fits all’ approach when it comes to leukemia.
Chemotherapy
This was the main backbone of treatment in the past.
Targeted Therapy
- Developed from recent advances that help us identify mutations that trigger one’s leukemia.
- Targets specifically cancer cells carrying a specific mutated gene, hence sparing normal cells from damage.
- “This gives hope to more tolerable and sustainable treatment for leukemia patients,” Dr Habibah points out.
Supportive therapy
These are therapies that support the patient throughout their main treatment.
Such therapies include:
- Pain management
- Blood transfusion
- Growth factors
- Antibiotics
- Antiemetic medications to treat chemotherapy-induced nausea and vomiting
A counsellor and spiritual advisor can also be present to provide the patient with emotional and spiritual support.
A CUSTOMIZED TREATMENT PLAN IS KEY
Dr Habibah shares that all these treatment options as well as the treatment schedule would be discussed between the oncologist and the patient as well as their family.
“There will be an emphasis on the justification and objectives of treatment, the potential side effects, and how treatment will affect their daily lives,” she elaborates, adding that the concerns of the patient and their family would be addressed as well during such discussion.
Such two-way open communication is necessary because the treatment journey is dynamic.
There may be adjustments and changes in the days ahead, so Dr Habibah points out that everyone involved will need to be vigilant, openminded, and flexible.
“It is important for the patient, their family, and their healthcare team to establish a good rapport and keep communication channels open,” she iterates.
| This article is part of our series on the facts of cancer, treatment options, and latest innovations in diagnosis and treatment of cancer. |
