Created by Alan Gaston • What is Leukemia? • How does Leukemia affect Adolescents? • The symptoms of the disease. • The recovery rate for adolescents with Leukemia. • Is there a cure for the disease? • How can teachers help? • • • • 1 Leukemia is cancer of the white blood cells. The word cancer refers to diseases in which certain cells in the body become abnormal and the body produces too many of these cells. Leukemia cells do not function normally and cannot do what normal blood cells do, such as fight off infection. The most common types of leukemia are acute lymphoblastic leukemia, acute myelogenous leukemia, cronic lymphocytic leukemia, and chronic myelocytic leukemia. ALL and AML are the two types of leukemia that affects adolescents the most. Acute lymphoblastic leukemia “affects the body’s blood making system, including bone marrow and the lymphatic system. It develops from lymphoblasts (a type of white blood cell) in the bone marrow.” “Bone marrow is the soft, inner component of bones. All forms of blood cells are produced in the bone marrow including white blood cells, red blood cells, and platelets.”1 Leukemia develops in the bone marrow, but quickly spreads into the blood, and eventually into the lymph nodes and other parts of the body. Mark Oren, MD, FACP, Cancer Health Online. • • • • 2 Leukemia accounts for the largest number of cases of adolescent and childhood cancer and are the main cause of cancer related deaths in adolescents in the U.S. Leukemia accounts for 32 percent of all cancer cases occurring among adolescents younger than 15 years of age and 26 percent of cancer cases occurring among those younger than 20.2 The two forms of leukemia that affect adolescents the most are acute lymphoblastic leukemia and acute myelogenoul leukemia. Both forms of the disease progresses very quickly in adolescents and can have a devastating effect on the individual. Leukemia influences adolescents emotionally, mentally, and physically. Fatigue and restlessness are common in leukemia patients. Research has shown that adolescents with leukemia enjoy going back to school and other “normal” activities. Many adolescent individuals that have leukemia go on to lead normal lives. Malcolm A. Smith, Lynn A. Gloeckler Ries, James G. Gurney, Julie A. Ross, National Cancer Institute, SEER Pediatric Monograph, Page 17. • Symptoms of the disease can include “frequent infections, poor healing of small cuts or sores, and anemia. • Other common symptoms include: fevers and night sweats, weakness and fatigue, headaches, bruising of the skin and bleeding from the gums, joint pain, swollen lymph nodes in the armpit, neck, or groin, and a decreased appetite or weight loss. • Many researchers believe that risk factors include: smoking and tobacco use, exposure to high doses of radiation or the chemicals benzene or formaldehyde, and chemotherapy used to treat other cancers. • Without identification of the disease and successful treatment, the disease is usually fatal. During 1995-2001, relative survival rates overall were: • • • • Acute lymphocytic leukemia: 64.6 percent overall; 88.4 percent for children under 5. Chronic lymphocytic leukemia: 74.2 percent. Acute myelogenous leukemia: 19.8 percent overall; 52 percent for children under 15. Chronic myelogenous leukemia: 39.3 percent. Five-Year Relative Survival Rates for Acute Lymphocytic Leukemia in Children Under 15 Years, 1964-2001 Sources: SEER (Surveillance, Epidemiology and End Results Cancer Statistics Review, 1975-2002, National Cancer Institute. The graph shows childhood ALL five-year relative survival rates have improved significantly over the past 40 years. • There is optimism within cancer research centers that work with adolescents with leukemia because survival statistics have dramatically improved over the past 30 years. Most children and adolescents with acute lymphocytic leukemia are cured of the disease if the illness is caught early enough, and treatment is implemented in time. • The exact cause for leukemia is not known, although research continues. There is no known cure for leukemia as of today, but there are forms of treatment for the disease. • The aim of treatment (or an attempt to cure the disease) is to bring about a complete remission. • Complete remission means that there is no evidence of the disease and the patient returns to good health with normal blood and marrow cells. Relapse indicates a return of the cancer cells and the return of other signs and symptoms of the disease. • For acute leukemia, a complete remission (no evidence of disease in the blood or marrow) that lasts five years after treatment often indicates cure. • Treatment centers report increasing numbers of patients with leukemia who are in complete remission at least five years after diagnosis of their disease, adolescents included, but there is no absolute cure as of today. • School is a respite for the adolescent with leukemia. Treat them as students not as patients or sick people. • Communication with the student and parents to determine an approach to dealing with absences and make up work is essential. Graduation and college entrance requirements can be met in spite of all the absences necessitated by treatment and the illness. • Confidentiality is crucial. Only talk with those people with a right to know (e.g. the student’s guidance counselor) and those people the student has agreed to have you talk to. As far as classmates, ask the student what approach they want to take. • Learn more about the disease so that you understand what the student is experiencing. This webpage provides a starting point and there are some other valuable websites as well: www.leukemiainfo.net www.americancancersociety.org www.wish.org