What is Bone Marrow Cancer, Its Symptoms, Diagnosis, and Treatment

Bone marrow, located in the center of large bones, is where blood cells, which are essential for the body, are produced. Since various types of blood cells are produced in this area, the types of cancer that develop can also vary. Therefore, bone marrow cancer does not refer to a single type of cancer; it encompasses many cancers, including acute or chronic forms (such as leukemia and lymphoma). For this reason, different methods are applied for symptoms, diagnosis, and treatment based on the affected cells.

What is Bone Marrow Cancer?

Bone marrow cancer occurs as a result of the excessive and uncontrolled growth of abnormal cells in the bone marrow. In the bone marrow, blood cells are produced that carry oxygen to the body (red blood cells), contribute to the immune system (white blood cells), and play a role in blood clotting (platelets). For this reason, many types of cancers that affect different cells in the bone marrow can be observed, and these cancers are of vital importance. Since the function of blood cells is essential for an individual to maintain a healthy life, early diagnosis and treatment of bone marrow cancer is crucial.

What Causes Bone Marrow Cancer?

Although the primary cause of bone marrow cancer is uncontrolled cell growth, the exact reason for this abnormal growth is not clearly known. However, there are risk factors that may lead to abnormal cell growth and uncontrolled multiplication resulting in cancer. The risk factors that may cause bone marrow cancer include:

• Age: The risk of bone marrow cancer increases with age, as cell damage accumulates over time, raising the likelihood of cancer development.
• Gender: For some types of bone marrow cancer, gender can be a risk factor due to certain cancers affecting individuals based on their anatomy and physiology.
• Genetics: Bone marrow cancer is related to genetic predisposition, so individuals with a family history of this cancer have a higher risk.
• Viruses: Certain types of viruses are significant risk factors for bone marrow cancer. For example, HIV, an immunodeficiency virus that affects the immune system, increases the risk of leukemia.
• Chronic Infections: Long-standing and frequently recurring infections can weaken immunity and lead to cell deterioration, increasing the risk of cancer.
• Exposure to Chemicals and Harmful Radiation: Exposure to chemicals and harmful radiation is among the most well-known causes of cancer. Exposure to chemicals like benzene or harmful radiation increases the risk of many cancers, including bone marrow cancer.

What are the Symptoms of Bone Marrow Cancer?

Since there are many types of bone marrow cancer, the symptoms can vary depending on the type, stage, and spread of the cancer. However, the most commonly observed symptoms of bone marrow cancer can be listed as follows:

• Bone Pain: Bone marrow cancer often causes pain in the bones, which is usually long-lasting and severe.
• Weakness and Fatigue: Cancer cells consume more energy than normal cells and expend significant energy due to their uncontrolled growth, leading to feelings of weakness and fatigue in the patient.
• Anemia: Since bone marrow cancer affects blood cells, it can hinder the production of normal blood cells, leading to anemia. Anemia may cause symptoms such as pale skin, rapid heartbeat, and weakness.
• Frequent Infections: Bone marrow cancer can weaken the immune system by affecting white blood cells associated with immunity, leading to frequent infections in the patient.
• Bone Fractures and Weakness: Types of bone marrow cancer, such as myeloma, can weaken bones, resulting in fractures.
• Mouth Sores: Like many cancers, bone marrow cancer can cause sores in the mouth, which may lead to swallowing and feeding difficulties.
• Weight Loss: Cancerous cells consume a lot of energy, leading to weight loss as the body uses its energy reserves.
• Swelling of Lymph Nodes: A type of bone marrow cancer known as lymphoma can cause growth and swelling of lymph nodes.
• Respiratory Problems: If bone marrow cancer spreads to the lungs, respiratory problems may arise.

Types of Bone Marrow Cancer

Bone marrow cancer can affect many different types of cells, which is why there are several types of bone marrow cancer. The types of bone marrow cancer can be listed as follows:

• Leukemia: This type occurs due to the abnormal proliferation of white blood cells found in the bone marrow. There are two types of leukemia: acute and chronic. Acute leukemia progresses rapidly and requires urgent treatment, while chronic leukemia progresses more slowly and allows time for treatment.
• Lymphoma: Lymphoma occurs due to the abnormal growth of immune cells known as lymphocytes. It can be divided into two types: Hodgkin lymphoma, which is characterized by lymph nodes and Reed-Sternberg cells, and non-Hodgkin lymphoma, which does not have specific cells and has many subtypes.
• Myeloma: Myeloma results from the abnormal growth of bone marrow cells called plasma cells, which can cause weakness and fractures in the bones.
• Hairy Cell Leukemia: This is one of the rare types of leukemia that occurs due to the abnormal growth of B cells in the immune system.
• Waldenström Macroglobulinemia: Another rare type of bone marrow cancer, Waldenström Macroglobulinemia, develops due to the excessive production of antibodies in the bone marrow.

Diagnostic Methods for Bone Marrow Cancer

Since there are many different types of bone marrow cancers such as leukemia, lymphoma, and myeloma, the diagnostic methods are also quite varied. The methods used to diagnose bone marrow cancers can be listed as follows:

• Blood Tests: Blood tests are one of the most effective methods for diagnosing cancer as they provide important information about blood cells. Anemia, abnormal cells indicative of leukemia, or the levels of specific chemicals can be detected through blood tests.
• Bone Marrow Biopsy: In a bone marrow biopsy, a sample is usually taken from a large bone, such as the hip or breastbone, using a thin needle. The sample is examined to determine the presence and type of cancer cells.
• Imaging Tests: Imaging tests such as X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) are used to assess whether cancer has spread to the bones and other areas of the body.
• Bone Scan: A radioactive substance is injected and spreads to the bones. Images taken with this radioactive material show whether cancer has spread to the bones.
• PET (Positron Emission Tomography) Scan: In this test, a radioactive substance is injected into the body, focusing on cancer cells to show abnormal activity in the images.
• Bone Marrow Aspiration: This is similar to a bone marrow biopsy, but typically the liquid portion of the bone marrow is taken.
• Lymph Node Biopsy: In types of cancer like lymphoma, samples taken from lymph nodes can help determine the type of cancer and the level of spread.
• Cytogenetic and Molecular Tests: These tests help identify the genetic and molecular characteristics of cancer cells to determine the type of cancer and treatment options.

Treatment of Bone Marrow Cancer

The treatment for bone marrow cancer is planned by a specialized healthcare team based on the type of disease, stage of progression, and the patient’s overall health status. The methods used to treat bone marrow cancer can be described as follows:

• Chemotherapy: Chemotherapy is commonly used in the treatment of bone marrow cancers. It is a medication treatment used to destroy or control cancer cells. The drugs are injected into the bloodstream, targeting cancer cells throughout the body, but some other cells may also be affected.
• Radiotherapy: The aim of radiotherapy is to destroy cancerous cells in a specific area using high-energy radiation.
• Bone Marrow Transplant: Bone marrow transplant is the process of replacing the patient's damaged or cancerous bone marrow cells with healthy donor cells. Bone marrow transplants can be used to renew the patient’s immune system cells and blood cells.
• Targeted Therapies (Smart Molecules): There are specially designed targeted drugs for some types of bone marrow cancers, providing a more effective treatment.
• Immunotherapy: Immunotherapy involves the immune system stepping in to help combat cancer cells. It can assist in the body’s recognition of cancer cells, facilitating their destruction.

Since early diagnosis is crucial in cancer treatment, if you suspect bone marrow cancer, consult a specialist doctor for your check-ups.