Leukaemia Treatment in India

Leukemia is a form of blood cancer characterized by the rapid growth and multiplication of abnormal blood cells. This unregulated growth occurs within the bone marrow, where a significant portion of the body's blood is produced. Typically, leukemia cells consist of immature white blood cells still in the developmental stage.

Why is Leukaemia Treatment Needed?

Individuals diagnosed with acute leukemia should receive prompt treatment due to the cancer's potential for rapid advancement. The primary objective of treatment is to eradicate any traces of leukemia within the body and alleviate associated symptoms, a state referred to as remission. After achieving remission, additional therapeutic measures may be administered to prevent the recurrence or relapse of the disease. These supplementary treatments are categorized as consolidation therapy or maintenance therapy. For patients in whom complete eradication of the disease via chemotherapy fails, consideration may be given to bone marrow transplantation.

As cancer treatments often yield side effects, delaying treatment can prolong the period before these side effects need to be managed. This management method is called active surveillance or watchful waiting. During this, the disease is closely monitored.

• Physical Examination: Your physician will conduct a physical examination to identify potential physical indicators of leukemia, such as pallor due to anemia, swelling of lymph nodes, and enlargement of the liver and spleen.
• Blood Tests: By analyzing a blood sample, your doctor can assess whether you have abnormal levels of red or white blood cells or platelets, which could indicate the presence of leukemia. In some instances, a blood test may also reveal the existence of leukemia cells, although not all types of leukemia lead to the circulation of leukemia cells in the bloodstream. At times, these cells remain confined to the bone marrow.
• Bone Marrow Examination: Your healthcare provider may recommend a bone marrow test, a procedure involving the extraction of a bone marrow sample from your hip bone using a long, slender needle. This sample is then sent to a laboratory for analysis to detect the presence of leukemia cells. Specialized tests performed on these leukemia cells can unveil specific characteristics that are essential for determining suitable treatment options.
• Lumbar Puncture: It is also known as a spinal tap, and may be performed by your healthcare provider to examine a sample of spinal fluid and check for the presence of leukemia in the fluid surrounding your brain and spinal cord.

• Chemotherapy: In this, chemicals are administered to eliminate or inhibit the multiplication of leukemia cells. 
• Immunotherapy (Biologic Therapy): This method employs specific drugs to enhance the immune system's ability to combat leukemia. 
• Targeted Therapy: It is used to target certain components of leukemia cells, such as proteins or genes, causing them to outpace normal blood cells.
• Radiation Therapy: This treatment employs high-energy beams or X-rays to eradicate or hinder the growth of leukemia cells. 
• Hematopoietic Cell Transplant or Bone Marrow Transplant: This approach replaces cancerous blood-forming cells eliminated by chemotherapy and/or radiation therapy with new, healthy hematopoietic cells. 
• Chimeric Antigen Receptor (CAR) T-Cell Therapy: An innovative therapeutic approach that involves extracting the patient's infection-fighting T-cells, engineering them to target leukemia cells, and reintroducing them into the body.

Leukemia treatment consists of three phases, each with a specific objective:

• Induction Therapy: The primary aim here is to eliminate as many leukemia cells as possible in the blood and bone marrow to achieve a state of remission. Remission is characterized by a return of blood cell counts to normal levels, the absence of leukemia cells in your blood, and the complete disappearance of all signs and symptoms of the disease. Induction therapy is typically administered over four to six weeks.
• Consolidation or Intensification: In this phase, the primary objective is to eradicate any remaining, undetected leukemia cells to prevent the cancer from recurring. Consolidation therapy is usually delivered in cycles spanning four to six months.
• Maintenance Therapy: The focus here is on eliminating any residual leukemia cells that may have survived the initial two treatment phases and preventing the disease from returning, known as relapse. Maintenance therapy is typically continued for approximately two years.

Immediate Complications

• Infections
• Breathlessness
• Paleness
• Bruising
• Bleeding gums
• Nose bleeding
• Tiredness and weakness
• Hair loss
• Soreness and ulcers in mouth
• Diarrhea
• Constipation
• Altered taste
• Difficulty in eating and drinking
• Abnormal heart rhythm

Delayed Complications

• Heart Problems
• Infertility
• Developing another type of cancer 
• Osteoporosis
• Early menopause 
• Loss of blood supply to the bone
• Cataracts

• When active treatment for cancer patients concludes, their care does not end. 
• Your medical team will keep an eye on your general health, manage any side effects, and make sure the cancer has not returned. It is referred to as follow-up care.
• Regular medical testing, physical examinations, or both may be part of your follow-up care. in the months and years ahead, your doctors will keep track of your recovery 
• It may be advised to undergo cancer rehabilitation, which can include any of a broad range of services like occupational therapy, physical therapy, career counseling, pain management, dietary planning, and/or emotional counseling. 
• Rehabilitating individuals to the greatest extent possible while maintaining their independence in several facets of their lives is the main aim of Cancer Rehabilitation Programs.

For months to years following your Leukemia treatment, you may be more susceptible to infections or other problems. You must see your doctor frequently for the rest of your life to monitor for late complications.

• Survival Rate at 5 years: 

5-year survival rate of Chronic lymphocytic leukemia (CLL): 88%
5-year survival rate of Acute lymphocytic leukemia (ALL): 71.3%
5-year survival rate of Chronic myeloid leukemia (CML): 70.6%
5-year survival rate of Acute myeloid leukemia (AML): 31.7%
5-year survival rate of Acute monocytic leukemia (AML-M5): 23.7%

• Survival Rate at 10 years: 

5-year survival rate of Chronic lymphocytic leukemia (CLL): 77.1%
5-year survival rate of Chronic myeloid leukemia (CML): 62.1%

The cost of leukemia treatment in India varies according to various factors which are discussed in the next section of this article. However, the approximate cost of the procedure  may range from AAAAAA—ZZZZZZ.

Following are the factors affecting the cost of Leukemia treatment in India:

• Doctor’s Fees: The number of successful cases accomplished by the doctor may affect the cost of treatment. Generally, higher the expertise, higher will be the cost. The doctor with more years of work experience in handling leukemia cases will charge more.
• Overall Health Status of Patients: People having prevailing illnesses and old-age people will be at risk of getting more complications. So, there will be more post-operative care for them which will increase the cost.
• Out of Pocket Expense: If your treatment is not being covered under your health insurance policy, then you may have to pay a higher out of pocket amount for the treatment. 
• Pre-Evaluation Expenses: Various tests will be performed to assess your condition thoroughly. This will alter the total cost of the program on the basis of the pre-evaluation examination suggested.
• Cost of Additional Services: You may have to pay more fees and increase your expenses if you are choosing extensive and more sophisticated services in the hospital.
• Type of Treatment: Depending upon your condition, your team of doctors will plan the treatment for you. Certain treatment modalities will cost you more than any other treatment modality for Leukaemia. 
• Type of Hospital: A corporate hospital will charge you more than the government hospital for the same services.
• The city where the hospital is located: Hospitals located in bigger cities like Delhi, Mumbai, Chennai, Noida, Gurugram, etc. may charge comparatively more than the hospitals located in smaller cities. This is because hospitals in the metropolises can facilitate you better in every aspect.

An approximate cost of diagnostics for Leukemia treatment:

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