Diagnosis of AML

Acute myeloid leukemia (AML) is a type of cancer of the body's blood-forming cells. AML will be diagnosed in almost 12,000 people this year, making it the most common form of leukemia in adults. However, 10 percent of patients diagnosed with AML are children.

Finding out that you have AML can come as a shock because its symptoms are common to many other conditions or diseases. By its nature, AML develops very rapidly, and without intervention, can easily spread to other parts of the body. Treatment for AML is usually aggressive and immediate to prevent or limit its spread. About 33 percent of patients diagnosed with AML before the age of 65 will successfully conquer their disease. With treatment options improving every day, learning about your disease is a great way to start taking care of yourself. Here is everything you need to know about AML.

What is AML?
There are several forms of leukemia, but all of them begin when cells in the bone marrow turn cancerous. This affects the production of blood cells and can quickly spread to other parts of the body, such as the lymph nodes, spleen, liver and central nervous system.

Acute myeloid leukemia is distinct because it grows rapidly and affects the immature cells that develop into blood cells. As these cancerous cells grow, they crowd the normal cells in the bone marrow, which prevents the body from effectively making new red blood cells. Without enough red blood cells circulating in the body, a person can show various symptoms, such as shortness of breath, fatigue, weakness, bleeding gums, nosebleeds, infections and pale skin.

The disease is not typically caused by genetic factors, so a parent who has had AML cannot pass the disease to his or her child. However, several lifestyle factors do seem to increase one's risk of developing AML. These include smoking (which causes 20 percent of all cases of AML) and obesity. In addition, exposure to high levels of radiation, benzene (a flammable liquid used as a solvent or additive to gasoline) or previous treatment with chemotherapy for another cancer may also raise one's risk of AML.

Over the years, there has been some discussion that living near high-voltage power lines increases the risk of developing AML, but, "so far the studies show either no increased risk, or a very slightly increased risk," says the American Cancer Society on their website. "Clearly, most cases of leukemia are not related to power lines."

How is AML Diagnosed?
Unfortunately, there are no screening tests for AML, so if you experience any suspicious symptoms, be sure to see a doctor early. Since many of the symptoms of AML are very general, they can be caused by many factors, but if your doctor has reason to suspect that you have AML, he will most likely take various blood tests to first determine if you have anemia, or too few red blood cells. Additionally, your doctor will check to see that the rest of your blood cells are shaped correctly and functioning properly.

If the blood tests are suspicious, your doctor will then turn to more concrete ways of determining if the cause of your anemia is AML. He will likely prescribe a bone marrow aspiration, which involves using a thin needle to collect some liquid bone marrow from your bones or a bone marrow biopsy, where the doctor removes a small core of bone marrow. This allows the doctor to look at the cells in the bone marrow and determine if you have cancer and, if so, what type of leukemia you have. Later on, these same tests are often used to determine how well your body is responding to treatment.

After the initial diagnosis of AML, your doctor will probably prescribe various imaging tests, such as an X-ray, CT scan or MRI, to determine how far the cancer has spread.

What is Treatment Like?
Since leukemia affects the bone marrow, which is found throughout the body, localized treatments like radiation and surgery are generally not used to treat AML, or any form of leukemia. That leaves chemotherapy as the main form of treatment for patients with AML.

Chemotherapy treatment for AML generally consists of taking several powerful drugs over the course of a week in the hospital. The goal of this treatment is to destroy as many cancerous bone marrow cells as possible. In the process, these drugs may also kill healthy bone marrow cells, leaving patients with very low blood cell counts and prone to infection. If the first week of treatment is not successful in causing a remission of your cancer, the process may be repeated one or two more times. This aggressive treatment, called remission induction, works in about 60 percent of patients.

Even if induction is successful, there still may be a few cancer cells in the body. So, to prevent a relapse, patients then undergo another step in treatment called consolidation or post-remission therapy. Here, patients can be prescribed more chemotherapy to ensure that all of the cancerous cells are dead or a bone marrow or stem cell transplant to help the body grow healthy bone marrow.

Bone marrow transplantation involves collecting healthy bone marrow cells from a donor and giving them to the patient by way of a blood transfusion. Then, the healthy cells will hopefully settle into the body and begin to produce healthy blood cells. A stem cell transplantation is similar, but here a doctor takes a sample of the patient's own stem cells and freezes them until needed.

Either type of transplantation is invasive and requires a lengthy hospital stay. However, if successful, a transplant can help the body quickly regenerate healthy bone marrow and blood cells, allowing doctors to use strong doses of chemotherapy beforehand to ensure that there are no more cancerous cells in the body.

What Happens After Treatment?
If your disease goes into remission after treatment, you will still need to see your doctor for routine visits to monitor for a relapse. Additionally, you may continue to have side effects from treatment long after your cancer is gone, and it is important to discuss these side effects with your doctor. Often, there are lifestyle changes that can be implemented to help.

Exercise has been shown to be particularly helpful for improving the overall energy of former cancer patients as well as lifting one's mood. Eating a nutritious, well-rounded diet can also help. Of course, if you smoke, it is important to quit to lower your risk of a relapse or even other forms of cancer.

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