1.  “Resident Expert Presentation” Leukemia Khadija Andrews CEP 661 Medical Psychology

2. What is Leukemia? According to the National Cancer Institute Leukemia is defined as: “Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream.”

3. Types of Leukemia Leukemia is usually separated into two types, based on how quickly the cancer progresses: ACUTE (Sudden Onset) CHRONIC (Long Term)  Progresses rapidly  Accumulation of immature and useless cells.  Crowds out useful and mature cells in the blood and marrow.  Progresses less rapidly  More mature useful cells can be made/produced  Crowding out of useful cells takes place but at a much lesser rate.

4. Types of Leukemia Cont’d Leukemia is also separated into two types, based on the type of blood cells affected: LYMPHOCYTICMYELOGENOUS Cancer develops in the marrow cells that make lymphocytes. Cancer develops in the marrow cells that produce red blood cells, other types of white cells, and platelets NB: A Lymphocyte is a kind of white blood cell inside the vertebrae immune system.

5. Recap of the types of Leukemia

6. Acute Leukemia Acute Lymphocytic Leukemia (ALL)  Most common type of leukemia among young children.  Adults can get ALL, particularly adults of 65 years old.  Survival rates of at least five years range from 85% among children and 50% among adults. Acute Myelogenous Leukemia (ACL)  More common among adults than children.  Affects males significantly more often than females.  40% of patients treated survive for more than 5 years.

7. Chronic Leukemia Chronic Lymphocytic Leukemia (CLL)  Most common among adults over 55, young adults can be affected.  CLL hardly ever affects children.  60% of persons afflicted are men.  75% of treated CLL patients survive for over five years. Chronic Myelogenous Leukemia (CML)  The majority of patients are adults.  A very small number of children get CML  90% of treated CML patients survive for more than 5 years.

8. Other Forms of Leukemia There are other forms of leukemia, that do not fit into the other categories. They are:  Hairy Cell Leukemia  T-Cell Prolymphocytic Leukemia  Large Granular Lymphocytic Leukemia  Adult T-Cell Leukemia

9. Causes & Risk Factors Risk factors/causes of Leukemia:  Previous cancer treatment  Genetic diseases or abnormalities  Maternal fetal transmission (rare)  Exposure to some chemicals (eg: Benzene)  Viruses – Human T-lymphotropic virus and Human immunodeficiency virus  Smoking  Family history of leukemia

10. Signs & Symptoms  Swollen lymph nodes  Poor blood clotting  Easy bruising or bleeding  Frequent Infection  Develop anemia  Experience difficult or labored respiration  Skin has a pale color  Nausea  Fever  Chills  Night sweats  Flu-like symptoms  Tiredness  Headaches

11. Treatment Treatment varies depending on the type of Leukemia, as well as other factors such as age and state of health. Some common treatments are:  Chemotherapy  Biological Therapy  Targeted Therapy  Radiation Therapy  Stem Cell Transplant

12. Leukemia Statistics  One person in the United States is diagnosed with a blood cancer approximately every four minutes.  Every day 118 are diagnosed with leukemia and 60 lose the fight.  Leukemia accounts for about 33% of cancer cases in children aged 0-14.  An estimated 47,150 new cases will be diagnosed this year.  An estimated 23,540 deaths due to leukemia will happen this year.

13. Psychosocial Risks & Factors Patients must confront a variety of psychosocial stressors, such as:  Fear of medical procedures and complications  Coping with physical effects of treatment  Fear of recurrence  Resolving problems relating to intimacy  Employment discrimination (Henderson, 1997).

14. Factors that Affect Employment Besides advancement in treatments, there are several variables that can help to predict continued employment, such as:  Patient’s disease stage  Level of physical disability  Job characteristics, and  Time flexibility (Laszlo, 1990)

15. Vocational Implications Vocational Rehabilitation Counseling for cancer patients should focus on:  Discrimination in the work place by employers and fellow employees  Employers’ expectation that those with cancer are less productive and more expensive  Acceptable and reasonable accommodations at work

16. Conclusion Cancer survivors endure many challenges, such as living with the emotional effects of their brush with death, learning to live with the physical effects of their treatment, and having to continue their former lives (Life after cancer, 1994).

17. References Facts and Statistics. Retrieved from http://www.lls.org/diseaseinformation/getinformationsupport/factsstatistics/ Henderson, P. A. (1997). Psychosocial adjustment of adult cancer survivors: Their needs and counselor interventions. Journal of Counseling & Development, 75 (3), 188-195. http://www.cancer.gov/cancertopics/types/leukemia Laszlo, J. (1990). Why some cancer patients can stay on the job. Cancer News, 44 (2), 17-20. Life after cancer. (1994, June). Harvard Women’s Health Watch, 1 (10), 6. Mayo Clinic Staff. (2010).Treatment and Drugs retrieved from http://www.mayoclinic.com/health/leukemia/DS00351/DSECTION=treatments-and-drugs Nordqvist. C. (2009, March 17). What Is Leukemia? What Causes Leukemia?. Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/142595.php. Picture (Slide 2) Retrieved from http://www.erichartwellfoundation.com/what-is-leukemia.html