It was 2014 and things were going well for Yogita Yadav. The Bengalurean was doing well in her B.Com and was looking forward to the world of possibilities ahead of her.
But one fateful night, she came down with fever, chills, sweating and extreme fatigue. Over the next few days, she also developed bleeding from the gums, bruises and a burning sensation all over her body. She went to the hospital and a bone marrow test revealed that she was suffering from acute promyelocytic leukaemia (APML), a type of blood cancer.
The diagnosis left her family thunderstruck. But Yogita didn’t give up.
The braveheart, now 29, has put the dark days behind her. She can proudly say that she has not only beaten cancer but also chased her dreams of becoming an air hostess.
Her initial days of treatment were difficult. She needed blood product support almost every day, and nausea and vomiting were part of her life. Dr Mallikarjun Kalashetty, the hemato-oncologist who treated Yogita recalls that she was disciplined in following the treatment and recovered well because of her positive outlook.
Induction therapy helped this blood cancer survivor
APML is a type of blood cancer arising in the bone marrow. Typical symptoms include bleeding and low platelet count.
According to Dr Kalashetty, consultant, hemato-oncology, bone marrow transplant, Manipal Hospitals, the need to initiate treatment even before confirming the diagnosis is crucial in a cancer like APML. This is to reduce the risk of life-threatening bleeding complications.
“Yogita was put on induction therapy,” says Dr Kalshetty. Induction therapy, the first line of treatment was coupled with chemotherapy. “With this, her blood count and coagulation parameters were carefully monitored and she was offered a transfusion. This is a type of blood cancer when treated well has very high cure rates,” he says.
Despite all odds, she continued her M.Com and completed it in 2017. Soon, she started working as an assistant professor at a private college in Bengaluru. But her dreams didn’t just end there.
Soaring to new heights
While she had found a comfortable career in teaching, there was something else she always wanted to do – to be an air hostess. She prepared herself for the new task and cleared all the tests. In September 2019, she joined an airline as a cabin crew. Yogita now spreads her good cheer and positivity among her passengers with a triumphant smile.
Chemotherapy side effects
Yogita recounts the challenging days when she was on chemotherapy. “When chemotherapy began, I had hair loss. My liver was swollen. The sight of blood with cough was nightmarish,” she says. She also lost her appetite and was on intravenous fluids for a while. “My skin was burnt even inside the mouth while I was on chemotherapy.”.
At one point, her platelet levels had declined dangerously to 14,000 as against the normal of one to two lakhs. “I remain thankful to 42 friends who came forward to donate blood and platelets which saved me,” recalls Yogita.
After cancer treatment, she was on maintenance therapy for two years and used to undergo a check-up every week. “Now I am not on any medication. I am leading a life like anyone else. I gathered the courage to fight it myself, especially when I saw my parents feeling low,” the blood cancer survivor recalls. And Yogita’s parents are proud of her. Her father, YS Yadav, is glad that through the storm, his daughter could continue her studies and pursue her dreams.
Symptoms of blood cancer
Dr Kalashetty highlights the importance of identifying the symptoms of blood cancer so that the person can receive timely treatment. He says that some people with blood cancer may also develop swellings in the neck, armpit or other areas due to lymph node enlargement. “Some can also present with severe back pain, bone pain and pathological fracture [fracture with no or minimal strain]. If any of the above symptoms are observed, such individuals should seek medical advice and undergo an evaluation,” says Dr Kalashetty.
Tests for blood cancer diagnosis
A battery of blood tests, PET scans and bone marrow tests are used to diagnose the cancer. “We order more specific genetic studies from the bone marrow sample not only to confirm the diagnosis but also to risk stratify the patient for the most appropriate treatment and prognosis. We may also consider doing a lymph node biopsy in a few cases,” says Dr Kalashetty.
Blood cancer treatment
Dr Kalashetty explains that there is a shift from conventional chemotherapy to more targeted, individualised, precision medicine. Treatment is decided based on the affected person’s
- Age
- Comorbid illnesses
- Fitness level
- Type of blood cancer
- Stage at diagnosis
- Molecular signature of the cancer.
The various modalities of treatment used for blood cancers include immunotherapy, chemotherapy, combined chemoimmunotherapy, bone marrow transplantation and radiation in some cases. “There have been some amazing advances in cellular therapies like checkpoint inhibitor immunotherapy, chimeric antigen receptor or CAR T cells and bispecific T cell engager antibodies (BiTEs) for certain relapsed or refractory blood cancers,” says Dr Kalashetty.
Cancer recovery: Follow-up a must
Even after recovery, blood cancer survivors must continue to follow up, says Dr Kalshetty. “They must continue to practise healthy living.” Healthy eating and physical exercise are fundamental. The treating doctor decides the frequency and duration of follow-ups.
Takeaways
Fever, extreme fatigue, night chills, gum bleeding and low platelet count are the initial symptoms of blood cancer. While the diagnosis can be heart-wrenching, the advances in cancer treatment have helped many. Doctors add that strict adherence to the treatment guidelines is a must. After recovery, follow-ups are necessary.
