Blood Cancer Awareness Month: Dr. Kunal Goyal Shares Key Insights on Diagnosis and Treatment

Dr. Kunal Goyal: Most people feel tired due to stress, long hours or lack of sleep—and this type of tiredness improves with adequate rest and recovery. In contrast, fatigue related to blood cancers such as leukemia, lymphoma or myeloma is persistent and disproportionate. It does not get better with rest and often keeps worsening over time. 

What makes it more concerning are the associated red-flag features: 

• Pallor and weakness due to anemia

• Recurrent or unusual infections because of low immunity

• Unexplained bruising or bleeding from low platelets

• Persistent fever, night sweats, or weight loss without obvious cause

• Swollen lymph nodes or bone pains.

If fatigue is ongoing, unexplained and accompanied by any of these warning signs, it should not be ignored. A simple blood test (CBC) is often the first step to detect abnormalities early.

Dr. Goyal: There is no single universal screening test—like a mammogram for breast cancer or colonoscopy for colon cancer—that can detect blood cancers early in healthy individuals. What usually helps in early detection: 

1. Complete Blood Count (CBC): This is the simplest, most widely available test. It can reveal anemia (low hemoglobin), abnormal white cell counts, or low platelets, which may be the first clue to leukemia, lymphoma, or myeloma. 

2. Peripheral Smear Examination: If the CBC is abnormal, a peripheral smear can show immature or abnormal blood cells, often guiding doctors toward a diagnosis. 

3. Basic Health Check Markers: ESR (erythrocyte sedimentation rate) or CRP (inflammatory markers) may be persistently high. Unexplained derangements in kidney or liver tests can sometimes point towards hidden myeloma or lymphoma. 

4. Physical Examination by a Physician: During check-ups, doctors may detect enlarged lymph nodes, liver or spleen that the patient hasn’t noticed.

Dr. Kunal Goyal: That’s a very natural concern. Most people immediately associate “cancer treatment” with severe pain, suffering or unbearable side effects. The good news is that treatment for blood cancers has advanced tremendously in the last decade, and both effectiveness and tolerability have improved significantly.

How treatment has changed:

1. Chemotherapy Then vs. Now

Earlier: Traditional chemotherapy was the mainstay, and while it worked, it often caused severe hair loss, nausea, infections, and prolonged hospital stays.

Now: Newer protocols are more targeted, better tolerated, and supported by advanced supportive care. Today we have highly effective anti-nausea medicines, infection-preventive strategies, and growth factors that make chemotherapy safer.

2. Targeted Therapies - Drugs that specifically attack cancer cells while sparing normal cells are now available (e.g., TKIs in CML, monoclonal antibodies in lymphoma, proteasome inhibitors in myeloma). This means fewer side effects and better quality of life.

3. Immunotherapy & CAR-T Cells - The most exciting advancement is harnessing the patient’s own immune system to fight cancer. CAR-T cell therapy, bispecific antibodies, and checkpoint inhibitors are providing hope even in relapsed or resistant cases.

4. Bone Marrow & Stem Cell Transplants - Transplant procedures have become much safer due to improved infection control, better donor selection, and reduced-toxicity conditioning regimens.

5. Supportive Care - Blood transfusion safety, antifungal/antiviral drugs, and pain management have all improved, ensuring patients suffer less and recover faster. In short: “Blood cancer treatment is no longer about just surviving—it is about surviving well”.

Dr. Kunal Goyal: When we say chemotherapy, bone marrow transplant, or immunotherapy, the words may sound scary—but the ideas are simple. Chemotherapy is medicine that kills cancer cells, like a weed-killer for unwanted growth. Bone marrow transplant means replacing the body’s faulty blood-making factory with healthy stem cells—like changing the soil so healthy plants can grow. Immunotherapy boosts your own immune system, giving it night-vision goggles to recognize and fight cancer cells. The good news is, modern treatments are far safer, more effective and allow patients not just to survive, but to live well.

Dr. Kunal Goyal: Immunotherapy is already established in India, and CAR-T cell therapy has now begun its journey here. With indigenous products and early successes, it is moving rapidly towards mainstream use. In fact, I have treated a patient with secondary CNS lymphoma using CAR-T therapy, and he has now crossed one year disease-free—showing the real promise of this treatment in India. Infact our centre is routinely doing CAR-T and we are expecting atleast of 5-6 CAR-T procedures per month in coming months.

Dr. Kunal Goyal: The biggest challenges in India are low awareness, late diagnosis, shortage of specialized centers, and financial constraints. Overcoming these will require strong public awareness campaigns, better training of primary doctors, expansion of BMT/CAR-T facilities, and supportive government/insurance policies. With these steps, blood cancers—many of which are now curable—can be diagnosed earlier and treated more effectively across India.

Dr. Kunal Goyal: Cure is possible in several blood cancers.

Acute leukemias (ALL, AML): With modern chemotherapy, targeted drugs and bone marrow transplant, many patients—especially children—can achieve a complete cure.

Hodgkin’s lymphoma: Cure rates can be as high as 80–90% with standard treatment.

Certain non-Hodgkin lymphomas and early-stage myeloma: Can also be cured or kept under very long-term remission.

Chronic Myeloid Leukemia (CML): With targeted oral medicines (TKIs), patients often live a normal lifespan and some can even stop treatment permanently after a few years.

Some blood cancers are more about long-term control. Diseases like chronic lymphocytic leukemia (CLL) or multiple myeloma are often controlled for years with modern therapies. Patients may not always be “cured” in the absolute sense, but they can live long, good-quality lives.

Dr. Kunal Goyal: Medicines treat the disease, but family and caregivers heal the person. Their emotional, practical, and moral support makes the journey less frightening and directly improves recovery and quality of life. Blood cancer treatment is never a solo journey, it’s a team effort, and family is the strongest part of that team.

Dr. Kunal Goyal:

Myth 1: Blood cancer always means death.

Reality: Many blood cancers are highly curable (like childhood leukemias and Hodgkin’s lymphoma), and others can be controlled for years with modern therapies. Survival rates today are far better than a decade ago. 

Myth 2: Blood cancer is contagious.

Reality: Blood cancer is not infectious. You cannot “catch it” from someone else. Patients deserve care and closeness, not isolation. 

Myth 3: Only elderly people get blood cancer.

Reality: Blood cancers can occur at any age—including children and young adults. In fact, leukemia is the most common childhood cancer. 

Myth 4: Chemotherapy and bone marrow transplant are unbearably painful.

Reality: While these treatments have side effects, modern medicine offers excellent supportive care, making them far more tolerable than most people imagine.

Myth 5: Alternative or “natural” remedies can cure blood cancer.

Reality: No herbal or alternative remedy has been scientifically proven to cure blood cancer. Delaying proper treatment for these options often worsens outcomes. 

Myth 6: A bone marrow transplant means surgery on the spine.

Reality: This is very common! In reality, a bone marrow transplant is not a surgery—it is a procedure similar to a blood transfusion, where healthy stem cells are given through a vein.

Dr. Kunal Goyal: Awareness months act as a spotlight—they educate, fight myths, encourage early diagnosis and showcase that cures are possible. They also empower patients and caregivers to come forward without fear. In short: “Awareness saves lives—because what is recognized early can be treated early and in blood cancers, timely treatment often means cure.”

Dr. Kunal Goyal: Blood cancers usually arise from genetic changes and environmental exposures, not directly from lifestyle. However, healthy habits can reduce risk and improve immunity: 

• Avoid tobacco, excessive alcohol and chemical exposures.

• Adopt a balanced diet, regular exercise, and proper vaccinations.

• Protect against infections like hepatitis and HIV.

• Check health with a simple CBC if symptoms persist.

While not all blood cancers are preventable, a healthy lifestyle and timely tests improve both protection and early detection.

Dr. Kunal Goyal: There is always a hope beyond you can see.