As the world marks World Cancer Day, attention turns to the growing burden of cancer in South Africa, where cancer is now the fifth leading cause of death in South Africa – and its impact is projected to grow in the coming decades.
Among the many forms of cancer, blood cancers are especially concerning, with a South African diagnosed with a blood-related cancer or disorder every hour. Within this group of blood cancers, lies chronic myeloid leukaemia (CML), a rare but treatable blood cancer affecting just 1–2 people per 100 000 globally each year.
Many may still go around not knowing they have CML, and unfortunately the most viable form of treatment for them is through a stem cell transplant. This according to Dr Renata Maharaj, country head: Medical Affairs at Novartis South Africa. “As we observe World Cancer Day on 4 February, I believe it’s imperative to shine light on this topic that not many may be aware of.”
CML’s silent symptoms
CML often begins in the bone marrow and progresses slowly, which makes it particularly difficult to detect early. Dr Maharaj states: “Because there are no routine checkups to do and symptoms are often mild or absent in the early stages, it is not something that can be diagnosed without a blood test.
“Some of the most common early signs of CML are easy to mistake for everyday issues, yet they should never be ignored.” Its symptoms such as persistent fatigue, heavy night sweats, unexplained weight loss or a feeling of fullness in the abdomen due to an enlarged spleen, are often vague and easily mistaken for stress or minor illness. This means many people remain undiagnosed until routine blood tests pick up abnormal results.
Because these symptoms are vague, only abnormally high white-cell counts can start to raise a red flag with a general practitioner. “The ‘rare but real’ nature of CML requires for doctors to be on high alert when patients present with these persistent, unexplained symptoms.”
CML typically develops in three stages; however, the World Health Organization typically recognises only two stages (chronic and blast). In the chronic phase, which is the earliest and most common stage, the cancer progresses slowly and often responds very well to treatment. “This is usually the stage where not everyone presents with symptoms,” Dr Maharaj notes.
If left undiagnosed, CML can advance to the accelerated phase, where abnormal cells increase more rapidly and symptoms become more noticeable. In the most severe blast phase, CML behaves more like an acute leukaemia, with fast-growing cancer cells that are harder to control.
“The key is to diagnose and begin treatment while the disease is still in the chronic phase, where outcomes are most successful.”
How CML can be treated
While CML is rare, it is treatable, and advances in medical science have significantly improved outcomes for patients worldwide. Dr Maharaj shares one important treatment option is a stem cell transplant, also called a bone marrow transplant, which can potentially offer a cure. “For this to be possible, however, patients need to find a suitable donor,” she adds.
In South Africa, this remains a significant challenge. Only around 0.04% of the population is registered as stem cell donors, and there is a particularly urgent need for more Black South Africans to register, as they are severely under-represented in donor databases.
To address this, organisations such as the South African Bone Marrow Registry and DKMS Africa work tirelessly to recruit donors, raise awareness and connect patients with life-saving matches. “Their efforts are critical in bridging the gap and ensuring patients who have CML and are in need of a transplant are given a fighting chance,” Dr Maharaj reiterates.
With modern therapy, a patient diagnosed in the early chronic phase of CML can also expect a near-normal lifespan. “But that success really depends on timing. When CML is caught late, for example, after it progresses to accelerated or blast phase, it becomes far harder to control and survival drops. That’s why recognising symptoms and testing quickly can literally save lives.
“CML is no longer the life-limiting disease it once was. With early diagnosis, awareness and the right treatment options, patients can live long, fulfilling lives. But in South Africa, limited access to stem cell transplants shows us just how important access to innovative medicines truly is.
“By growing awareness, strengthening donor registries and ensuring equitable access to treatment, we can give every patient real hope – and that hope is worth fighting for,” Dr Maharaj concludes.
Image credit: Freepik
