How can we try to prevent the development of blood diseases? And what can we do to at least identify them at an early stage? Hematologist-oncologist Mikhail Fominykh spoke in detail about this in his book Five Liters of Red: What You Need to Know About Blood, Its Diseases and Treatment (Alpina Publisher Publishing House). We publish a chapter from it.
There are two main ways to reduce the incidence of malignant neoplasms — prevention and screening.
Screening is testing for cancer in healthy people, even if they don’t have symptoms. To date, screening has been proven effective for only a few diseases: cervical cancer (cytology), breast cancer (mammography), and colorectal cancer (occult blood test). For other diseases, its implementation is doubtful and ineffective.
It turns out that there is no screening for hematological diseases, and this is true. The only thing that hematologists can offer is periodic monitoring of a clinical blood test to detect chronic diseases: anemia, chronic leukemia, and others. Other diseases are diagnosed only in the presence of symptoms, especially acute leukemias and lymphomas, and this is already called early diagnosis, it has nothing to do with screening and prevention.
Predictive genetic markers have not yet been developed, but we can influence risk factors, that is, prevent their growth
Risk factors are changeable and immutable, that is, we can influence some things, but not others. Genetic predisposition and age are fixed factors, but quit smoking is a changeable factor. Speaking about the prevention of the disease and about what measures we can take ourselves, it is reasonable to analyze modifiable risk factors.
For malignant hematological diseases, modifiable risk factors include smoking, alcohol abuse, sedentary lifestyle, overweight, and chronic diseases (especially autoimmune).
The first one is smoking. It leads to additional sporadic mutations, damages blood vessels and increases the risk of thrombotic complications. If you smoke, do everything in your power to completely quit the habit, or significantly reduce smoking, even secondhand. There are many options available to help you quit smoking, such as nicotine gum, patches, and various drugs to help you quit smoking. If you are unable to do this on your own, seek help from specialists, doctors and psychotherapists.
“Doctor, is alcohol allowed during treatment?” This is a question I often hear from my patients.
In my opinion, there is little benefit from alcohol, but the side effects are a wagon and a small cart. Perhaps the only useful property of alcohol is socialization during its use: the conversation becomes relaxed, and people are more liberated. Well, plus the consumption of alcohol is a kind of tribute to traditions: they sat down at the festive table, they should have a drink. But I will say this: if you absolutely cannot do it, then you can drink a glass of wine (100 ml) or 25 ml of strong alcohol. It will be great if you keep your alcohol intake to a minimum.
To reduce excess weight and rethink a sedentary lifestyle, you need to eat right and increase physical activity. When it comes to diet, an individual approach is needed here, but the main rule is the same: the weight we gain depends on the difference between the number of calories consumed and burned. It will be right to either reduce the number of calories consumed, or spend more.
In the first case, the result can be achieved by changing your diet. Fortunately, there are no strict restrictions in this matter. I would recommend sticking to the so-called Mediterranean diet. This is even more likely not a diet and not a strict nutrition system, but eating habits. According to a large number of medical studies, following a Mediterranean diet reduces the risk of developing cardiovascular complications — the first cause of death worldwide. And I recommend it to everyone, not just my patients.
People who follow a healthy diet are significantly less likely to suffer from overweight, diabetes and high blood pressure. WHO has developed a special set of nutrition rules for those who care about their health. These rules have much in common with the principles of the Mediterranean diet.
As you can see, there are no strict prohibitions in this diet, and by following the simple recommendations above, you can create a completely tasty and healthy diet for the whole family.
What about physical activity?
«Can I get back to weightlifting?» — I heard from my 30-year-old patient with a diagnosis of chronic myelogenous leukemia, three months after the start of therapy. By that time, his condition had returned to normal in everything, the spleen became normal in size, red blood cells were completely restored, and leukocytes returned to normal. Weakness and malaise were gone and forgotten, and he was again full of strength.
A year after returning to sports, the mentioned patient won prizes at city weightlifting competitions in his weight and age category along with healthy athletes; no one knew about his oncological diagnosis. These sporting achievements have only provided an additional incentive to further fight the disease and once again demonstrate that the quality of life of patients with CML during therapy with tyrosine kinase inhibitors does not differ in any way from the quality of life of other people.
Undoubtedly, it is worth increasing physical activity gradually.
Nobody forbids you to perform the minimum and comfortable amount of physical exercises that can benefit you.
Aerobic exercise includes walking, running, cycling, and swimming, all of which increase your heart rate. Strength exercises involve the use of weights in the form of dumbbells or barbells, simulators, they help build muscle mass and increase endurance. Relaxation exercises include yoga and breathing exercises. Exercise helps maintain a healthy body weight (which goes hand in hand with healthy eating habits), improves joint function, and helps maintain muscle tone.
In my opinion, the most important thing to understand is that there is no one specific training program for everyone. Everything from the specific type of exercise to the intensity depends on your abilities and preferences. Regularity is important here, then the results will not keep you waiting.
Some people doubt that they can do regular training and think that this requires a personal trainer and a personal program, which they may not be able to afford. If you are still worried about some chronic problem or injury, then talk to a physical therapist or sports instructor. But you can do without their help.
Start with what you enjoy doing the most and listen to your body
Do not set yourself unattainable goals like winning one of the world’s major marathons or setting a new world record, although this is, of course, very cool. Do not reproach yourself for the fact that it will be hard in the early stages — this will pass with time. Instead, focus on how your quality of life will improve in the future, such as seeing old friends while walking or jogging, enjoying the fresh air and sun, or just de-stressing and relaxing.
Move daily and as much as possible, diversify your diet. Fill your life with joy, vivid impressions and travel. Read interesting books, watch movies, listen to music and go to concerts. Spend more time with those who love you and who make you feel good. Appreciate every day. Take care of yourself and your loved ones.
(Alpina Publisher, 2022)