South Africa faces rising blood cancer burden as World Cancer Day highlights awareness

As the world unites on February 4 to observe World Cancer Day, South Africa stands at a critical juncture in its fight against cancer, now the fifth leading cause of death in the country. Recent statistics indicate a significant surge in cancer cases, with projections suggesting that the burden will continue to grow significantly in the coming decades. Amongst various forms of cancer, blood cancers pose a particular concern, as a South African is diagnosed with a blood-related cancer or disorder every hour.

Within the spectrum of blood cancers lies Chronic Myeloid Leukaemia (CML), a rare yet treatable malignancy that manifests in just 1–2 individuals per 100,000 people globally each year. Regrettably, many remain unaware of their condition until it reaches advanced stages. Dr Renata Maharaj, Country Head: Medical Affairs at Novartis South Africa, emphasises the urgent need to increase awareness, stating, “It’s imperative to shine a light on this topic that not many may be aware of.”

The hidden symptoms of CML

CML is particularly insidious; it often begins in the bone marrow and progresses slowly, making early detection a challenge. “There are no routine check-ups to do, and symptoms are often mild or absent in the early stages,” Dr Maharaj explains. Common early symptoms such as persistent fatigue, heavy night sweats, unexplained weight loss, and a feeling of fullness in the abdomen due to an enlarged spleen are easily mistaken for everyday stress or minor ailments.

This vagueness means many individuals remain undiagnosed until routine blood tests reveal abnormal results. Dr Maharaj cautions, “The ‘rare but real’ nature of CML requires doctors to be on high alert when patients present with these persistent, unexplained symptoms.”

Recognised by the World Health Organization, CML typically develops in two significant stages: the chronic phase and the blast phase. The chronic phase, often symptom-free and responsive to treatment, is crucial for early intervention. If undetected, CML can escalate to the accelerated phase, marked by rapid cell proliferation and more acute symptoms. At its most severe, the blast phase resembles acute leukaemia, with challenging treatment outcomes. “The key is to diagnose and begin treatment while the disease is still in the chronic phase,” Dr Maharaj says.

Understanding treatment options

Despite its rarity, CML is treatable, and ongoing advancements in medical science have revolutionised patient outcomes globally. Dr Maharaj highlights stem cell transplants, a key treatment option that can potentially offer a cure. “For this to be possible, however, patients need to find a suitable donor,” she notes.

In South Africa, registering as a stem cell donor is notably low, with only around 0.04% of the population listed. There is an urgent demand for increased participation, especially among Black South Africans, who are starkly under-represented in donor databases. Organisations like the South African Bone Marrow Registry (SABMR) and DKMS Africa are working tirelessly to bridge this gap, recruiting donors and raising awareness. “Their efforts are critical in ensuring that patients with CML have a fighting chance,” Dr Maharaj says.

With modern therapies, patients diagnosed in the early chronic phase of CML can anticipate a near-normal lifespan. However, timing remains critical. Late diagnosis, particularly after progression to the accelerated or blast phase, diminishes survival rates significantly. “Recognising symptoms and prompt testing can literally save lives,” warns Dr Maharaj.

“CML is no longer the life-limiting disease it once was. With early diagnosis, heightened awareness, and the right treatment options, patients can lead long, fulfilling lives. Yet, South Africa's limited access to stem cell transplants underscores the necessity for equitable access to innovative medicines.”

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