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Are Myelodysplastic Syndromes Cancer? 2 RCCA Oncologists Provide the Answer
Being diagnosed with a disease is always concerning, but in the case of myelodysplastic syndromes, or MDS, the news can be confusing, as well. Are these hematologic conditions forms of cancer, or are they instead potential precursors of cancer, such as intestinal polyps that over time may become malignant and cause colon cancer?
Two medical oncologists/hematologists who practice with Regional Cancer Care Associates (RCCA), one of the nation’s largest networks of cancer specialists serving patients at locations in New Jersey, Connecticut, Massachusetts, Maryland, and the Washington, D.C. area, addressed that question and related issues in a recent interview.
“The short – and unfortunate – answer is that myelodysplastic syndromes are, indeed, cancer,” says May Abdo-Matkiwsky, DO, who practices at RCCA’s Sparta, NJ, office and who has a practice emphasis on MDS along with breast cancer and other solid tumors and cancers of the blood and blood-forming tissues. She adds, “People’s uncertainty on this score is understandable. In fact, for many years, physicians debated the issue of whether these syndromes represented outright cancer or instead were risk factors for acute myeloid leukemia, or AML. However, as research provided more insights into the biology of the conditions, their progression, and how they affect people, it became clear that we were dealing with one type of cancer that also had the potential to transform into an even-more aggressive type of cancer, AML.”
—May Abdo-Matkiwsky, DO
—Joseph McLaughlin, MD
Joseph McLaughlin, MD, who practices at RCCA’s Manchester, CT, office, explains, “More than 90% of our blood cells are produced in the bone marrow, a spongy material that contains special blood-forming cells, including blood stem cells. When these blood stem cells become abnormal – or dysplastic, in medical terminology – they may not make enough blood cells, or the cells that they do produce may be defective. As a result, people may be deprived of a sufficient amount of properly functioning red blood cells to carry oxygen throughout the body, white blood cells to fight infection, or platelets to help blood clot and control bleeding. In keeping with the roles that those different types of blood cells play, the first signs of MDS may be anemia, reflecting a low red blood cell count; infections due to inadequate white cells; or abnormal bleeding or bruising arising from having too few platelets. However, MDS may cause no symptoms or only mild symptoms in its early stages, and many people are diagnosed when we investigate surprising findings on blood work ordered as part of a routine wellness check.”
Diagnosing and Categorizing MDS
When a person’s symptoms or blood work raises the possibility of MDS, doctors typically begin their evaluation by taking a detailed history and performing a comprehensive physical examination.
In terms of risk factors that physicians ask about in taking a history, Dr. Abdo-Matkiwsky explains, “Extended exposure to benzene and other chemicals common to the petroleum industry and agricultural work increases a person’s chances of developing MDS, as does having received radiation therapy or certain forms of chemotherapy for prior cancers. Several rare genetic syndromes also are associated with MDS. However, most people diagnosed with the condition do not have those risk factors. Smoking also raises the odds of developing MDS. Age is a consideration, with MDS most often being diagnosed in people in their 70s or 80s. Further, men appear to be at somewhat higher risk than women. Having a close relative who was diagnosed with MDS also is a risk factor.”1
Dr. McLaughlin says that the evaluation of potential MDS generally includes a complete blood count (CBC) and a peripheral blood smear to look for indicators of the condition and to rule out other possible causes. He explains that when MDS is suspected, a bone marrow aspiration and biopsy, in which samples of the marrow are obtained by insertion of a hollow needle, typically at the hip, are critical for obtaining the tissue needed for pathologists to evaluate cells under a microscope and by other means, including sophisticated genetic analyses.
What Happens After MDS Is Detected?
“If MDS is identified, the next step is to draw on the information obtained by evaluating those blood and bone marrow samples to classify the condition,” says Dr. McLaughlin, who treats MDS and other cancerous and benign blood disorders as well as solid tumors in his practice. He explains that the morphology (or microscopic appearance) of blood cells and the presence or absence of various genetic abnormalities, among other factors, enable hematologists and pathologists to assign a risk category to the patient’s MDS and formulate treatment plans accordingly. He adds that the prognosis for MDS varies based on this risk assessment. “The latest statistics shared by the American Cancer Society show that median survival for someone with very low risk disease – as determined by a widely used scoring system – is more than 10 years, while that number drops to 1.7 years for someone with high-risk MDS.2 However, I want to emphasize that these statistics are derived from data gathered over the course of many years. Based on the latest scientific literature and my own clinical experience, I believe that the outlook across the spectrum of MDS has improved considerably just in the last five years or so.”
Treatment Goals and Options for MDS
“The treatment goals for MDS include preserving the patient’s health and quality of life, prolonging life, and reducing the likelihood that the condition will progress to acute myeloid leukemia (AML), which eventually occurs in about one-third of cases,”3 says Dr. Abdo-Matkiwsky. The cancer specialist adds that when a person has low-risk MDS – meaning that the condition is not likely to transform into AML – initial management may be limited to treating the consequences of MDS, such as the anemia that can cause fatigue, the low white cell counts (neutropenia) that increase infection risk, and the low platelet numbers that result in excessive bleeding or bruising. “In these cases, we customize our supportive care to the individual’s specific needs, and can draw on blood transfusions and other interventions, as needed, for anemia and thrombocytopenia, the use of growth factors to increase white cells or platelets, and other approaches,” Dr. Abdo-Matkiwsky adds. Comprehensive care of MDS also involves ensuring that the patient has received all appropriate vaccinations to reduce the risk of developing an infection such as influenza and educating the person to promptly contact his or her primary care physician when antibiotics may be needed to treat an illness, she notes.
When treating MDS itself is indicated based on a person’s risk status or overall health, hematologists can draw on a wide range of therapies to individualize care to optimal effect, says Dr. McLaughlin. “The last several years have seen a significant increase in the number of treatments effective in managing myelodysplastic syndromes,” he notes, explaining that these include hypomethylating agents and other forms of chemotherapy, immunotherapies, and a targeted agent for people whose MDS is marked by a genetic mutation known as IDH1.
“My colleagues and I at RCCA have extensive experience prescribing these agents, recognizing and managing the side effects associated with them, and monitoring patients’ well-being while working in close collaboration with their other physicians. This enables people to receive care in the community, close to their homes. Further, should we determine that a person would benefit from stem cell transplantation, which is the best option for some patients, we work in partnership with our colleagues at the academic medical centers that offer that treatment, providing continuity of care for the patient before, during, and following the procedure,” Dr. McLaughlin says.
Dr. Abdo-Matkiwsky adds, “In recent years, our understanding of MDS and our ability to identify it quickly and treat it effectively have increased dramatically. While it remains a serious disease, both in its own right and due to the risk of progression to AML, people diagnosed with the condition have more options — and more cause for hope — than ever before.
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Dr. Abdo-Matkiwsky and Dr. McLaughlin are among 100+ medical oncologists and hematologists who practice with RCCA at more than 20 locations near you across New Jersey, Connecticut, Massachusetts, Maryland, and the Washington, D.C., area. RCCA’s cancer specialists see more than 30,000 new patients each year and provide care to more than 265,000 established patients, collaborating closely with those patients’ other physicians. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, as well as access to approximately 300 clinical trials. In addition to serving patients who have solid tumors, blood-based cancers, and benign blood disorders, RCCA care centers also provide infusion services to people with a number of non-oncologic conditions—including multiple sclerosis, Crohn’s disease, asthma, iron-deficiency anemia, and rheumatoid arthritis—who take intravenously-administered medications.
To learn more about RCCA, call 844-346-7222 or contact us.
References
- American Cancer Society. Risk Factors for Myelodysplastic Syndromes (MDS). Available at https://www.cancer.org/cancer/types/myelodysplastic-syndrome/causes-risks-prevention/risk-factors.html. Accessed June 11, 2025.
- American Cancer Society. Survival Statistics for Myelodysplastic Syndromes (MDS). Available at https://www.cancer.org/cancer/types/myelodysplastic-syndrome/detection-diagnosis-staging/survival.html. Accessed June 11, 2025.
- The Aplastic Anemia and MDS International Foundation. Acute Myeloid Leukemia (AML). Available at https://www.aamds.org/diseases/acute-myeloid-leukemia-aml. Accessed June 11, 2025.
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Myelodysplastic Syndromes: Facts at a Glance
- Estimates of new cases diagnosed in the U.S. each year range from 10,000 to 20,0001,2
- Most commonly diagnosed in people ages 70 to 79 years1
- More common in men than women3
- Estimates of total number of people in the US with MDS – both newly diagnosed and those with established disease – range from 60,000 to 170,0002
- Risk factors include exposure to benzene and other industrial chemicals, radiation exposure, prior treatment with certain chemotherapies, smoking, several rare genetic conditions, and family history of the disease3
Sources: 1. American Cancer Society. Key Statistics for Myelodysplastic Syndromes (MDS). Available at https://www.cancer.org/cancer/types/myelodysplastic-syndrome/about/key-statistics.html. Accessed June 11, 2025. 2. Leukemia & Lymphoma Society. Myelodysplastic Syndrome (MDS) Research Funded by LLS. Available at https://www.lls.org/research/myelodysplastic-syndrome-mds-research-funded-lls. Accessed June 11, 2025. 3. American Cancer Society. Risk Factors for Myelodysplastic Syndromes (MDS). Available at https://www.cancer.org/cancer/types/myelodysplastic-syndrome/causes-risks-prevention/risk-factors.html. Accessed June 11, 2025.
Regional Cancer Care Associates is one of fewer than 200 medical practices in the country selected to participate in the Oncology Care Model (OCM); a recent Medicare initiative aimed at improving care coordination and access to and quality of care for Medicare beneficiaries undergoing chemotherapy treatment.