TREATMENT & MANAGEMENT

Chemotherapy

Chemotherapy may be given as pills or by injection. Chemotherapy drugs interfere with the ability of cancer cells to grow and spread, but they also damage healthy cells. Although healthy cells can recover over time, you may experience side effects from your treatment like nausea, vomiting, loss of appetite, fatigue, hair loss and an increased risk of infection. 

Stem cell transplant

Sometimes high doses of chemotherapy are used to treat leukemia that has come back or if there is a high risk that it may come back. High-dose chemotherapy destroys the bone marrow cells as well as the leukemia cells, so the bone marrow will need to be replaced with a transplant of stem cells. All blood cells develop from stem cells found in the bone marrow and in the bloodstream. 

Before high-dose chemotherapy is given, stem cells will be taken from you or from a donor whose bone marrow is a close match to your own. Soon after the chemotherapy treatment, the stem cells are put back into your blood. Within a few weeks, the new stem cells will start to make blood cells.

A stem cell transplant is a very and complex procedure. For this reason, stem cell transplants are done in specialized transplant centres or hospitals by a team of highly trained healthcare professionals. Side effects can be very serious and may even be life-threatening. You will be watched very closely after a stem cell transplant and carefully followed up for a period of time after leaving the hospital. It may take several months to fully recover after a stem cell transplant.

Radiation therapy

In external beam radiation therapy, a large machine is used to carefully aim a beam of radiation. The radiation damages the cells in the path of the beam – normal cells as well as cancer cells. Radiation side effects will be different depending on what part of the body receives the radiation. You may feel more tired than usual, have some diarrhea, or notice changes to the skin (it may be red or tender) where the treatment was given.

Radiation may be used for some types of leukemia to treat the disease or prevent it from spreading. If you need a stem cell transplant, you may also be given radiation to the whole body to destroy the bone marrow cells. This is called total body irradiation.

Biological therapy

Biological therapy uses your immune system to fight cancer or to help control side effects of other cancer treatments. Natural body substances or drugs made from natural body substances are used to boost the body’s own defences against illness.

There are two forms of biological therapy used to treat leukemia: monoclonal antibodies and interferon alfa. Both are given by injection. Monoclonal antibodies are sometimes used to treat people with CLL, ALL and AML. Interferon alfa may also be used for CML (although people with CML are more likely to be treated with cancer growth inhibitors). Side effects of these drugs often cause flu-like symptoms, such as chills, fever, muscle aches, weakness and nausea. More serious side effects are rare. Some people may have a severe skin rash, breathing problems or low blood pressure. The side effects usually disappear once treatment is finished. Be sure to discuss the risks and benefits of this treatment with your healthcare team.

Targeted therapy

Targeted therapies use drugs that attack specific types of cancer cells without damaging healthy cells. Cancer growth inhibitors are a type of targeted therapy. They interfere with a cancer cell’s ability to grow and divide. Some cancer growth inhibitors can be used to treat people with CML, ALL and AML. These drugs are taken by pill or capsule. Side effects are most likely to occur during the first few months of treatment. Side effects may get better as treatment continues.

Watchful waiting

Watchful waiting is a treatment option that may be offered to people with CLL who have no symptoms. Watchful waiting means your healthcare team will watch the leukemia closely. You will visit your doctor regularly for a physical examination. Other tests may be done from time to time. Active treatment, such as chemotherapy or radiation, may be considered if signs of leukemia appear or change. Once the symptoms are controlled, you and your doctor may decide to return to a watchful waiting program.

Surgery

Surgery is rarely used to treat chronic leukemia, but some people with chronic leukemia will need to have their spleen removed. The spleen is located in the abdomen and is attached to the stomach, left kidney and colon. In chronic leukemia, the spleen may become enlarged. An enlarged spleen can cause discomfort and pain. It also destroys red blood cells and platelets, causing anemia and bleeding. If chemotherapy or radiation doesn't shrink the spleen, then it may be removed by surgery. Surgery to remove the spleen is called splenectomy. It is done under general anesthetic (you will be unconscious).
After surgery you may have some pain or bleeding. These side effects are temporary, and can usually be controlled. Without a spleen, you may be more at risk of infections.

Side Effects of treatment

Relieving Pain

Learn more about ways to manage and control your pain and discomfort, side effects and stress when you are having cancer treatments.

Coping with Cancer

Everyone’s cancer experience is different. Whether you are newly diagnosed, in active treatment, or are caring for someone with cancer, you will probably need to deal with many day-to-day issues, make tough decisions, and cope with a range of emotions.

Long-term monitoring

Growth factors may be used in order to decrease the length of neutropenia following chemotherapy in patients with (chronic lymphoid leukemia, CLL).