Each type of leukemia has its own typical course of treatment, but there are only a few different types of treatment for leukemia. Explore the way each treatment works, how it is given, and what some of the most common side effects are.
Chemotherapy
How Chemotherapy Works: The body naturally replaces normal cells only when cells die, but leukemic cells will divide constantly, which causes a build-up of cancer cells in the body. Chemotherapy drugs kill all rapidly dividing cells in the body, which is both the reason that chemotherapy works and the reason for most of its side effects. The ultimate goal of chemotherapy is to eliminate any visible signs of leukemia cells in the body; this elimination of any detectable signs of cancer is called remission.
How Chemotherapy is Given: Drugs can be given by mouth (orally) in the form of a pill, by injection into a muscle, or by IV directly into a vein. Instead of putting in a new IV for each chemotherapy session, many patients have a long-term IV catheter inserted, more commonly known as a port. Putting the port in is a minor surgical procedure, and it saves the person receiving treatment from a lot of extra needle sticks. Drawing blood for lab work can usually be done through the port as well.
The combination of drugs used will be different for each patient, but the process of chemotherapy is generally the same. Most leukemias are treated initially with inpatient chemotherapy. This is required because of the intensity of the chemotherapy and because hospital staff can administer blood products and antibiotics to inpatients as needed to keep blood counts higher and ward off infections. Chemotherapy is only halted in an inpatient setting if it is not working. Subsequent cycles of maintenance chemotherapy may be done in an outpatient setting after remission has been acheived.
Common Chemotherapy Side Effects: When people think of chemotherapy, they often think of guaranteed hair loss, endless nausea and vomiting, and lots of suffering and discomfort. However, some patients are able to get through chemotherapy without a lot of side effects, while others have a more difficult time. While side effects can be difficult, the benefits of timely and appropriate treatment will usually outweigh the discomfort, though it may not seem like it at the time! Chemotherapy drugs can cause constipation and diarrhea or nausea and vomiting. Too much of these side effects can cause dehydration or weight loss. In the hospital, weight and body functions are monitored closely and side effects treated as they appear, but it's always helpful to be open and honest about how you're feeling, especially when you are in the hospital.
Hair loss is one of the more well-known effects of chemotherapy, and can be one of the most difficult for male and female leukemia sufferers alike. Fortunately, wigs are much more natural looking than they used to be, and free or low-cost wigs can be obtained through wig banks at your cancer treatment center or in your community. Ask your healthcare team for information, resources, and assistance in dealing with treatment-related hair loss.
Radiation Therapy
How it works: External radiation therapy uses highly complex equipment to deliver an appropriate dose of ionizing radiation to specific places in the body to damage the DNA and ultimately kill cancer cells. Normal cells that are near the site being treated may also be damaged by the radiation, but are usually able to recover and continue functioning. Radiation is specifically used in people with leukemia to target leukemic cells in spots that it's difficult to reach with chemotherapy, like the spaces around the brain and spinal cord.
How it's given: Radiation can be given in a variety of ways, but patients usually have fairly similar experiences. The first visit for radiation therapy is longer and the radiation therapy team uses this visit to specifically identify the site to be irradiated (given radiation). Molds and positioners may also be made during this first visit to help the patient hold still in a certain position. After extensive planning on where and how the radiation dose will be delivered, the patient is positioned on a table in the room with the equipment, and technicians operate the equipment from outside the room. Actual radiation therapy sessions usually last only a few minutes, with extra time if a meeting with the radiation oncologist (a doctor specializing in the treatment of cancer with radiation) is needed.
Common Side Effects: Radiation therapy does have some side effects which may or may not be experienced during or after treatment. The most common side effects noticed are very tired feelings (fatigue) or changes in the skin, including dryness, burning, itching, or peeling. Creams or lotions may be prescribed to treat or lessen these effects, but it's important to follow the radiation therapy team's instructions on caring for the skin during and after treatment. Because leukemia patients often undergo whole brain irradiation, hair loss is a possibility as well. There may be other side effects specific to the site that's being treated, and these will be discussed with the person receiving treatment and their caregiver before treatment begins.
