Leukemia Treatment

Leukemia is a type of cancer involving the blood-forming tissues, including the lymphatic system and bone marrow.  There are many types of leukemia.  Some are more prevalent in children, while others are more common in adults.

Leukemia generally involves the white cells of the body.  The white cells are strong infection fighters in the body.  They grow and divide in a methodical way, just as the patient’s body needs them.  In those people with leukemia, the bone marrow makes abnormal white cells that don’t work properly. 

The treatment for leukemia can be complicated and depends on the kind of leukemia the patient has.  There are resources and strategies that can help make the treatment for leukemia successful. The major goal of the treatment for leukemia is to get rid of the leukemia cells and help normal cells grow in the patient’s bone marrow.  Treatment is based on the type of leukemia the patient has, its stage and the patient’s general health.

The treatment for acute lymphoblastic leukemia or ALL has three steps, including the following:

• Induction therapy. This kills the leukemia cells in the bone marrow and blood in order to cause remission.  The treatment includes corticosteroids and chemotherapy.  Induction therapy generally lasts four weeks and is done when the patient is hospitalized.  Some people with acute lymphoblastic leukemia have cells that have a hereditary change in them.  This hereditary change involves a gene known as the Philadelphia chromosome.  It is generally treated with a tyrosine kinase inhibitor.
• Consolidation Therapy. This involves killing any leukemia cells that may be in the bone marrow even though they aren’t seen in blood testing.  If these cells grow again, they could result in a relapse.  Treatments involve chemotherapy and may also include giving the patient a stem cell transplant.  This may also include preventative treatment of the spinal cord and brain using chemotherapy or radiotherapy.  This phase usually takes many months but the patient doesn’t need to stay in the hospital.
• Maintenance Therapy. This involves preventing any leftover leukemia cells from growing.  It may be done using low dose chemotherapy—lower than is seen in the induction phase or the consolidation phase.  Chemotherapy is generally given using pills as well as IV treatments given once per month.  This phase is often continued for as many as three years; however, during this time, most patients are able to return to being as active as they were prior to treatment.

When there is no evidence of leukemia for five years, the individual is generally considered to be cured of the disease.  If the leukemia doesn’t enter remission or if it comes back after a few years, the treatment usually involves giving more chemotherapy, doing a stem cell transplant, or entering a clinical trial.

Prior to treatment for leukemia, the patient needs to see their primary care physician if they have any signs or symptoms that might be related to having leukemia.  If the patient’s doctor suspects they have leukemia, they may refer the patient to a hematologist, who is a doctor who specializes in blood diseases and bone marrow diseases.

Because appointments can be short and because there is a lot to talk about, the patient should be prepared by providing a list of questions for the doctor.  They also need to quit smoking at least two weeks before being treated for leukemia because smoking can interfere with healing.  Smoking should be stopped during treatment as well.

The patient need to be aware of any restrictions the doctor is placing on them.  At the time of the first appointment, the patient needs to be aware of anything they need to do in advance of the treatment, such as changing their diet.  The patient should write down any symptoms they have, including those symptoms that may be unrelated to the reason why they have the appointment. 

The patient should also list personal information, including any recent life changes or major stressors going on.  All medications should be listed as well.  This includes any medicines, supplements, or vitamins they are taking.  They need to consider taking a family member along with them to the appointment as it can be difficult to recall all the material given during the appointment.  The person who comes along may remember something the patient forgot. 

Treatment for leukemia is done to remove any cancerous white blood cells from the patient’s bloodstream.  This can be done using chemotherapy treatments or stem cell transplants. 

After the surgery, the patient needs to make healthier lifestyle choices.  They need to focus on their health in ways that they may not have done in the past.  They need to think about which things they need to do in order to stay healthy.  They may try to get more exercise or eat better.  They may need to reduce their alcohol consumption and should give up smoking.  They need to control their stress levels.  This is a good time for the patient to think about making lifestyle changes that have a positive effect on the rest of their lives.

Eating properly can be difficult for anyone but it can be harder after treatment for leukemia.  The chemotherapy may change their sense of taste and there may be problems with nausea. They may not feel like eating and may lose some weight.  Some people can gain weight after leukemia treatment.  These things can be extremely frustrating.

If problems with taste or eating occur, the patient needs to remember that these things go away over time.  They may find it helpful to eat smaller portions of food every two to three hours until they feel better.  They may want to ask their treatment team about seeing a nutritionist, who can help them learn how to eat better after leukemia treatment. 

Patients can have difficulty with extreme fatigue after leukemia treatment.  This is extremely common.  It is not a normal kind of fatigue, but is instead an exhaustion that doesn’t improve with resting.  For some people, this stage lasts quite a while after cancer treatment and can make it difficult for them to participate in activities of daily living.  Exercise can help reduce this kind of fatigue. The patient needs to follow an exercise program that can help then overcome their fatigue.