Introduction
What Is Leukemia?
Normal Blood Cells
Leukemia Cells
Types of Leukemia
Leukemia: Who’s at Risk?
Symptoms
Diagnosis
Treatment
Getting a Second Opinion
Preparing for Treatment
Methods of Treatment
Chemotherapy
Biological Therapy
Radiation Therapy
Stem Cell Transplantation
Side Effects of Cancer Treatment
Chemotherapy
Biological Therapy
Radiation Therapy
Stem Cell Transplantation
Supportive Care
Nutrition
Followup Care
Support for People with Leukemia
The Promise of Cancer Research
National Cancer Institute Booklets
National Cancer Institute Information Resources
Introduction
This
National Cancer Institute (NCI) booklet (NIH Publication No. 02-3775) has important information about
leukemia,* cancer that starts
in blood cells. Each year, leukemia is diagnosed in about 29,000 adults
and 2,000 children in the United States.
This
booklet discusses possible causes, symptoms, diagnosis, treatment, and followup
care. It also has information to help
people with leukemia and their families cope with the disease.
Research
is increasing what we know about leukemia.
Scientists are studying its causes.
They are also finding better ways to treat this disease. Because of research, adults and children
with leukemia can look forward to a better quality of life and less chance of
dying from the disease.
Information specialists at the NCI's
Cancer Information Service 1
at 1-800-4-CANCER can
answer questions about cancer and can send NCI materials. Many NCI publications
and fact sheets can be viewed on the Internet at
http://www.cancer.gov/publications. People in the United States and its territories
may use this Web site to order publications.
This Web site also explains how people outside the United States can
mail or fax their requests for NCI publications.
*Words that may be new to readers appear in italics.
The Dictionary 2 section explains these terms. Some
words in the “Dictionary” have a “sounds-like”
spelling to show how to pronounce them.
What Is Leukemia?
Leukemia is a type of cancer.
Cancer is a group of many related diseases.
All cancers begin in cells,
which make up blood and other
tissues.
Normally, cells grow and divide to form new cells as the body needs
them. When cells grow old, they die,
and new cells take their place.
Sometimes
this orderly process goes wrong. New
cells form when the body does not need them, and old cells do not die when they
should. Leukemia is cancer that begins
in blood cells.
Normal Blood Cells
Blood cells form
in the bone marrow. Bone
marrow is the soft material in
the center of most bones.
Immature blood cells are called
stem cells and
blasts. Most blood cells
mature in the bone marrow and then move into the
blood vessels. Blood
flowing through the blood vessels and heart is called the
peripheral blood.
Picture of blood cells maturing from stem cells.
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The bone marrow makes different types of blood cells. Each type has a special function:
Leukemia Cells
In people with leukemia, the
bone marrow produces abnormal white blood cells. The abnormal cells are
leukemia cells. At first, leukemia cells function almost normally. In time,
they may crowd out normal white blood cells, red blood cells, and platelets.
This makes it hard for blood to do its work.
Types of Leukemia
The
types of leukemia are grouped by how quickly the disease develops and gets
worse. Leukemia is either chronic
(gets worse slowly) or acute
(gets worse quickly):
Chronic
leukemia—Early in the disease, the abnormal blood cells can
still do their work, and people with chronic leukemia may not have any symptoms. Slowly, chronic leukemia gets worse. It causes symptoms as the number of leukemia
cells in the blood rises.
Acute
leukemia—The blood cells are very
abnormal. They cannot carry out their normal
work. The number of abnormal cells
increases rapidly. Acute leukemia
worsens quickly.
The types of leukemia are also grouped by the type of
white blood cell that is affected. Leukemia can arise in
lymphoid
cells or myeloid
cells. Leukemia that affects lymphoid cells is called
lymphocytic
leukemia. Leukemia that affects
myeloid cells is called myeloid leukemia or
myelogenous
leukemia.
There are four common types of leukemia:
Hairy
cell leukemia is a rare type of chronic leukemia. This booklet does not deal with hairy cell
leukemia or other rare types of leukemia.
Together, these rare leukemias account for about 5,200 new cases of
leukemia each year. The Cancer
Information Service (1-800-4-CANCER) can provide information about these types
of leukemia.
Leukemia: Who’s at Risk?
No one knows the exact causes of leukemia. Doctors can seldom
explain why one person gets this disease and another does not. However, research has shown that people with
certain risk
factors are more likely than others to develop leukemia. A risk factor is anything that increases a
person’s chance of developing a disease.
Studies have found the following risk factors for leukemia:
Very high levels
of radiation—People
exposed to very high levels of radiation are much more likely than others to
develop leukemia. Very high levels of
radiation have been caused by atomic bomb explosions (such as those in Japan
during World War II) and nuclear power plant
accidents (such as the Chernobyl [also called Chornobyl] accident in
1986).
Medical treatment that uses radiation can be another source of high-level
exposure. Radiation used for diagnosis, however, exposes people to much
lower levels of radiation and is not linked to leukemia.
Working with certain chemicals—Exposure to high levels of benzene
in the workplace can cause leukemia.
Benzene is used widely in the chemical industry. Formaldehyde
is also used by the chemical industry.
Workers exposed to formaldehyde also may be at greater risk of leukemia.
Chemotherapy—Cancer patients treated with certain cancer-fighting
drugs sometimes later develop leukemia.
For example, drugs known as alkylating agents are associated
with the development of leukemia many years later.
Down syndrome and certain other genetic diseases—Some diseases
caused by abnormal chromosomes may increase the risk of
leukemia.
Human T-cell leukemia virus-I
(HTLV-I)—This virus causes a rare type of chronic
lymphocytic leukemia known as human T-cell leukemia. However,
leukemia does not appear to be contagious.
Myelodysplastic syndrome—People with this blood
disease are at increased risk of developing acute myeloid leukemia.
In the past, some studies suggested exposure to
electromagnetic fields as
another possible risk factor for leukemia.
Electromagnetic fields are a type of low-energy radiation that comes
from power lines and electric appliances.
However, results from recent studies show that the evidence is weak for
electromagnetic fields as a risk factor.
Most
people who have known risk factors do not get leukemia. On the other hand, many who do get the
disease have none of these risk factors.
People who think they may be at risk of leukemia should discuss this
concern with their doctor. The doctor may
suggest ways to reduce the risk and can plan an appropriate schedule for
checkups.
Symptoms
Like all blood cells, leukemia cells travel through the body. Depending
on the number of abnormal cells and where these cells collect, patients
with leukemia may have a number of symptoms.
Common symptoms of leukemia may include:
Fevers or night sweats
Frequent infections
Feeling weak or tired
Headache
Bleeding and bruising easily
(bleeding gums, purplish patches in the skin, or tiny red spots under the skin)
Pain in the bones or joints
Swelling or discomfort in the
abdomen
(from an enlarged spleen)
Swollen lymph nodes, especially in
the neck or armpit
Weight loss
Such symptoms are not sure signs of leukemia.
An infection or another problem also could cause
these symptoms. Anyone with these symptoms should see
a doctor as soon as possible. Only a
doctor can diagnose and treat the problem.
In the early stages of chronic leukemia, the leukemia cells function
almost normally. Symptoms may not
appear for a long time. Doctors often
find chronic leukemia during a routine checkup—before there are any
symptoms. When symptoms do appear, they
generally are mild at first and get worse gradually.
In acute leukemia, symptoms appear and get worse quickly. People
with this disease go to their doctor
because they feel sick. Other symptoms
of acute leukemia are vomiting, confusion,
loss of muscle control, and seizures.
Leukemia cells also can collect in the testicles
and cause swelling. Also, some patients develop sores in the
eyes or on the skin. Leukemia also can
affect the digestive tract,
kidneys, lungs,
or other parts of the body.
Diagnosis
If a person has symptoms that suggest leukemia, the doctor may do a
physical exam and ask about the patient's personal and family medical
history. The doctor also may order laboratory tests, especially blood
tests.
The exams and tests may include the following:
Physical exam—The doctor checks for swelling of the
lymph nodes,
spleen,
and liver.
Blood tests—The lab checks the level of blood
cells. Leukemia causes a very high
level of white blood cells. It also
causes low levels of platelets and hemoglobin,
which is found inside red blood cells. The lab also may check the blood for signs
that leukemia has affected the liver and kidneys.
Biopsy—The
doctor removes some bone marrow from the hipbone or another large
bone. A pathologist
examines the sample under a microscope. The removal of tissue to
look for cancer cells is called a biopsy.
A biopsy is the only sure way to know whether leukemia cells are in
the bone marrow.
There are two ways the doctor can obtain bone marrow. Some patients
will have both procedures:
Local anesthesia helps to make the patient more
comfortable.
Cytogenetics—The lab looks at the chromosomes of
cells from samples of peripheral blood, bone marrow, or lymph nodes.
Spinal tap—The doctor removes some of the cerebrospinal
fluid (the fluid that fills the spaces in and around the brain and
spinal cord). The doctor uses a long,
thin needle to remove fluid from the spinal column. The procedure takes about 30 minutes and is performed with local
anesthesia. The patient must lie flat
for several hours afterward to keep from getting a headache. The lab checks the fluid for leukemia cells
or other signs of problems.
Chest x-ray—The x-ray can reveal signs of disease in the chest.
A person who needs a bone marrow aspiration or bone
marrow biopsy may want to ask the doctor the following questions:
Will you remove the sample of bone marrow from the
hip or from another bone?
How long will the procedure take? Will I be awake? Will it hurt?
How soon will you have the results? Who will explain them to me?
If I do have leukemia, who will talk to me about
treatment? When?
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Treatment
Many people with leukemia want to take an active part in
making decisions about their medical care.
They want to learn all they can about their disease and their treatment
choices. However, the shock and stress
after a diagnosis of cancer can make it hard to think of everything to ask the
doctor. Often it helps to make a list
of questions before an appointment. To
help remember what the doctor says, patients may take notes or ask whether they
may use a tape recorder. Some also want
to have a family member or friend with them when they talk to the doctor—to
take part in the discussion, to take notes, or just to listen.
The
doctor may refer patients to doctors who specialize in treating leukemia, or
patients may ask for a referral.
Specialists who treat leukemia include
hematologists,
medical oncologists, and
radiation oncologists.
Pediatric
oncologists and hematologists treat childhood leukemia.
Whenever possible, patients should
be treated at a medical center that has doctors experienced in treating
leukemia. If this is not possible, the
patient’s doctor may discuss the treatment plan with a specialist at such a
center.
Getting a Second Opinion
Sometimes
it is helpful to have a second opinion about the diagnosis and the treatment
plan. Some insurance companies require
a second opinion; others may cover a second opinion if the patient or doctor
requests it. There are a number of ways
to find a doctor for a second opinion:
The patient’s doctor may be
able to suggest a doctor who specializes in adult or childhood leukemia. At cancer centers, several specialists often
work together as a team.
The Cancer Information Service, at 1-800-4-CANCER, can
tell callers about nearby treatment centers.
A local or state medical society, a nearby hospital, or a
medical school can usually provide the names of specialists.
The American Board of Medical Specialties (ABMS) has a list of doctors who have met certain education and training requirements and have passed specialty examinations. The Official ABMS Directory of Board Certified Medical Specialists lists doctors' names along with their specialty and their educational background. The directory is available in most public libraries. Also, ABMS offers this information on the Internet at http://www.abms.org. (Click on "Who's Certified.")
Preparing for Treatment
The
doctor can describe treatment choices and discuss the results expected with
each treatment option. The doctor and
patient can work together to develop a treatment plan that fits the patient’s
needs.
Treatment
depends on a number of factors, including the type of leukemia, the patient’s
age, whether leukemia cells are present in the cerebrospinal fluid, and whether
the leukemia has been treated before.
It also may depend on certain features of the leukemia cells. The doctor also takes into consideration the
patient’s symptoms and general health.
These
are some questions a person may want to ask the doctor before treatment
begins:
What type of leukemia do I have?
What
are my treatment choices? Which do
you recommend for me? Why?
What
are the benefits of each kind of treatment?
What are the risks and possible
side effects
of each treatment?
If I
have pain, how will you help me?
What is the treatment likely to cost?
How
will treatment affect my normal activities?
Would a
clinical
trial (research study) be appropriate for me? Can you help me find one?
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People
do not need to ask all of their questions or understand all of the answers at
one time. They will have other chances
to ask the doctor to explain things that are not clear and to ask for more
information.
Methods of Treatment
The doctor is the best person to describe the treatment choices and discuss
the expected results. Depending on the type and extent of the disease, patients may have chemotherapy,
biological therapy,
radiation therapy, or
bone marrow transplantation.
If the patient’s spleen is enlarged, the doctor may suggest surgery
to remove it. Some patients receive a combination of treatments.
People with acute leukemia need to be treated right away. The goal of
treatment is to bring about a remission.
Then, when signs and symptoms disappear, more therapy may be given to prevent
a relapse. This type of therapy
is called maintenance therapy. Many people with acute leukemia
can be cured.
Chronic leukemia patients who do not have symptoms may not require
immediate treatment. The doctor may suggest
watchful waiting
for some patients with chronic lymphocytic leukemia. The health care
team will monitor the patient’s health so that treatment can
begin if symptoms occur or worsen. When treatment for chronic leukemia is
needed, it can often control the disease and its symptoms. However,
chronic leukemia can seldom be cured. Patients may receive maintenance
therapy to help keep the cancer in remission.
A patient may want to talk to the doctor about taking part in a
clinical trial, a research study of new treatment methods. The section
on “The Promise of Cancer Research 3” has more information
about clinical trials.
In addition to anticancer therapy, people with leukemia may have
treatment to control pain and other symptoms of the cancer, to relieve
the side effects of therapy, or to ease emotional problems.
This kind of treatment is called symptom management,
supportive care,
or palliative care.
Chemotherapy
Most patients with leukemia receive chemotherapy. This type of
cancer treatment uses drugs to kill leukemia cells. Depending on
the type of leukemia, the patient may receive a single drug or a
combination of two or more drugs.
People
with leukemia may receive chemotherapy in several different ways:
By mouth
By injection directly into a vein
(IV or intravenous)
Through a catheter (a thin,
flexible tube) placed in a large vein, often in the upper chest—A
catheter that stays in place is useful for patients who need many IV
treatments. The health care professional injects drugs into the catheter,
rather than directly into a vein. This method avoids the need for many
injections, which can cause discomfort and injure the veins and skin.
By injection directly into the cerebrospinal fluid—If the
pathologist finds leukemia cells in the fluid that fills the spaces in
and around the brain and spinal cord, the doctor may order
intrathecal chemotherapy.
The doctor injects drugs directly into the cerebrospinal fluid. This method is
used because drugs given by IV injection or taken by mouth often do not reach
cells in the brain and spinal cord. (A network of blood vessels filters blood
going to the brain and spinal cord. This
blood-brain barrier stops
drugs from reaching the brain.)
The patient may receive the drugs in two ways:
Injection into the spine:
The doctor injects the drugs into the lower part of the spinal column.
Ommaya reservoir:
Children and some adult patients receive intrathecal chemotherapy
through a special catheter called an Ommaya reservoir. The doctor
places the catheter under the
scalp. The doctor injects the
anticancer drugs into the catheter.
This method avoids the discomfort of injections into the spine.
Patients
receive chemotherapy in cycles: a
treatment period, then a recovery period, and then another treatment
period. In some cases, the patient has
chemotherapy as an outpatient at the hospital, at the doctor’s
office, or at home. However, depending on which drugs
are given, and the patient’s general health, a hospital stay
may be necessary.
Some
people with chronic myeloid leukemia receive a new type of treatment called
targeted therapy. Targeted therapy blocks the production of
leukemia cells but does not harm normal cells.
Gleevec, also called STI-571, is the first targeted therapy approved for
chronic myeloid leukemia.
Biological Therapy
People with some types of leukemia have biological therapy. This
type of treatment improves the body’s natural defenses
against cancer. The therapy is given by injection into a vein.
For some patients with chronic lymphocytic leukemia,
the type of biological therapy used is a
monoclonal antibody.
This substance binds to the leukemia cells. This therapy enables the
immune system to kill leukemia cells in the blood and bone
marrow.
For some patients with chronic myeloid leukemia, the biological
therapy is a natural substance called
interferon. This
substance can slow the growth of leukemia cells.
Patients may want to ask these questions about
chemotherapy or biological therapy:
Why do I need this treatment?
What drugs will I get?
Should I see my dentist before treatment begins?
What will the treatment do?
Will I have to stay in the hospital?
How will we know the drugs are working?
How long will I be on this treatment?
Will I have side effects
during treatment? How long will
they last? What can I do about
them?
Can these drugs cause side effects later on?
How often will
I need checkups?
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Radiation Therapy
Radiation
therapy (also called radiotherapy) uses high-energy rays to kill leukemia
cells. For most patients, a large
machine directs radiation at the spleen, the brain, or other parts of the body
where leukemia cells have collected.
Some patients receive radiation that is directed to the whole body.
(Total-body irradiation usually
is given before a bone marrow transplant.)
Patients receive radiation therapy at a hospital or clinic.
These are some questions a person may want to ask the
doctor before having radiation therapy:
Why do I need this treatment?
When will the treatments
begin? How often will they be
given? When will they end?
How will I feel during
therapy? Will there be side
effects? How long will they
last? What can we do about them?
Can radiation therapy cause side effects later on?
What can I do to take care of myself during therapy?
How will we know if the radiation is working?
Will I be able to continue my normal activities during
treatment?
How often will
I need checkups?
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Stem Cell Transplantation
Some patients with leukemia have
stem cell transplantation. A stem cell transplant allows a patient to
be treated with high doses of drugs, radiation, or both. The high doses destroy both leukemia cells
and normal blood cells in the bone marrow.
Later, the patient receives healthy stem cells through a flexible
tube that is placed in a large vein in the neck or chest area. New blood cells
develop from the transplanted stem cells.
There are several types of stem cell transplantation:
Stem cells may come from the patient or from a donor:
Autologous stem cell transplantation—This
type of transplant uses the patient’s own stem cells.
The stem cells are removed from the patient, and the cells may be
treated to kill any leukemia cells present.
The stem cells are frozen and stored.
After the patient receives high-dose chemotherapy or radiation therapy,
the stored stem cells are thawed and returned to the patient.
Allogeneic stem cell transplantation—This
type of transplant uses healthy stem cells from a
donor. The patient's brother,
sister, or parent may be the donor.
Sometimes the stem cells come from an unrelated donor. Doctors use blood
tests to be sure the donor’s cells match the patient’s cells.
Syngeneic stem cell transplantation—This type
of transplant uses stem cells from the patient’s
healthy identical twin.
After a stem cell
transplant, patients usually stay in the hospital for several weeks. The health care team protects patients from
infection until the transplanted stem cells begin to produce enough white blood
cells.
These are some questions a
person may want to ask the doctor before having a stem cell transplant:
What kind of stem cell transplant will I have? If I need a donor, how will we find one?
How long will I be in the hospital? What care will I need when I leave the
hospital?
How will we know if the treatment is working?
What are the risks and the side effects? What can we do about them?
What changes in normal activities will be
necessary?
What is my chance of a full recovery? How long will that take?
How often will I need checkups?
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Side Effects of Cancer Treatment
Because
cancer treatment may damage healthy cells and tissues, unwanted side effects
are common. Specific side effects
depend on many factors, including the type and extent of the treatment. Side effects may not be the same for each
person, and they may even change from one treatment session to the next. Before treatment starts, health care
providers will explain possible side effects and suggest ways to manage them.
The NCI provides helpful booklets about cancer treatments and coping
with side effects, such as
Chemotherapy and You 4,
Radiation Therapy and You 5, and
Eating Hints for Cancer Patients 6.
See the “National Cancer Institute Information Resources 7”
section for other sources of information about side effects. NCI’s
Web site includes a section called “Coping with Cancer” at
http://www.cancer.gov/cancertopics/coping.
This section presents information about
coping with fatigue, pain, and other problems.
Chemotherapy
The side effects of chemotherapy
depend mainly on the specific drugs and the dose. In general,
anticancer drugs affect cells that divide rapidly,
especially leukemia cells. Chemotherapy
can also affect other rapidly dividing cells:
Blood cells:
These cells fight infection, help the blood to clot, and carry oxygen to
all parts of the body. When blood cells
are affected, patients are more likely to get infections, may bruise or bleed
easily, and may feel very weak and tired.
Cells in hair roots: Chemotherapy can lead to hair loss. The hair grows back, but the new hair may be somewhat different
in color and texture.
Cells that line the digestive tract: Chemotherapy can cause mouth and lip sores,
nausea and vomiting, diarrhea, and poor appetite. Many of these side effects can be controlled with drugs.
Some
anticancer drugs can affect a patient’s
fertility. Women may have irregular menstrual periods or periods may stop
altogether. Women may have symptoms of
menopause, such as hot flashes and
vaginal dryness. Men may stop producing
sperm. Because these changes may be
permanent, some men have their sperm frozen and stored before treatment. Most children treated for leukemia appear to
have normal fertility when they grow up.
However, depending on the drugs and doses used and the age of the
patient, some boys and girls may be infertile
when they mature.
Because
targeted therapy (sometimes used for chronic myeloid leukemia) affects only leukemia cells, it causes fewer side effects
than most other anticancer drugs.
However, Gleevec may cause patients to retain water. This may cause swelling or bloating.
Biological Therapy
The
side effects of biological therapy differ with the types of substances used,
and from patient to patient. Rashes or
swelling where the biological therapy is injected are common. Flu-like symptoms also may occur. The health care team may monitor the blood
for signs of anemia
and other problems.
Radiation Therapy
Radiation
therapy may cause patients to become very tired as treatment continues. Resting is important, but doctors usually
advise patients to try to stay as active as they can. In addition, when patients receive radiation therapy, it is
common for their skin to become red, dry, and tender in the treated area. Other side effects depend on the area of the
body that is treated. If chemotherapy
is given at the same time, the side effects may be worse. The doctor can suggest ways to ease these
problems.
Stem Cell Transplantation
Patients
who have stem cell transplantation face an increased risk of infection,
bleeding, and other side effects because of the large doses of chemotherapy and
radiation they receive. In addition,
graft-versus-host disease
(GVHD) may occur in patients who receive stem cells from a donor’s bone
marrow. In GVHD, the donated stem cells
react against the patient’s tissues.
Most often, the liver, skin, or digestive tract is affected. GVHD can be mild or very severe. It can occur any time after the transplant,
even years later. Steroids or other drugs may
help.
The NCI offers a fact sheet called
“Questions and Answers About Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation 8.”
It is available on the Internet at
http://www.cancer.gov/publications. Also,
information specialists at the NCI's Cancer Information Service at
1-800-4-CANCER can send this fact sheet and
answer questions about stem cell transplantation.
Supportive Care
Leukemia and its treatment can lead to other health
problems. Patients receive supportive care to prevent or control
these problems and to improve their comfort and
quality of life during
treatment.
Because people with leukemia get infections very easily,
they may receive antibiotics and other drugs to help protect them from
infections. The health care team may
advise them to stay away from crowds and from people with colds and other
contagious diseases. If an infection
develops, it can be serious and should be treated promptly. Patients may need to stay in the hospital
for treatment.
Anemia
and bleeding are other problems that often require supportive care. Patients may need transfusions of red blood
cells to help them have more energy.
Platelet transfusions can help reduce the risk of serious bleeding.
Dental
care also is very important. Leukemia
and chemotherapy can make the mouth sensitive, easily infected, and likely to
bleed. Doctors often advise patients to
have a complete dental exam and, if possible, undergo needed dental care before
chemotherapy begins. Dentists show
patients how to keep their mouth clean and healthy during treatment.
Nutrition
Patients need to eat well during cancer
therapy. They need enough calories to
maintain a good weight and protein to keep up strength. Good nutrition often helps people with cancer
feel better and have more energy.
But eating well can be
difficult. Patients may not feel like
eating if they are uncomfortable or tired.
Also, the side effects of treatment, such as poor appetite, nausea, or vomiting,
can be a problem. Foods may taste
different.
The doctor, dietitian, or other
health care provider can suggest ways to maintain a healthy diet. Patients and their families may want to read
the National Cancer Institute booklet
Eating Hints for Cancer Patients 6,
which contains many useful ideas and recipes.
The “National Cancer Institute Booklets 9” section
tells how to get this publication.
Followup Care
Followup care after treatment for
leukemia is an important part of the overall treatment plan. Regular checkups ensure that any changes in
health are noted. The doctor can find
problems and treat them as soon as possible.
Checkups may include a careful physical exam, blood tests, x-rays, bone
marrow aspiration, or spinal tap. The
doctor can explain the followup plan—how often the patient must visit the doctor
and what tests are needed.
The NCI has
prepared a booklet for people who have completed their treatment to help answer
questions about followup care and other concerns.
Facing Forward Series: Life After Cancer Treatment 10
provides tips for getting the most out
of medical visits. It describes the
kinds of help people may need.
Support for People with Leukemia
Living
with a serious disease such as leukemia is not easy. Some people find they need help coping with the emotional and
practical aspects of their disease.
Support groups can help. In
these groups, patients or their family members get together to share what they
have learned about coping with the disease and the effects of treatment. Patients may want to talk with a member of
their health care team about finding a support group. Groups may offer support in person, over the telephone, or on the
Internet.
People
living with cancer may worry about caring for their families, keeping their
jobs, or continuing daily activities.
Concerns about treatments and managing side effects, hospital stays, and
medical bills are also common. Doctors,
nurses, and other members of the health care team can answer questions about
treatment, working, or other activities.
Meeting with a social worker, counselor, or member of the clergy can be
helpful to those who want to talk about their feelings or discuss their
concerns. Often, a social worker can
suggest resources for financial aid, transportation, home care, or emotional
support.
The
Cancer Information Service can provide information to help patients and their
families locate programs, services, and publications.
The Promise of Cancer Research
Doctors all over the country are conducting many types of clinical
trials. These are research studies in which people take part
voluntarily. Studies include new
methods of treatment and supportive care for patients with leukemia. Research already has led to advances, and
researchers continue to search for more effective approaches.
Patients who join these studies have the first chance to
benefit from treatments that have shown promise in earlier research. They also make an important contribution to
medical science by helping doctors learn more about the disease. Although clinical trials may pose some
risks, researchers take very careful steps to protect their patients.
Researchers
are testing new biological therapies and new anticancer drugs, doses, and
treatment schedules. They also are
working with various drugs and with combinations of drugs, biological therapy,
radiation therapy, and stem cell transplantation.
Patients who are interested in being part of a clinical
trial should talk with their doctor.
They may want to read the NCI booklet Taking Part in Cancer Treatment Research Studies 11. It explains how clinical trials are carried out and explains their possible benefits and risks.
NCI’s Web site includes a section on clinical trials at
http://www.cancer.gov/clinicaltrials.
This section of the Web site provides
general information about clinical trials.
It also offers detailed information about ongoing studies of leukemia
treatment. The Cancer Information
Service at 1-800-4-CANCER can answer questions and provide information
about clinical trials.
National Cancer Institute Booklets
National Cancer Institute (NCI)
publications can be ordered by writing to the address below, and some can be
viewed and downloaded from http://www.cancer.gov/publications on
the Internet.
Publications Ordering Service
National Cancer Institute
Suite 3036A
6116 Executive Boulevard, MSC 8322
Bethesda, MD 20892-8322
In addition, people in the United
States and its territories may order these and other NCI booklets by calling
the Cancer Information Service at 1-800-4-CANCER. They may also order many NCI publications on-line at http://www.cancer.gov/publications.
See the complete index of What You Need To Know About Cancer 12 publications.
Booklets About Cancer Treatment
Booklets About Living With Cancer
National Cancer Institute Information Resources
You may want more information for yourself, your family, and your doctor. The following National Cancer Institute (NCI) services are available to help you.
Cancer Information Service 1 (CIS)
Provides accurate, up-to-date information on cancer to patients and their families, health professionals, and the general public. Information specialists translate the latest scientific information into understandable language and respond in English, Spanish, or on TTY equipment.
Toll-free: 1-800-4-CANCER (1-800-422-6237)
TTY (for deaf and hard of hearing callers): 1-800-332-8615
The NCI's Cancer.gov Web site provides information from numerous
NCI sources. It offers current information on cancer prevention, screening,
diagnosis, treatment, genetics, supportive care, and ongoing clinical trials.
It also provides information about NCI's research programs and funding
opportunities, cancer statistics, and the Institute itself. Cancer.gov can be accessed at
http://www.cancer.gov on the Internet.
Cancer.gov also provides live, online assistance through LiveHelp.
Information specialists are available Monday through Friday from 9:00 AM
to 10:00 PM Eastern Time. LiveHelp is at
http://www.cancer.gov on the Internet.
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