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 diving 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 women may consider harvesting ova (eggs) and 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.
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.
Radiation therapy may cause patients to become very tired as treatment continues. Resting is important, but doctors usually advice 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 effect may be worse.
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 GVHS, 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 sever. It can occur any time after transplant, even years later.
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.
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.