The aim of treatment is to bring about a
complete remission, that is a state in which there is no
evidence of the disease and the patient returns to good health.
For acute leukemia, a complete remission that lasts five years
after treatment often indicates cure. Treatment centres indicate
an increasing number of people who are in complete remission
after at least five years from treatment.
The most common treatments used to beat leukemia are
chemotherapy and radiation. Chemotherapy involves killing the
abnormal cells in the blood by means of injections of drugs.
However, chemotherapy is not selective and also kills the good
cells (see “chemotherapy side effects” below).
This is why the patient will often receive transfusions of blood
components to support the therapy.
Antibiotics are also used as supportive treatments to fight
infections or to avoid them.
Radiation involves the use of ionizing radiation to break down
the bad cells.
In many cases a bone marrow transplant will be necessary to cure
leukemia. This consists of a strong chemotherapy or radiation
aimed at eradicating the natural production of blood cells by
the body, eliminating the disease followed by an infusion of new
stem cells to resume the normal functions of the bone marrow.
This may last a few months during which the patient has to stay
in isolation to prevent fatal infections. When the infused stem
cells come from the patient himself, the transplant is called
autologous. When instead the stem cells come from a donor, the
transplant is called allogeneic.
Continued research is leading to improved drugs that in certain
cases can lead to a cure even without the need of a bone marrow
transplant.
Chemotherapy side effects
Not only the bad cells are sensible to chemotherapy but also the
healthy ones at high replication rates. This means that
chemotherapy has a number of side effects that include
deficiency of the immune system, anemia, low platelet count,
loss of hair, nausea, diarrhea, hemorrhoids, mucositis, and
temporary sterility. The side effects depend on the type of drug
used, the dosage, and the patient’s conditions. Certain drugs
can have specific side effects on liver, heart, or lungs, so it
is important to keep these checked regularly before, during, and
after the therapy.
Side effects shouldn’t last long since normal cells tend to
reform after the end of the chemotherapy.
It is possible to limit certain side effects (i.e. nausea) with
the use of some provisions.
How to behave during chemotherapy
A. Diet: a balanced diet is paramount to ensure a proper amount
of calories and reduce or avoid weight loss. In case of nausea
you should refer to your physician. In case of loss of appetite
it can help to eat smaller quantities of food but more often
during the day. Eat more at the times of the day when you feel
stronger, like at breakfast. Eating every few hours, before you
get hungry, can also help with nausea, as hunger pangs can make
nausea worse. It is also important to drink much water and
juices to help the body eliminate the toxins of chemotherapy
drugs. Ask your physician if you can drink wine or beer.
B. Hygiene: Cleaning your hands often reduces the odds of
contracting infections, while a correct oral hygiene prevents
mucositis.
C. Psychological aspects: If you notice changes in your body or
mood you should not get scared. Talk to your physician about it.
D. Sex: It is possible to have sex during chemotherapy as long
as it is protected, to avoid contracting infections and also to
avoid damage to the fetus.
E. Taking other drugs: Always ask your physician to ensure
compatibility and avoid interactions.
F. Work: It is possible to continue working or studying if your
body allows you to, but always keep in mind that the highest
priority is fighting leukemia, and you may need extra rest for
that.
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