Leukemia

Leukemia 

Leukemia is a type of cancer of the blood or bone marrow  marked by an abnormal increase of immature white blood cells called "blasts". Leukemia is a treatable disease where most treatments involve chemotherapy, radiotherapy, hormone therapy, or bone marrow transplant.  The rate of cure depends on the type of leukemia as well as the age of the patient. Children are more likely to be permanently cured than adults. Even when a complete cure is unlikely, most people with a chronic leukemia and many people with an acute leukemia can be successfully treated for years.

Symptoms commonly shared among the different types of leukemia include: fever and night sweats, headache, bruising or bleeding easily, bone or joint pain, swollen or painful belly from an enlarged spleen, swollen lymph nodes in the armpit, neck, or groin, getting a lot of infections, extreme fatigue or general weakness, weight loss and feeling hungry more often.

Diagnosis of leukemia usually includes the following: physical exam to check for swollen lymph nodes, spleen or liver; blood tests; biopsy (bone marrow aspiration and/or bone marrow biopsy) to check the tissue for leukemia cells in your bone marrow.   Other tests include cytogenetics where the lab looks at the chromosomes of cells, spinal tap for the lab to examine the cerebrospinal fluid, and chest x-ray. 

Treatment options for leukemia, depending mainly upon the type of leukemia (acute or chronic), age of patient, and whether leukemia cells were found in the cerebrospinal fluid,  are watchful waiting, chemotherapy, targeted therapy, biological therapy, radiation therapy, stem cell transplant, and surgery for the removal of enlarged spleen. Sometimes a combination of these treatments is needed.  Symptoms and the general health condition of the patient are also factors for treatment decisions. 

Side effects associated with the treatment of leukemia vary from person to person and even from one treatment to the next. When we make a treatment plan, one of the main goals is to keep the side effects to a minimum.  Most side effects go away gradually between treatments or after the treatment stops. Our doctors and nurses explain the side effects in detail and help the patient deal with them by suggesting medicine, diet changes, and other methods suitable for the patient.   Below are some of the commonly seen post-treatment side effects experienced by leukemia patients:

• less energy
• increased risk of infections
• bruising or bleeding easily
• nausea, vomiting, mouth sores, loss of appetite
• hair loss
• red, dry, tender, and itchy skin
• possible graft-versus-host disease (GVHD)
• possible infertility – male patients often have their sperm frozen and stored
• changes in menstrual periods and/or menopause-like symptoms

 

Life after leukemia

Maintaining the quality of our patients' life has always been one of the main goals of this cancer center.  We offer supportive care to prevent or fight infections, to control pain and other symptoms, to relieve the side effects of therapy, and to help patient cope with the feelings that a diagnosis of cancer can bring.

Our staff may advise you to stay away from crowds and from sources of other contagious diseases. In the event of any infection, patient should be treated promptly and hospitalization may be necessary. Transfusions may be needed to help treat anemia and reduce the risk of serious bleeding.

Dental issues may be problems for leukemia patients because of the therapy-induced mouth sensitivity, which renders the patient vulnerable to infections and bleeding. A complete dental exam and needed dental care before chemotherapy are often suggested. Our dentists take care of the patients' teeth and educate them on oral hygiene so their teeth can stay clean and healthy during treatment.

Nutrition, especially protein, is another focus of patient education by our leukemia team.  An adequate amount of calories is essential to help patients maintain a good weight and keep up strength. Some of the side effects may drive patients away from food, and this is why knowing and adhering to a good eating habit is very important to leukemia patients.  

One other important path back to health is physical activity. It’s proven that staying active can make people with cancer feel better. Exercise, walking, yoga, and other activities can keep patients strong and increase their energy. Routine physical exercise can relieve stress and may reduce nausea and pain, which makes treatment easier to handle. Our doctors will talk to the patient about which type of exercise is suitable.

 

 

Facing cancer

Facing cancer is facing a threat to one’s very existence.  The blow from cancer hits not just the physical being but often scars the mental and emotional presence of the patient as well as the patient’s family.  The different phases of reactions, from shocking blank to angry denial, are normal and expected. But if not managed well, they could add more pain and damage on top of the cancer itself.   Anxiety, sense of loss, fear of uncertainty, insomnia, guilt, depression, despair, and anger are among the commonly seen symptoms which require professional help as well as social support. 

 

Stress Screening

About 50% of cancer patients worldwide develop psychological symptoms but only 8 – 10 % would voice their concerns and seek help.  In our hospital, a Distress thermometer is offered to every patient upon their first visit to assess their distress level.  When necessary, the social psychotherapy team and the social workers are asked to join the multidisciplinary team to help patients and the family cope with cancer and to safeguard the quality of life for patiens.   There are also various cancer support groups and religious support organizations that will offer to accompany the patient in their walk with cancer and fight against cancer.

 

A letter to the family

Being there for the patient means the world to the patient.  Support and company from the family and relatives are a critical part in cancer care.   Listening to the patient and respecting the patient’s wishes bring positive energy.    When a member in the family gets cancer, the rest of the family is affected in many aspects: physical, psychological, financial, and emotional, to where the whole family system could collapse.  When providing the much deserved and much needed care to the patient, the family members must remember to also provide an equal amount of care to one another and to oneself.   In the event of exhaustion or burn-out, remember to seek professional help.