Chemotherapy uses drugs to kill cancer cells. The drugs enter the bloodstream and travel through the body in order to kill cancer cells. The side effects from the chemotherapy come from the fact that it destroys normal cells as well as cancer cells. Chemotherapy may be given either alone or along with radiation therapy. When given alone, it is given in a higher dose designed to kill off cancer cells. When given along with radiation therapy, it is delivered at a lower dose and is designed to make the cancer more sensitive to the radiation.
The type and combinations of drugs that are used to treat leukemia will vary depending on the type of leukemia, as well as the age and condition of the patient. In general, there are several equally effective combinations available for each of the major types of leukemia, giving physicians the ability to tailor treatment to patient needs and tolerance.
Chemotherapy is usually given by vein, but some forms can be given by mouth. Your medical oncologist will tell you how many cycles or courses of chemotherapy are best for you. He or she will also be able to tell you what side effects to expect from your particular type of treatment, as side effects differ depending on the drugs given and the doses involved.
The side effects and amount of time required in the doctor’s office depend on the type of chemotherapy you receive, as well as how many cycles you receive and how often. The most common chemotherapy-associated side effects are:
- Nausea and vomiting
- Fatigue or tiredness
- Hair loss
- Esophagitis (irritation of the swallowing tube)
Note: Infertility and premature menopause may occur as a result of chemotherapy. If fertility is a concern, talk to your doctor about storing sperm or eggs before starting therapy.
When chemotherapy is given at a lower dose, as when it is given along with radiation, these side effects are less common. However, most people still feel very fatigued.
Long term side effects can include damage to the heart and peripheral nerves, some decrease in mentation, and, very rarely, development of other cancers, including other leukemias.
Chemotherapy is given in two phases for acute leukemia:
- Induction—to bring about a remission
- Consolidation—to kill any leukemia cells still in the body and reduce the chances of the cancer coming back
Chemotherapy may not be given for chronic leukemias until the patient begins to develop rapidly increasing cell counts, more immature cells in the blood, or significant symptoms from the leukemia.