Once the diagnosis of leukemia is established, the most important thing is to administer chemotherapy in a timely manner. The specific chemotherapy regimen to be used for each patient will be considered holistically by the doctor based on the patient’s leukemia typology, age, and the presence of other prior diseases, especially heart, liver, and kidney diseases.
Chemotherapy is a necessary step to cure leukemia, so let’s learn about chemotherapy, deal with chemotherapy, and get through this difficult period of chemotherapy.
I. What is chemotherapy?
Chemotherapy, as it is usually called, is short for “chemotherapy”. For leukemia and lymphoma, the patient is treated with different chemical drugs, which are usually cytocidal, i.e. cytotoxic drugs are used to kill tumor cells, while inevitably, some normal cells will also be harmed. Chemotherapy is a double-edged sword, and only by mastering it and using it can it benefit mankind.
The introduction of various chemotherapy drugs has brought more multi-faceted means to tumor treatment and more hope to patients. Many patients have been cured through chemotherapy, so that we can see that tumor is no longer an incurable disease.
II. The three stages of chemotherapy
Chemotherapy is like a battle, which needs to be carried out in stages.
1.Induction of remission.
The first chemotherapy conducted after the diagnosis of the disease. The purpose is to give the patient “complete remission” in a relatively short period of time with a course of treatment as much as possible. Complete remission means that the bone marrow and blood picture are back to normal.
2. Maintenance therapy.
This is only the first step of chemotherapy, because there are still a large number of residual tumor cells in the body, and each course of chemotherapy should kill a group of them.
3. Intensive treatment.
It is a part of maintenance therapy, but the dose of the drug used is larger and the killing effect is stronger. The purpose is to kill the cells hidden in the “shield” and those cells that may have drug resistance.
Some patients are cured after these three stages of chemotherapy, some go on to bone marrow transplants, and others are converted to immunotherapy. It is important for each patient to decide which path to take, and these will be discussed with the patient during the course of treatment, depending on the situation.
Third, the preparation before chemotherapy
Relax your mind and respond positively
When the patient learns of the diagnosis, it is inevitable that he or she will be depressed and the family will have a momentary panic. You must admonish yourself to be strong, optimistic and adjust your mind. Communicate with your doctor to understand the disease development pattern. Your doctor will give you detailed information about the prognosis of the disease and the precautions to be taken during the treatment process.
Come prepared with a comprehensive medical examination
The main purpose is to examine and evaluate the important organs of the body, such as doing ECG, chest X-ray, abdominal ultrasound and other examinations, because these organs may be damaged to a certain extent during chemotherapy, and the doctor should try to avoid drugs that may aggravate the original disease when choosing drugs.
Cleanliness and hygiene to prevent problems before they occur
After chemotherapy, there is often a decrease in white blood cells and resistance, so you must develop good hygiene habits, especially the “two heads”: one is the oral cavity, teeth should be brushed in the morning and evening, and must rinse after meals; one is the vulva, especially the anus, which must be washed after the stool, and a sitz bath before bedtime.
Fourth, the side effects of chemotherapy
As we all know, there are three kinds of drugs, not to mention that chemotherapy drugs are basically cytocidal. In understanding its efficacy, patients and families should know the toxic side effects.
What are the main toxicities of chemotherapy drugs?
Suppression of bone marrow: manifested as a decrease in whole blood, patients show immune deficiency due to lack of white blood cells and are easily combined with various infections, which are also most difficult to control when the cells are at their lowest. Thrombocytopenia may cause bleeding in vital organs and brain bleeding may be life-threatening. And bleeding gums are an important sign. Severe anemia and thrombocytopenia both rely on component transfusion support to help patients get through this low point in treatment. The myelosuppression period usually lasts 1-2 weeks after the end of chemotherapy and varies depending on the chemotherapy dose and individual differences.
Cardiotoxicity: Some chemotherapeutic drugs (such as erythromycin) have strong cardiotoxicity, mainly tachycardia, cardiac enlargement, arrhythmia, acute heart failure, etc.
Gastrointestinal reactions: often include loss of appetite, nausea, vomiting, abdominal pain, mouth ulcers, constipation, etc., which usually occur during chemotherapy and can gradually recover after stopping the drug.
Neurotoxicity: Some drugs (such as vincristine, etc.) can cause peripheral neuritis, manifested as numbness of the fingers (toes), which can be partially recovered after stopping the drug.
Hepatotoxicity: Most of the drugs are metabolized from the liver, and some patients will have drug-related liver damage, manifested as elevated liver transaminases and bilirubin, which occurs during and after drug administration, and doctors will add liver-protective drugs to chemotherapy.
Urinary tract damage: After chemotherapy drugs kill a large number of cells, the products of their destruction are excreted through the kidneys. In addition, some drugs are metabolized and excreted with urine, which may damage the bladder wall and cause hemorrhagic cystitis (such as high-dose application of cyclophosphamide, etc.), manifested as hematuria, urinary urgency, frequency, painful urination, and severe oliguria. Therefore, it is necessary to drink as much water and urinate as much as possible during chemotherapy.
Mucosal damage: mainly ulcers appear in the oral mucosa, which affects eating because of pain. Some special drugs, such as methotrexate, are more likely to cause mucosal ulcers, which occur in the course of chemotherapy or about 7 days after stopping chemotherapy, so it is necessary to follow the doctor’s prescription and apply the relief drugs on time. Avoid spicy diet.
Other: hair loss, pigmentation, skin rash, local tissue necrosis and phlebitis caused by leakage of chemotherapy drugs.
V. Precautions after chemotherapy
Post-chemotherapy acute injury period (1-3 days after chemotherapy).
The side effects in chemotherapy will still persist, especially poor appetite and nausea, so don’t be nervous and just eat lightly. Continue to maintain hygiene, because soon you will enter the leukopenia phase, still remember to keep the “two ends” closed.
Bone marrow suppression (7-14 days after chemotherapy).
As the red blood cells, white blood cells and platelets decrease, you will feel tired. However, the most important thing is “granulocyte deficiency” and thrombocytopenia. During the granulocyte deficiency period, the immunity is extremely low, and various infections are very likely to occur, such as fever, cough, diarrhea, painful urination, skin boils, and perianal pain. Early use of antibiotics will lead to early control of the disease.
Self-care and self-protection.
Protecting yourself is the most proven method. Rinse your mouth regularly and take a sitz bath. Don’t go to crowded places. If you go out, bring a mask. Eat clean and wash your hands regularly. Wash often and change clothes regularly. Ventilate the room and keep the air clear. If you find bleeding, such as subcutaneous petechiae, bleeding gums, increased menstruation, etc., be sure to seek medical attention promptly.