Treatment Options

If you have been diagnosed with leukemia or another form of cancer you should seek immediate help from an oncology specialist, a hematologist, or a board certified hematology oncology specialist. Oncology specialists focus on the study and treatment of cancer. Hematologists are specialists that study disorders of the blood. The best type of doctor to see is one who has board certification in both fields - a hematology oncologist. You can check to see what board certifications your doctor has at the American Board of Medical Specialties.

There are various treatment options for people with cancer and leukemia: chemotherapy, radiation therapy, bone marrow or stem cell transplants, monoclonal antibodies, as well as clinical trials. These treatments are often used in combination.

When deciding on a treatment plan a number of factors will be taken into consideration such as: your age, overall health, the type of cancer, and the stage of the disease. A specialist will help you determine which treatments to pursue based on your needs and desires.

Chemotherapy
Chemotherapy is one of the most common treatments for patients diagnosed with leukemia or another form of cancer. Patients often start chemotherapy treatment very soon after being diagnosed. Chemotherapy uses strong drugs to kill rapidly growing cells, such as cancer cells. Unfortunately, other healthy cells (such as hair cells) that grow rapidly are also damaged by chemotherapy. Chemotherapy can cause a variety of side effects including a weakened immune system, increased bleeding, temporary hair loss, nausea, fatigue, vomiting, lack of appetite, etc.

In leukemia patients, chemotherapy is used to kill the leukemia cells and hopefully achieve remission. Remission is where the blood does not show signs of leukemia cells and normal blood production is restored. Once the disease is in remission, the patient should consider long-term treatment options such as further chemotherapy or a blood stem cell transplant.

Radiation Therapy
Radiation therapy is often used in along with chemotherapy. During radiation therapy, beams of high-energy radiation are focused at the cancer cells to kill them. To destroy a tumor, radiation is focused on the specific area(s) of the body that are infected. Radiation therapy can also be used on the entire body before a stem cell or bone marrow transplant. Some side effects of radiation therapy are fatigue, skin rashes, and dry, sensitive skin.

Stem Cell or Bone Marrow Transplant
Another option for leukemia patients is to have a stem cell or bone marrow transplant. Stem cell and bone marrow transplants are often preceded by intensive chemotherapy and/or radiation therapy to prepare the body to receive the transplant. For a stem cell transplant, the next step is to introduce the stem cells into the patient. This is primarily done through a vein in the neck or chest. These new stem cells then replicate and replace the cells that were destroyed during chemotherapy and/or radiation therapy. There are currently three sources from which stem cells are being used for transplants: bone marrow, circulating blood (or peripheral blood), and umbilical cord blood.

In a bone marrow transplant the stem cells may be provided by the patient (autologous transplant) or by a donor (allogeneic transplant). In an autologous stem cell transplant, the patient's blood stem cells are collected and frozen, and then reintroduced into the patient after he/she has received intensive chemotherapy and/or radiation therapy. In an allogeneic transplant, the stem cells are taken from a donor and infused into the patient within 24 hours. The donor may or may not be a relative of the patient. Allogeneic transplants are more common than autologous transplants because there is a greater chance for patients to relapse if they have autologous transplants. A relapse is when a patient contracts leukemia again after being in remission.

Monoclonal Antibodies
Monoclonal antibodies are used to assist the body's immune system in getting rid of the disease. Once the monoclonal antibodies are put into the patient's body, they seek out and bind themselves to the leukemia cells. Then the immune system responds by destroying the antibodies and the cancer cells simultaneously. However, it is important to keep in mind that monoclonal antibodies are a recent development in leukemia treatment, thus the long-term effectiveness is still being investigated.

Three Common Cancer Misunderstandings

Cancer is a fascinating and very complex subject.  As with any scary and complicated situation, many misconceptions can arise in the minds of people.  And when you are a cancer patient, or a family member, sometimes your fears and misunderstandings can get away from you and cause you to make poor choices.  This article discusses a few ideas that will help you put cancer into a reasonable perspective.

Chemotherapy is a poison that harms the immune system so why would I want to use it?
Many people have trouble understanding this common misunderstanding.  The simple answer is you want to take chemotherapy because it has been shown in careful studies time and time again to help cancer patients.  While it lowers the immune system when you are taking it, and for a short time after, the immune response typically bounces back.  And if it doesn’t, there are ways to help it bounce back.  Another thing to think about while you are trying to preserve your immune system is; if your system was so great before, why did it not stop your cancer then?  Clearly, you need more than your own immune system to attack the cancer.

Forty years ago every child with Acute Lymphocytic Leukemia (ALL) died of the disease as did adult Hodgkin’s Lymphoma patients.  Now 85 percent of the children with ALL are cured of it; a remarkable achievement all thanks to chemotherapy.   And Hodgkin’s is no longer that death sentence it once was and these days has very high survival rates.  These are just two examples of poison curing cancer, and there are many more.  And in other situations where chemo can’t cure the cancer, it can greatly delay how quickly it comes back.

There are certain cancers where chemo doesn’t work, like prostate cancer, and so is not used.  If your doctor offers you chemotherapy it is because long and expensive studies have shown that it works in spite of its effect on the immune system.  If studies don’t show that it works, then like with prostate cancer, the doctor won’t offer you that treatment.

This same argument, by the way, goes for radiation therapy also.

If they can send a man to the moon, why can’t they cure cancer?

It’s easy to send a man to the moon.  Why?  Because we get to begin at the beginning and figure out each step of the way.  We designed everything very logically from the ground up based on things we already knew.  We made each and every component of the rocket, and we laid out each wire and jet thruster.  This means we know everything about what we are doing because after all, we designed it.  We drew up the blueprints.

We didn’t design the strange and wonderful human body.  Evolution did over millions of years and generations.  Evolutionary design is anything but logical.  It is the result of millions of mistakes all coming together to actually work.  These natural “designs” are incredibly intricate and convoluted.  Many systems are interacting in highly complex ways that are maddening to figure out.  In comparison, a Saturn V rocket is a wonder of simplicity.  This wire goes from here to there and not anywhere else and does not affect anything else but what we tell it to.  It doesn’t have any unexpected consequences - because we designed it that way.

We still have a long way to go in understanding how the body functions, how cancer cells begin, how they grow and spread, and how our treatments affect the cancer and the body.  We have only sketchy blueprints of the body and of cancer at this point. 

An additional problem is that a moon shot is a moon shot.  It is basically the same each time.  But cancer is not cancer meaning a small cell lung cancer is a completely different thing from a prostate cancer of a brain tumor.  Depending on how you count them, there are 200 cancers.  Each one different and each one requiring a different treatment.  Even within each cancer they are subtypes and different stages, each requiring a different treatment. 
Also, it is incorrect to say we can’t cure cancer.  We can and we do, every day.  But we can only cure a handful of them, only certain types and only is we catch them early enough.

This is why we can send a man to the moon, but can’t cure all cancers.

All forms of radiation cause cancer.

Radiation includes visible light waves, radio waves, x-rays and many other types of electromagnetic waves.  The only ones that can possibly cause cancer are the ones with high enough energy to do irreparable damage to your DNA; this is called ionizing radiation.  The amount of energy that these waves carry is directly related to the frequency; the higher the frequency the more energy.  An ion is an atom that has lost or gained an electron and is no longer electrically neutral.  This happens when say an x-ray, which always has enough energy to ionize an atom, slams into an electron in the atom and knocks it completely out of its orbit.  The electron can then hit a strand of DNA and cause damage.  The DNA has repair mechanisms and so may be able to repair this damage before it does any harm.  But sometimes it can’t make the repair and so the DNA is permanently damaged.  If enough damage is don’t in the right places the cell can loss control of its own growth mechanism and become cancer.

So it is important to separate out the ionizing radiation from the non-ionizing radiation.  Some ultraviolet rays, x-rays and gamma rays are ionizing radiations.  All the rest including radio waves, microwaves, infrared, visible light and the lower end of ultraviolet rays do not have enough energy to create ions thus causing DNA damage.  While these non-ionizing types of radiation can be dangerous in other ways (don’t put a cat in the microwave oven), they don’t lead to cancer.