Acute Myeloid Leukemia
Planning ahead reduces concerns about treatment side effects
Many people fear the side effects that accompany cancer treatment. It may comfort you to know that although most cancer treatments do have side effects, you likely will not experience all of them. People respond differently, even to the same diagnosis and type of treatment. However, being informed about symptoms to watch for and knowing what to do if they occur can help you maintain your best possible quality of life.
Your health care team will work closely with you to meet that goal by drawing on a broad range of services known as supportive care. Supportive care addresses the physical, emotional, practical, spiritual, financial and family-related challenges of people diagnosed with cancer and their loved ones. This includes assisting your children, family members, caregivers and others close to you. Resources your team may offer include pain management; counseling about nutrition, fitness, mental health or spirituality; physical therapy; occupational therapy; speech therapy; complementary medicine and others.
Also called palliative care, these services are designed to benefit anyone with a serious or life-threatening illness from diagnosis through survivorship. Palliative care is often confused with hospice care, which is reserved for the end of life. Think of the purpose of palliative care as “quality-of-life preservation or restoration.”
You can help your health care team members help you by letting them know as soon as a symptom or side effect occurs so it can be addressed early, hopefully before it gets worse. Be honest with your family and caregiver about your side effects and their level of severity.
Potentially severe side effects
Certain types of treatment may be accompanied by severe side effects. Though they are not common, it is important to know if you are at risk for them and how to identify the symptoms that should be reported immediately. Severe side effects include the following:
- Infection can occur as a result of a low white blood cell count (neutropenia) or other factors. Contact your doctor immediately – do not wait until the next day – if you have any of these symptoms: oral temperature over 100.4° F, chills or sweating; body aches, chills and fatigue with or without fever; coughing, shortness of breath or painful breathing; abdominal pain; sore throat; mouth sores; painful, swollen or reddened skin; pus or drainage from an open cut or sore; pain or burning during urination; pain or sores around the anus; or vaginal discharge or itching. If you cannot reach your doctor, go to the emergency room.
- Infusion-related reactions may occur with some intravenous (IV) treatments. Most reactions are mild with symptoms such as chills, fever, nausea, headache and skin rash. Some can be serious and even fatal without medical intervention.
- Tumor lysis syndrome may occur after treatment (commonly chemotherapy) of a fast-growing cancer, especially certain blood cancers. Common symptoms include nausea, vomiting and diarrhea. There may also be worsening of your kidney function or increases in the level of potassium in the blood.
- Graft-versus-Host Disease (GvHD) may occur with an allogeneic stem cell transplantation. Call your doctor immediately if you have tightening, blistering or burning of the skin; jaundice; fever; sudden weight loss; or abdominal pain, bloating or diarrhea.
Common side effects
Table 1 includes some of the common side effects that accompany AML and its treatments. You may have more than one type of therapy at a time, and sometimes, when therapies are combined, side effects are more intense. Monitor any that you experience and talk with your medical team about them.
Table 1. Common Side Effects
|Anemia||Low energy, weakness, dizziness, light-headedness, shortness of breath, rapid heartbeat|
|Appetite loss||Decreased desire to eat, often resulting from treatment side effects such as taste changes, mouth sores, nausea and vomiting|
Bleeding and bruising problems
||Blood in your stools or black stools (looks like tar); pink or brown urine; unexpected bleeding or severe bleeding that you cannot control; vomit that looks like coffee grounds; coughing up blood or blood clots; increased bruising, dizziness, weakness, or confusion; changes in speech; or a headache that lasts a long time|
|Bone loss||Weakened bone caused by the cancer or treatment|
|Cardiotoxicity||Ask your doctor if you are at risk and the symptoms that require immediate attention|
|Chemo brain (cognitive dysfunction)||Brain fog, confusion and/or memory problems|
|Constipation||Difficulty passing stools or less frequent bowel movements compared to your usual bowel habits|
|Diarrhea||Frequent loose or watery bowel movements|
|Fatigue||Tiredness that is much stronger and harder to relieve than the fatigue an otherwise healthy person has|
|Fever||Raised body temperature (100.4° F or higher) that could signal an infection|
|Hair loss (alopecia)||Hair loss on the head, face and body|
|Headache||Pain or discomfort in the head|
|Leukocytosis||Elevated white blood cell count that may involve fever, fatigue, weakness, dizziness or nausea|
|Mouth sores||Tiny sores in the lining of the mouth and gums, tongue, roof of mouth and/or lips|
|Nausea and vomiting||Stomach upset and/or more than three episodes of throwing up per hour for at least three hours; blood in vomit; vomit resembling coffee grounds; inability to drink more than eight cups of fluid or ice chips in 24 hours or eat solid food for more than two days; weakness or dizziness; or being unable to keep down medications|
|Neutropenia||Low white blood cell count that increases the risk of infection|
|Pain||Musculoskeletal pain and aches that occur in the muscles, bones, tendons, ligaments or nerves|
|Respiratory problems||Shortness of breath (dyspnea) with or without cough, upper respiratory infections|
|Skin reactions||Rash, redness and irritation or dry, flaky or peeling skin that may itch|
|Thrombocytopenia||Low number of platelets in the blood, which can lead to bruising and bleeding|
Caring for your mental health and emotional well-being
A cancer diagnosis and its treatment affect many parts of your life, including your mental health. You may have feelings that range from anxiety and fear to anger and depression. These feelings are normal, and you are encouraged to find healthy ways to express them.
Support is available to ensure that you do not have to go through this alone. If you are having challenges in an area not listed here, talk with your health care team. Tell your doctor if you have feelings of hopelessness or depression. Seek medical attention immediately if you have thoughts of suicide.
Dietary support may be needed if you have challenges eating or with your appetite. Ask your health care team for a referral to a dietitian who can help ensure your body gets the nutrients it needs.
Financial counseling is accessible from a social worker, nurse navigator or financial counselor. The stress and anxiety of paying for treatment and other related expenses can negatively affect your well-being. Understanding the costs ahead can help you feel more in control.
Individual activities that may offer relief include deep breathing, yoga, listening to music and physical exercise.
Social support is available in many forms. Family and friends are wonderful resources, but they can only understand so much. Ask your doctor or social worker to find a support group for cancer survivors online or in your area. Many organizations offer one-on-one buddy programs that pair you with another person who has the same type of cancer as you. Opening up to people who have had a similar experience can offer comfort and support that is invaluable. Consider contacting a counselor or therapist with expertise in working with people living with cancer.
Spirituality or religious guidance may be available from a chaplain or spiritual care advisor at the hospital or in your community. Spiritual support is available even if you
do not consider yourself a religious person.