Managing side effects of acute leukaemia treatment

To prevent the spread of infection:

• check your temperature daily and any time you feel unwell
• avoid touching your eyes, nose and mouth with your hands
• check with your doctor about having vaccines for COVID-19, flu and pneumococcal disease
• ask people close to you to consider having the COVID-19 and flu vaccines
• ask family and friends with a cold, flu, COVID-19 or other contagious infections (e.g. a cold sore) not to visit until the symptoms have gone away
• avoid shaking hands, hugging and kissing other people
• try to avoid crowded places, such as shopping centres; or, if you must visit a busy place, wear a mask
• wash your hands with soap and water before preparing food and eating, and after using the toilet
• prepare and store food properly to avoid foodborne illness and food poisoning
• eat freshly cooked foods; avoid raw foods (fish, seafood, meat, eggs and soft cheeses); wash fruits and vegetables well before eating.

Contact your doctor or go to the nearest hospital emergency department immediately if you experience one or more of the following symptoms:

• a temperature of 38°C or higher
• chills or shivering
• sweating, especially at night
• burning or stinging feeling when urinating (weeing)
• a severe cough or sore throat
• shortness of breath
• vomiting that lasts more than a few hours
• severe abdominal pain, constipation or diarrhoea
• unusual bleeding or bruising, such as heavy nosebleeds, blood in your urine (wee or pee) or black faeces (poo)
• prolonged faintness or dizziness and a rapid heartbeat
• any sudden deterioration in your health.

You will be given anti-nausea medicine to take before and during chemotherapy. If you still feel sick (nauseous) or vomit after taking the medicine, let your doctor know so another can be tried.

Chemotherapy drugs may affect your appetite or change how food tastes. Try eating snacks frequently instead of large meals, and enriching drinks with powdered milk, yoghurt or honey. A dietitian at the treatment centre can help you work out an eating plan.

Chemotherapy can cause mouth sores (such as ulcers), tooth or gum infections, and a dry mouth. To keep your mouth comfortable, sip water throughout the day and eat moist foods such as casseroles and soups. Your health care team may recommend that you use mouthwashes and have regular dental check-ups. Tell the dentist about the type of treatment you are having and talk to your haematologist before you have any dental work.

Hard, dry bowel movements (constipation) or loose, watery movements (diarrhoea) can be caused by chemotherapy drugs and other medicines. Tell your doctor or nurse if your bowel habits have changed, as it is important to act early to prevent further problems. They may suggest changing what you eat or medicines.

Some chemotherapy drugs can cause tingling (“pins and needles”), pain or loss of feeling in your fingers and/or toes, and muscle weakness in your legs. This is called peripheral neuropathy. It is usually a short-term issue, but for some people, it can last a long time or even be permanent. If you have these side effects, tell your doctor or nurse before your next treatment. Your treatment may need to be changed or the problem may need to be carefully monitored.

This is a common side effect of some chemotherapy drugs and is usually temporary. Some people find it better to cut their hair short when it starts to fall out. Wearing some form of head covering will help keep you warm and protect your head from direct sunlight. Look Good Feel Better runs free workshops on managing appearance-related side effects – call 1800 650 960.

Some people have difficulty concentrating, focusing and remembering things after chemotherapy. This is called cancer-related cognitive impairment or, sometimes, “chemo brain” or “cancer fog”. These problems usually improve with time, although some people experience issues for years. Tell your doctor if this issue is affecting your day-to-day life or return to work.

If you have periods, they may become irregular during treatment, but return to normal when it finishes. For other people, periods stop permanently (menopause). After menopause, it is no longer possible to have a child naturally. Chemotherapy drugs may lower the number of sperm produced and reduce their ability to move. This can sometimes cause infertility, which may be temporary or permanent. Total body irradiation can also reduce sperm production. Speaking to your doctor or a counsellor about your feelings and individual situation can be helpful.

Early menopause may cause bones to become weaker and break more easily. This is called osteoporosis. Talk to your doctor about having a bone density test or taking medicinesto prevent your bones becoming weak. Healthy Bones Australia has more information on preventing osteoporosis. Call 1800 242 141.