The treatment you get for chronic lymphocytic leukemia (CLL) can slow your cancer, but it also might cause some physical and emotional side effects. Your doctor or mental health counselor can suggest medicine or therapy that can ease the impact of treatments like chemotherapy, radiation, targeted drugs, and monoclonal antibodies. If your side effects are serious, they may make adjustments to your treatment plan such as changing dosages or your treatment schedule.
Nausea and Vomiting
CLL treatments affect signals in your brain that make you feel the urge to throw up. This side effect is less common than it used to be, because now there are medicines to prevent nausea and vomiting. You'll get these drugs a few days before and after your chemotherapy or radiation treatment.
If it's hard for you to keep food down, eat smaller meals. Choose bland foods like dry toast and bananas, and drink ginger ale. Talk to your doctor or a dietitian to make sure you still get the nutrition you need. And drink extra water and other fluids to prevent dehydration.
Anxiety and Depression
You might find you're on an emotional roller coaster as you go through treatment for CLL. Sometimes it can make you anxious or depressed.
Talk to your doctor if you feel sad or hopeless. You might find relief from counseling or therapy. Your doctor may also prescribe antidepressants.
Also talk to your doctor about finding a support group. You'll be able to talk with others who have CLL and understand just what you're going through.
Low Blood Cell Counts
Chemotherapy attacks cells that divide quickly. These include not only cancer, but also the cells inside your bone marrow that grow into new blood cells.
Which side effects you have depend on the type of blood cell your chemotherapy attacks. If chemo affects your white blood cells, you might have greater chances of getting an infection. If the impact is on your red blood cells, you may have symptoms like feeling tired or getting short of breath. If chemo affects your platelets, you could bruise or bleed easily.
While you're on treatment, be extra careful to stay away from people who are sick. Wash your hands often during the day. Your doctor may suggest medicine to raise the number of infection-fighting cells your body makes.
Be careful when you shave or trim your nails so that you don't cut yourself. Avoid contact sports and any other activity that could injure you and cause you to bruise or bleed.
If your blood cell counts are very low, you might need a transfusion of platelets or red blood cells.
Tiredness
Many treatments for CLL cause you to lose energy. It happens when the medicine kills healthy cells along with the cancer, or changes your hormone levels. The cancer itself can also lead to fatigue.
Cancer fatigue isn't normal tiredness. It's much more extreme. Simply getting enough sleep won't fix it, though. Taking rest breaks or naps during the day can help. Walk or do other exercises every day to keep up your energy level. And ask your health care team or dietitian whether any changes to your diet might help with fatigue.
Diarrhea and Constipation
Chemotherapy and radiation can damage the lining of your intestine and cause loose stools (diarrhea) or hard stools (constipation).
For diarrhea, drink plenty of fluids so that you don't get dehydrated. Eat foods that are easy to digest, such as rice, bananas, and dry toast.
If you're constipated, eat more fiber from fruits, vegetables, and whole grains. Drink extra fluids. And try to exercise as often as you can.
Lymphedema
If your doctor removed your lymph nodes during surgery, there's a chance you could get swelling called lymphedema. It happens when lymph fluid builds up under your skin.
The swollen area may feel heavy or hard. Ask your doctor what exercises you can do to improve drainage and cut the swelling.
Changes in Taste and Smell
Radiation and chemotherapy cause changes in your taste and smell because they damage taste buds, leave sores in your mouth, and lessen the amount of saliva you make.
It may be harder for you to eat if food tastes strange to you. But it's important to keep up a well-balanced diet. You need your strength to get through treatment and heal afterward.
Play around with different food flavors. Add spices like onion, garlic, mustard, or lemon until you find ones you like. Serve foods at room temperature. Cold foods don't have as strong of a smell or taste as hot foods. Brush your teeth often and rinse to wash the bad taste out of your mouth.
Hair Loss
Losing hair is a common side effect of chemotherapy and some types of radiation. It's only temporary.
Your hair should start to grow back 3 to 6 months after your treatment ends. In the meantime, you can cover the hair loss with a hat, kerchief, or wig.
Finding It Hard to Concentrate
After CLL treatment, some people say they feel foggy, can't seem to concentrate, or have trouble remembering things. Doctors call this side effect "chemo brain."
Most of the time, these problems don't last long. Talk to your doctor if you notice symptoms of chemo brain. They can suggest ways to help, including exercise, meditation, or a therapy program that helps improve your thinking skills.
When to Call Your Doctor
When you start CLL treatment, ask your doctor what side effects to expect and how to manage them. You can handle some of these problems on your own at home, but call your doctor if you have any of these more serious treatment side effects:
- Fever of 100.4 F or higher
- Chest pain
- Shortness of breath
- Confusion
- Shaking chills
- Severe headache
- Swelling or redness