Overcoming Leukemia and Chemo-Related Side Effects
- Ismahan Ahmad was just 11 when she was first diagnosed with acute myeloid leukemia. She relapsed in 2021, and chemotherapy left her unable to walk, but she’s overcome the disease and relearned how to walk at the age of 14.
- Acute myeloid leukemia (AML), is a blood cancer that affects the spongy tissue inside of your bones called bone marrow.
- Although we’ve come a long way with managing the side of effects of chemotherapy, they can still have a great impact on people throughout their cancer journeys.
Ahmad’s Leukemia Battle
Ahmed was living in Kenya when she began feeling sick and fainting on a daily basis. She was also struggling with dehydration, weight loss and anemia, so her family knew something was wrong. It turns out the leukemia was causing her symptoms.Read More
Ahmed’s leukemia treatment path included three rounds of chemotherapy followed by a stem cell transplant that came from her brother.
“I was lucky that my brother was a 100 percent match and was my stem cell donor,” she said.
Her leukemia treatments seemed to be successful until February 2021 when routine blood work revealed that she had relapsed.
“I was devastated, my life was just getting better, now this,” she said.
She then underwent more rounds of chemotherapy for the leukemia as well as another stem cell transplant. Thankfully, her treatments were successful, but Ahmed’s chemotherapy reportedly resulted in “extreme weakness and stress-induced injuries” that left her unable to walk.
But the resilient little girl was not about to give up. She set a goal to learn how to walk again by the time she turned 14, and she achieved it.
“It’s been such a difficult three years, particularly being in hospital during the pandemic, but having this goal and timeline to focus on has helped me stay positive,” she said. “I’m so happy to achieve my goal of learning how to walk again.”
Her progression in ability and confidence has been incredible, and now she’s able to walk up and down stairs and do some exercises. She’s also due to leave the hospital soon with a wheelchair in case she needs it.
“I’m so thankful to the entire clinical team, but particularly the physio team who have really helped me overcome the weakness I was experiencing and help build my confidence to succeed,” she said of her leukemia treatment, adding that she’s hoping for a better 2022.
Understanding Acute Myeloid Leukemia
Ahmed’s type of leukemia, acute myeloid leukemia (AML), is a blood cancer that affects the spongy tissue inside of your bones called bone marrow. Acute myeloid leukemia is a rare cancer, but it is the most common type of leukemia in adults.
Dr. Mikkael Sekeres, chief of the Division of Hematology at the University of Miami Sylvester Comprehensive Cancer Center, explains that bone marrow is essentially the factory that makes all of the cells in the blood stream. This includes the red blood cells that bring oxygen to our tissues, white blood cells that make up the immune system and the platelets which help stop bleeding.
When a person has AML, “that factory gets broken” because the bone marrow fills with cancer cells. Ultimately, this hinders the creation and function of the important blood cells.
“So there’s a bit of a paradox,” Dr. Sekeres previously told SurvivorNet. “The bone marrow has too many cells, yet the bloodstream has too few cells as the normal bone marrow cells die off.”
Symptoms of AML can include shortness of breath, decreased exercise tolerance, unexplained bruising or infections. But sometimes people with AML have no symptoms at all.
“Most of the time, this comes as an unwelcome surprise diagnosis,” Dr. Gail Roboz, a medical oncologist at Weill Cornell Medicine, previously told SurvivorNet. “Often, patients have no idea that leukemia is even anywhere on the radar.”
Understanding Chemotherapy Side Effects
Chemotherapy treatments affect everyone differently, so there’s no real definite side effects you can count on. Below are some of the more common side effects that can affect patients during and after chemo treatments. And while it’s important to note that we’ve come a long with the management of these side effects, they can still have a great impact on people throughout their cancer journeys.
“One of the things that patients worry most about is nausea with chemotherapy,” Dr. Michael Ulm, gynecologic oncologist at West Cancer Center, said in a previous interview with SurvivorNet. “Everybody remembers what their parents went through or what their aunts and uncles went through probably 15 or 20 years ago.”
Although people can still anticipate nausea, Dr. Ulm says your nausea shouldn’t be as bad as you’re imagining with today’s arsenal of effective treatments to combat the side effect with medications you can even take at home.
“I tell my patients, with modern medicine and modern antiemetics that you should never have severe nausea and you should never throw up,” Dr. Ulm said.
Hair Loss or Thinning
Many chemotherapies can cause hair loss or thinning. Hair loss typically begins about three to four weeks after a woman begins chemotherapy and continues throughout treatment. Woman can expect regrowth around four to six weeks after they complete treatment, but some patients may experience some changes to hair color and texture when it begins growing back.
The hair loss associated with chemo is temporary, but this can be an incredibly distressing side effect for some. It’s important to speak with your doctor about any personal issues that may be caused by treatment side effects including the loss or thinning of your hair. To help patients cope with hair loss, a doctor or nurse may be able to recommend a local wig-maker or other resources that can help slow down the process.
Cardiotoxicity, or problems in the heart and vascular (circulation) system, can be a side effect of chemotherapy. Although uncommon, cardiovascular disease is the second leading cause of death among breast cancer survivors – behind only secondary malignancies – due, in part, to the damage some cancer therapies can cause to the heart.
“From chemotherapy, high doses of anthracyclines, in particular, have been the prototype of cancer therapies that lead to cardiotoxicity,” Dr. Emanuel Finet, a transplant cardiologist at Cleveland Clinic Cancer Center, previously told SurvivorNet.
Cancer patients at a high risk for heart problems can be older, younger with more aggressive chemotherapy, obese, smokers or dealing with pre-existing cardiovascular disease.
Blood-forming Cell Damage
Chemotherapy drugs can damage all three types of blood-forming cells: red blood cells, platelets and white blood cells. This is turn can lead to various issues like anemia (low red blood cell count), thrombocytopenia (low blood platelet account) or neutropenia (low number of a type of white blood cell called neutrophil).
“One of the things that’s changed in the coronavirus days is that now we’re giving everybody this drug called Neupogen or Neulasta, and it helps boost your white [blood cell] count,” Dr. Ulm said as a way to help your body fight infections.
Fatigue is another possible symptom that has the potential to worsen as chemo cycles add up. If chemotherapy left you with anemia, you can try treating that ease exhaustion. But rest breaks, frequent exercise, and getting plenty of sleep at night can also help fight fatigue.
In an earlier interview, Dr. Zachary Reese, a Medical Oncologist at Intermountain Healthcare, spoke with SurvivorNet about what chemotherapy-related fatigue is like.
“What I typically tell patients is that [chemotherapy] is a bit of a roller coaster ride,” he said. “You’re going to feel tired about a week into treatment, and that’s when you’ll hit bottom. And then you’ll start to come back up again just in time to do it all over… You’ll feel a little more tired the second time around than you did the first, and it will last a day longer.”
Nerve damage, or neuropathy, can leave you with symptoms like ‘pins-and-needles,’ pain, burning, numbness, weakness or trouble detecting heat and cold.
These symptoms might worsen as your chemo treatments progress, but there are ways to combat them. Steroids, numbing patches or cream, antidepressant medicine, anti-seizure medication physical therapy, relaxation techniques, acupuncture or dosage adjustments may help with these symptoms. And while the symptoms of nerve damage might go away once you finish treatment, there can be lasting effects that require ongoing treatments.