Blood cancer treatments and side effects

Updated 11 Aug 2017

Different cancer treatments come with different possible benefits, risks and side effects. While some slow-growing blood cancers can be managed by taking daily medication, people with faster-growing acute blood cancers may need stronger (intensive) treatments.

The treatment your doctors recommend will depend on the type of blood cancer you have, your health, and your wishes. You might have one type of treatment or a number of them. Some people may never need treatment, or will choose not to have treatment.

Stronger treatments can be hard on your body and aren't suitable – or needed – for everyone. Some people may get more benefit from gentler (less intensive) treatment that supports them to have the best possible quality of life, even if it doesn’t cure their blood cancer.

This section of our website gives a broad overview of the types of treatment available to people with blood cancer. Everyone is different, so not all of the information in this section will be relevant to you. Choose a specific type of blood cancer to find out more about which treatments are available.

Types of treatment

There are many possible treatments for blood cancer. You might hear the following terms or phrases used to describe treatment for blood cancer:

Intensive treatment / high-intensity treatment

Intensive treatment means strong treatments. For blood cancer, this often means using strong drugs to try and kill cancer cells or stop them from spreading. The main types of intensive treatment for blood cancer are:

  • Standard-dose or high-dose chemotherapy: using cell-killing drugs with the aim of killing cancerous cells and stopping them from multiplying.
  • Stem cell transplant: having high doses of chemotherapy to kill the abnormal cells in your bone marrow or lymph nodes, then receiving new blood stem cells (either your own or from a donor) through a drip. The aim is for these new stem cells to start producing healthy blood cells.
    • Order or download our booklet Seven steps: blood stem cell and bone marrow transplants for more information on stem cell transplants.
  • Some types of biological therapy / immunotherapies / monoclonal antibodies: drugs that encourage your immune system to fight cancerous cells.
  • Radiotherapy: using high energy rays to kill cancer cells in a particular area (mostly used to treat lymphoma).
  • Surgery: rarely, you may be offered a splenectomy (having your spleen removed).

While some of these treatments offer the opportunity to control or cure blood cancer, many of them are associated with shorter and longer term side effects.

Non-intensive / low-intensity treatment

Non-intensive treatments such as lower-dose chemotherapy are usually gentler and cause fewer side effects. In most cases these treatments won’t cure the cancer but they may help to keep you in remission or manage your symptoms for a good length of time. Types of lower intensity treatment for blood cancer include:

  • Low-dose chemotherapy: using cell-killing drugs with the aim of killing cancerous cells and stopping them from multiplying. 
  • Some biological therapies / immunotherapies / monoclonal antibodies: drugs that encourage your immune system to fight cancerous cells.

These gentler treatments may be used over a longer period of time to keep cancer under control.

Curative treatment

This means treatment that aims to cure blood cancer. 

If your medical team feel that you are unlikely to cope with strong treatments they may offer you some gentler non-curative treatments which may be able to give you a good quality of life and better prognosis (outlook) with fewer risks or side effects.

Non-curative treatments

This means treatment that aims to reduce blood cancer, keep you in remission, or manage your symptoms – rather than curing the cancer. Non-curative treatment can be strong (intensive / high intensity) or more gentle (less intensive / lower-intensity).

> Talk to your healthcare team or see our treatment decisions fact sheet for more information.

Watch and wait

One type of treatment for some people with certain types of slow-developing blood cancer is called watch and wait (you may also hear it called 'watchful waiting' or 'active surveillance'). This means you won’t start treatment straight away, but you’ll have regular blood tests and appointments where you’ll be monitored closely for any changes. You’ll only start treatment – usually low or standard dose chemotherapy – if and when you need it.

> Find out more about watch and wait

Supportive care

People having intensive or non-intensive treatment will have supportive care alongside this. Supportive care means treatments that don’t directly fight cancer but will help manage your symptoms and help you feel better. For example, you may have blood transfusions for anaemia, antibiotics to prevent or treat an infection, or drugs to help manage any side effects of chemotherapy such as mucositis.

Palliative care

Palliative care means care or treatment that you have to help with your symptoms. It aims to give you a good quality of life and look after your emotional and physical well-being. Palliative care isn’t just available at the end of life. You might be offered palliative care earlier, while you’re still having other treatments.

> Read more about palliative care on the Marie Curie website

Follow-up care

The aim of follow-up is to look out for signs of relapse and treatment complications and make sure you get the right treatment if and when you need it.

Treatment decisions fact sheetFind out more

Our treatment decisions fact sheet is designed to help you understand the types of treatments available, what choices you’ll be asked to make, and who can make treatment decisions.

> Download now 

Side effects

Different people have different responses to their treatment. 

  • Short-term side effects are usually temporary ones you get during and immediately after your treatment.
  • Long-term side effects may last for more months or years, or even for life.

People get different long-term and short-term side effects of treatment. Even if two patients are receiving the same treatment, they might have a different experience. So you might not get all, or even any, of the side effects that can be associated with the particular type of treatment you're having. Try to bear this in mind when you read about them.

Your healthcare team will help you manage any side effects you have.

Remission

The aim of most - but not all – blood cancer treatment is to achieve remission. Remission means that the cancer cells in your body have gone. After you've had treatment, your healthcare team will do more tests, similar to the ones you had when you were diagnosed.

These tests will find out how many cancer cells – if any – are still in your body, and whether the cancer cells have gone completely or partially. So you might hear people talking about different types of remission, depending on how well your body has responded to treatment and how many cancer cells are still there. Some doctors may describe you as being 'cured' if you're in complete remission and for many people this can, thankfully, be the case.

Clinical trials

Although the outcome for people with blood cancer continues to improve, there's still a long way to go to improve treatments and quality of life for patients.

Therefore if there’s a clinical trial (study) available, your consultant might recommend that you consider this.

A clinical trial is a planned medical research study involving patients. These studies are done with the aim of looking for new treatment options and improving existing treatments.

Taking part in a clinical trial has many advantages, such as the opportunity to have the newest available treatment which may not be offered outside of the trial. You’ll also be very closely monitored and have detailed follow-up.

If you take part in a clinical trial you'll either have the best current treatment available, or one that has the potential to be better. This allows the two treatments to be compared. Your safety and wellbeing is always the first priority.

Deciding whether to take part in a trial

Taking part in a clinical trial does come with uncertainties, and you may prefer not to take part in one. If you don’t want to be in a trial, or there isn’t a suitable trial available, you’ll be offered the best treatment available at that time which is suitable for your individual condition.

Download or order our booklet: Your guide to clinical trials

> Find out more information on Bloodwise-funded clinical trials

Follow-up

The aim of follow-up is to look out for signs of relapse and treatment complications. These appointments are really important so do make sure you get to them.

For the first year after your treatment, you’ll normally have a check-up every one to two months. After one year, your check-ups will get less and less frequent, until they’re given every year at five years and onwards.

In these check-ups it's important to report any new signs or symptoms to your healthcare team, so that they can investigate these.

Relapse

In some people and with some blood cancer, you can relapse. This means the cancer comes back.

Your healthcare team will monitor your risk of relapse carefully, throughout your treatment and afterwards. Many factors determine your risk of relapse, including the individual condition you have, the stage you were diagnosed at, your age and general health. For many blood cancers, there are options for further treatment after relapse, which aim to get you back into remission.

In general, the longer you stay in remission before a relapse, the better your overall outlook (prognosis).

Prognosis

Each person will have a different outlook (prognosis), which depends on a range of factors. These can include the condition you have, the stage you were diagnosed at and other factors like your age and general fitness. Remember that even the information your healthcare team give you about your outlook may still be quite general, and based on outcomes for other similar patients. It doesn't necessarily mean your outlook will be the same.

Talking about your prognosis

You may find it hard to ask or talk about your prognosis. Sometimes those close to you might want to know your prognosis even if you don’t. However, your healthcare team aren’t allowed to give this or any other information to anyone – not even family members – without your permission.

Try to decide early on who you want to know about your condition, then tell your healthcare team – you can change your mind at any time.

If things change

Remember that your outlook might change, for example, if you respond well to treatment.

If there’s a change in your condition, or if you’ve finished all or part of your treatment, you might want to consider asking if your prognosis is still the same.

Complementary therapies

Updated 17 Nov 2017

Complementary therapies are treatments like massage, meditation or acupuncture that are used alongside standard medical treatments with the aim of making you feel better.

There’s no evidence to suggest that these therapies can treat or cure blood cancer, but there’s some that suggests some of them may help you manage your symptoms or the side effects of your treatment. Other therapies may just help you relax or improve your general sense of wellbeing.

Alternative therapies

There’s an important difference between complementary therapies, which are used alongside standard medical treatments (like chemotherapy and radiotherapy), and alternative therapies, which are offered instead of these treatments. We don’t recommend that you use any alternative therapy in place of proven medical care, but you may be interested in using complementary therapies alongside your treatment.

Keeping yourself safe

If you’re thinking about using complementary therapies, you should let your healthcare team know, so you can discuss what’s safe for you. They may advise you to avoid certain therapies because of specific risks to do with your condition or the treatments you’re receiving. In other cases, they may say a therapy is OK as long as you take specific precautions, like visiting a complementary therapist who’s a member of the relevant professional association or register. Your healthcare team can explain how to check this.

Some hospitals will have a complementary therapies team that offers sessions free of charge, while others might have a specialist who visits once or twice a week. Sometimes these therapies are there for your partner or close relatives, too. Your healthcare team will be able to tell you what’s on offer.

If your hospital doesn’t offer complementary therapies, there may be a local cancer centre or charity that you could visit instead. Speak to your healthcare team to see if they can recommend anywhere nearby.

Some people choose to see an independent complementary therapist.  If you do this, it’s important to make sure they will keep you safe. Speak to your healthcare team about what you need to keep in mind when finding a therapist.

Who's who on your healthcare team

If you’re diagnosed with a blood cancer, your hospital will give you the names and contact details of your consultant, clinical nurse specialist and other members of your healthcare team. You can then use these details to contact your team if you have any questions you want to ask when you’re not in the hospital.

Your consultant

Most people with blood cancer have a haematologist as their main doctor. A haematologist specialises in treating people with blood diseases. Your consultant will be an expert in treating your specific condition.

Your clinical nurse specialist

They are your key point of contact with the rest of your healthcare team. You may like to see your clinical nurse specialist when you’re first diagnosed, to talk about blood cancer and your care.

Your clinical nurse specialist will be with you right through your treatment, and you can always go to them with any worries or questions. They get to know you well, and can support you and your family and friends, and help you access resources that could help you through your treatment. Many patients say it can be really helpful to have them by their side at every step.

Talking to other patients

You might like to ask your consultant or key worker if you can talk to someone who’s had the same diagnosis and treatment as you. If you do this, remember that someone else’s experience won’t always be the same as yours. For example, some patients have side effects from a drug and others don’t.

You may also want to contact a support organisation – many provide patient meetings or further online support.

> You can find a list of other support organisations, along with their contact details, here

Your multidisciplinary team

When you’re diagnosed with a blood cancer, your care is discussed at a multidisciplinary team (MDT) meeting. An MDT brings together doctors, nurses and any other specialist staff who’ll be looking after you. A senior consultant usually leads the meetings, which are held regularly. They’ll discuss the best treatment for you and every aspect of your care, including any changes in your condition.

Your other healthcare professionals

It’s definitely worth telling other healthcare professionals you see – like your dentist or optician – about your diagnosis and any medication you’re taking.

Questions to ask your healthcare team

It’s easy to forget the questions you wanted to ask when you’re sitting with your healthcare team and trying to take in lots of new information. Some people find it useful to write down the questions they want to ask, before they get there.

Tests

  • What tests will I have?
  • What will these tests show?
  • Where will I have the tests done?
  • Are there any risks associated with the tests?
  • Will any of the tests be painful?
  • Do I need to know anything about preparing for the tests, for example, not eating beforehand?
  • How long will it take to get the results?
  • Who will explain the results?
  • What is my exact diagnosis?

Treatment

  • Will I need to have treatment? If so, when?
  • What does the treatment do?
  • Is there a choice of treatments?
  • Is there a clinical trial that I could join?
  • What’s likely to happen if I decide not to have the treatment my healthcare team recommended?
  • If I don’t need to start treatment straight away, how will I know when I need to start it?
  • Who do I contact if I take a turn for the worse?
  • Who can I contact if I have any questions?
  • Is there any written information available or any recommended websites?

My main treatment

  • What type of treatment will I have?
  • Will I have to stay in hospital?
  • If not, how often will I need to go to hospital as an outpatient?
  • What drug regimen will I be given? Will I be given it by mouth, injection or drip (into a vein)?
  • Will my treatment be continuous or in blocks of treatment with a break in between?
  • How long will my treatment last?
  • What side effects could I get from my treatment?
  • Can side effects be treated or prevented?
  • Will they affect me all the time or only while I’m taking certain drugs?
  • What are the fertility risks with treatment and what options are available to me to protect my fertility?
  • What effect is the treatment likely to have on my daily life?
  • Will I be able to carry on working or studying?
  • Will I need to take special precautions, for example against infection?
  • Will I need to change my meal times or work my drugs around these?

Stem cell transplant

  • Is a transplant an option for me?

If I’m having a transplant:

  • How long will I be in hospital for?
  • Do I have to be in isolation?
  • How long will it be before I get back to normal?

Choosing the right treatment for you

If you’re asked to choose between treatments, you might like to ask your consultant these questions about each one:

  • What’s the best outcome I can hope for?
  • How might the treatment affect my quality of life?
  • How will the cancer be monitored after my treatment?
  • How often will I need to have follow-up appointments?
  • Is there anything I need to watch out for after my treatment?
  • Who can I contact if I have any questions or worries?
  • How will doctors know if the cancer is progressing?
  • What are the options for more treatment?
  • What will the treatment involve? Will it be different from my initial treatment?
  • Will there be any side effects from more treatment?
  • Is my prognosis likely to change with more treatment?
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