When you get there, you will meet members of your transplant team. The team has doctors, nurses, nurse practitioners, and clinical nurse specialists. Other members of the team that you will meet are the social worker, the psychiatrists, dietitian, chaplain, nursing assistants and unit secretaries.
Radiation Therapy (RT)
Radiation therapy may be part of the preparation for your transplant. Small doses of radiation will be delivered to your whole body, Total Body Irradiation (TBI) or to the parts of your body that have lymph nodes (TLI). These doses are given two to three times a day over several days. They are called “fractionated” treatments because the whole dose is divided up. Each treatment takes from 10 to 30 minutes. If you are male and have leukemia or lymphoma, you may have a boost to the testes. This is done to destroy cancer cells that might be hidden there.
You may also need a boost to other parts of your body. The treatment depends on the disease you have. Your transplant doctor and the radiation oncologist will explain the details of your treatment plan.
Having a radiation treatment is something like having an x-ray. The treatment does not hurt. Do not wear any jewelry during treatments. The metal may change the radiation dose to that area.
You and your clothes do not become radioactive during or after the treatments. You cannot pass the radiation to other people.
Stop using any creams, lotions, deodorants, or oils (even lip balm) two days before you start radiation treatments. Do not use them at all while you are getting radiation. You may use Aquaphor© at night.
Family members may go with you when you have your treatments. They must wait outside the treatment room. The nurse will tell you more about how the radiation treatment is given and what you will do during treatment.
Chemotherapy alone or combined with radiation therapy does two things:
- Helps treat your disease
- Prevents your body from rejecting the transplanted stem cells
Some people receive several chemotherapy drugs instead of chemotherapy and radiation. Your doctor will tell you which drugs you will get.
Side Effects of Radiation and Chemotherapy
There are side effects to radiation therapy and chemotherapy. Possible side effects of this therapy include the following:
Bone Marrow Suppression
Radiation and chemotherapy treatments kill both leukemia cells and normal cells in your bone marrow. Because the bone marrow produces your blood cells, your blood counts will be very low until the donor’s marrow begins to work. While you blood counts are low, special measures will be used to protect you from infection and bleeding.
Gastrointestinal Tract Symptoms
Radiation and chemotherapy can make you feel sick when they are given. They also destroy normal cells lining the mouth and intestines. This may cause nausea, vomiting, and diarrhea during and after the treatments. You may also develop painful sores in your mouth and mild to severe pain in your throat and lower esophagus. These are temporary. You will be given anti-nausea and pain medicine when you need it. As your white blood cell count starts to increase, your mouth and throat will start to heal.
You will temporarily lose hair on your body and scalp. This begins about seven to ten days after you have finished your treatment. Until your hair grows back, it may help to wear a scarf, wig or hat. Your hair will start to grow back beginning about three months after the transplant.
The “Look Good….Feel Better”program has specially trained people to teach you how to use make-up to cover sallow skin and hide the loss of eyebrows. The program is offered at 1:30 p.m. on the third Monday of each month in the Patient Support Pavilion in the Cancer Institute. Call 501-686-5578 to sign up.
Sterility is a side effect of both TBI and high-dose chemotherapy. It is highly likely that you will not be able to have children after your transplant. You will be able to have sexual relations. If you have any problems, tell your doctor. There many causes and most problems can be helped. Your feelings about a cancer diagnosis and treatment can make you less interested in sex. Fatigue is also common after transplant. You may not have the energy to have sex when you are tired. Sometimes, physical problems interfere.
Your periods may become irregular or stop. While you are in the hospital, you will take medicine to stop your periods. This is because your platelet count will be low and you will bleed very easily. The medicine will be stopped when your platelets are high enough so that it is safe for you to have periods again. You may need hormone replacement after treatment.
After treatment, your sperm count may be much lower or you may not produce any sperm. If you want to bank your sperm, you MUST do it BEFORE radiation and chemotherapy. Ask your doctor, nurse, or social worker for details before your admission. Some male patients develop erectile dysfunction (impotence). If this occurs, please let you doctor know.
Difficulty with Concentration
Some people tell us they have trouble concentrating after transplant. They complain that their attention span is short. Math may become difficult. This often improves over time, but some patients will not return to the same level they had before transplant.