Managing side effects for AML

Chemotherapy drugs affect both cancerous cells and healthy fast- dividing cells. This can cause side effects such as nausea, hair loss and fatigue. Side effects vary depending on the drugs, but most are temporary and there are ways to prevent or reduce them. Here we will discuss some common side effects of treatment for acute myeloid leukaemia (AML).

Tell your treatment team about your side effects or anything unusual you experience. Check with your doctor before using ibuprofen, aspirin or other medicines, including herbal medicines. These may affect how the chemotherapy works and may make side effects worse.

Learn more about these treatments for AML:

• Easy bruising or heavy bleeding
• Increased risk of infections 
• Fatigue
• Nausea and appetite changes
• Changed bowel habits
• Mouth problems
• Nerve and muscle effects
• Hair loss
• Thinking and memory changes
• Infertility

Listen to our podcasts on Managing Cancer Fatigue,  Appetite Loss and Nausea, and Sleep and Cancer

Easy bruising or heavy bleeding

Chemotherapy can lower the number of platelets in your blood. This is called thrombocytopenia and it means you will bruise and bleed more easily from cuts and scrapes. Women who are menstruating will be given drugs to stop monthly periods and prevent any unnecessary blood loss while platelet counts are low. Your doctor may recommend you have a platelet transfusion to help raise your platelet count.

Increased risk of infections

The combination of chemotherapy drugs, as well as the leukaemia itself, will lower your levels of the white blood cells called neutrophils. This is known as neutropenia and it can make you more likely to get infections such as colds or infected cuts, so it is important to take extra precautions (see table below). To speed up the production of new white blood cells, your doctor may prescribe a growth factor drug called granulocyte-colony stimulating factor (G-CSF).

Taking care with infections during chemotherapy

Fatigue

The level of your red blood cells may drop (anaemia), causing you to feel tired and breathless. This can be treated with blood transfusions. However, some people feel fatigued for weeks or months after cancer treatment, even once their blood count returns to normal. To manage this, plan activities for the time of day you feel most energetic. Exercise can reduce fatigue and improve mood. Talk to your health care team about the best exercise for you, and find out about Cancer Council’s exercise programs and resources.

For more on this, see Fatigue and listen to our podcast on Managing Cancer Fatigue

I do become tired and I have to be careful, but if I pace myself, I can achieve what I want to achieve.

— Read more of Sue’s story

Nausea and appetite changes

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.

Your appetite may change during chemotherapy. The drugs sometimes change how food tastes (e.g. it may taste metallic), cause mouth ulcers, and, less often, make you feel nauseous. Try having frequent snacks instead of large meals. You can also enrich drinks with powdered milk, yoghurt, eggs or honey. A dietitian at the treatment centre can help you work out an eating plan.

For more on this, see Nutrition and cancer, and listen to our podcast on Appetite Loss and Nausea

Changed bowel habits

Hard, dry bowel movements (constipation) or loose, watery stools (diarrhoea) can be caused by chemotherapy and other medicines. Speak to your doctor if you are experiencing bowel changes, as it is important to act early to prevent further problems. For constipation, they may suggest you eat more fibre or prescribe some laxatives. Your doctor can also prescribe medicines to control diarrhoea.

Mouth problems

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 team may prescribe mouthwashes to help with mouth care, or you can rinse your mouth four times a day with a teaspoon of bicarbonate of soda or salt in a glass of warm water.

Have regular dental check-ups, but talk to your haematologist before you have any dental work during your leukaemia treatment.

Read more about mouth health and cancer treatment.

Nerve and muscle effects

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 and it is usually a short-term issue, but for some people, it can last a long time or even be permanent.

If you experience 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.

Hair loss

Hair loss 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. Wear some form of head covering to keep warm and to protect your head from direct sunlight.

Look Good Feel Better runs free programs on how to manage the appearance-related side effects of cancer treatments. To book into a workshop, call 1800 650 960 or visit Look Good Feel Better.

Read more about hair loss.

Thinking and memory changes

Some people say they have difficulty concentrating, focusing and remembering things after they have had 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 your return to work.

For more on this, see Changes in thinking and memory, and listen to our podcast on Brain Fog and Cancer

Infertility

Some women’s periods become irregular during treatment, but return to normal when it finishes. For other women, chemotherapy or total body irradiation may cause periods to stop permanently (menopause). Menopausal women can no longer conceive a child naturally. Early menopause may also cause bones to become weaker and break more easily. This is called osteoporosis.

In men, chemotherapy may lower the number of sperm produced and reduce the sperm’s ability to move. This can cause infertility, which may be temporary or permanent. Total body irradiation can also reduce sperm production. Before treatment starts, your doctor will talk to you about infertility and can refer you to a fertility specialist.

For more on this, see Fertility and cancer.