Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Specialists who treat blood disorders and other kinds of cancer are either hematologists or hematologist-oncologists. These specialists treat leukemia.
Children are usually treated by a specialist in childhood cancers (pediatric hematologist or hematologist-oncologist).
On other occasions, more than one opinion may be sought by the patient or by the referring primary care physician.
Leukemia patients often find it helpful to take a family member or close
friend along to these consultations in order to take notes and assist in
remembering some of the points of the discussion.
Most patients are treated in major medical centers with state-of-the-art cancer treatment programs.
Once the patient has had the first encounter with the specialist, he or she will have ample opportunity to ask questions and discuss treatment options. The advantages and disadvantages of various treatment options are thoroughly discussed.
Leukemia treatment depends almost exclusively on the type. Modifying factors may be age, overall health, and prior therapy. Treatment is almost always carried out as part of carefully controlled multi-center programs so that information from many different areas may be constantly analyzed and altered if the results appear to necessitate changes. The patient is always kept abreast of ongoing treatment activities and changes in the treatment plan.
Treatment commences only if the patient or the patient's guardian concurs.
In addition to the blood specialist, the patient's medical care team usually includes a specialist nurse or physician assistant, social worker (and for children, child-life worker), and sometimes a member of the clergy, all of whom play major roles in furthering well being.
Leukemia Medical Treatment
Leukemia treatment falls into two categories -- treatment to fight the cancer and treatment to relieve the symptoms of the disease and the side effects of the treatment (supportive care).
The most widely used antileukemic treatment is chemotherapy, that is, the use of powerful drugs to kill leukemia cells.
Treatment usually involves combinations of chemotherapy.
Depending on the medication, therapy may be administered by vein or by mouth.
In some cases, chemotherapy can be given at the doctor's office or some may be taken at home; in other cases, the patient may have to stay in a hospital. This depends on which agents the patient is receiving along with his or her overall condition (sometimes measured in terms of "performance status").
Many people with leukemia have a semi-permanent intravenous (IV) line placed in the upper chest, near the shoulder.
A thin, plastic tube called a catheter is passed through the skin of the chest and inserted into a large vein. It is held in place, usually for the planned duration or therapy, with a few stitches, which makes it possible to use the same vein on numerous occasions without worry about the intravenous line being pulled out. The line is often burrowed under the skin.
People who have leukemia in their cerebrospinal fluid, or who are at high risk of having leukemic cells migrate to the spinal fluid, receive chemotherapy directly into the cerebrospinal canal. This is known as intrathecal chemotherapy.
Intrathecal chemotherapy is necessary because drugs given via IV do not sufficiently penetrate into the cerebrospinal fluid or brain and, thus, cannot kill leukemia cells there. Insufficient penetration of drugs into the cerebrospinal fluid results in uncontrolled growth of leukemic cells in the cerebrospinal fluid. Sometimes the therapy is inserted into a sac placed in one of the larger fluid-filled areas of the brain, a ventricle. The sac is known as an Ommaya reservoir, so named after its developer.
The reservoir stays in place for the duration of the treatment.
Reviewed by Melissa Conrad Stöppler, MD on 8/13/2012