Once you're in remission and have finished postremission (consolidation and maintenance) therapy for acute lymphoblastic leukemia (ALL), you'll need to visit your doctor for regular follow-up care. He or she monitors your health and looks for signs that you may need more treatment. Some treatments can cause long-term effects or late effects.
Your doctor will let you know how often you need physical exams and blood tests to check your blood cell counts. Your oncologist will screen you for cancer recurrence and the development of a secondary cancer. This may include bone marrow tests to detect cancerous cells.
If you continue to show no signs of ALL and no long-term or late effects, your doctor may suggest longer periods between visits.
The National Comprehensive Cancer Network (NCCN) produces Clinical Practice Guidelines in Oncology for most cancers, which many doctors follow. Their guidelines are among the most comprehensive and most frequently updated clinical practice guidelines available in any area of medicine. You can download guidelines at the NCCN website for helpful information about ALL to discuss with your doctor.
Some treatment centers have comprehensive follow-up care clinics for cancer survivors. To find a long-term survival clinic near you, visit The National Coalition for Cancer Survivorship.
Long-Term and Late Effects of Treatment
Some side effects of cancer treatment, such as fatigue and infertility, can linger for months or years after therapy. Other medical conditions like heart disease and other cancers may not appear until years after treatment ends.
Not everyone suffers from long-term effects and late effects of treatment, but for some patients the effects can range from mild to severe. Your risk for developing long-term or late effects can be influenced by:
- your treatment type and duration
- your age at the time of treatment
- your gender
- your overall health
Long-term and late effects can impact your physical, mental and cognitive (brain function) health in several ways, including:
- heart or thyroid problems
- a secondary cancer
- a low energy level
- hearing loss
- posttraumatic stress disorder
- an inability to concentrate or focus
Stem cell transplantation patients are at increased risk of infertility, thyroid dysfunction and chronic fatigue. They're also at risk of developing a secondary cancer such as lymphoma; melanoma; and cancers of the central nervous system, bone, soft tissue, thyroid gland, tongue and salivary glands. However, the number of patients who develop a secondary cancer is small.
Researchers are working to improve their understanding of long-term and late effects and create guidelines for follow-up care. If you'd like to contribute to this important research, you can take part in a clinical trial that collects data on long-term and late effects.