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Chronic Myeloid Leukemia (CML): Radiation Therapy

Chronic Myeloid Leukemia (CML): Radiation Therapy

What is radiation therapy?                

Radiation therapy is a treatment for cancer that uses high-energy X-rays. A machine directs the rays of energy to the area of cancer. Radiation therapy is also called radiotherapy. Its goal is to kill or shrink cancer cells.

When is radiation therapy used for chronic myeloid leukemia (CML)?

Radiation therapy is not a common treatment for CML. Your doctor may advise it for these reasons:

  • Your symptoms aren't being helped by other treatments. For example, you may have a swollen spleen pressing against another organ, such as your stomach. This can cause a loss of appetite. In this case, radiation can be used to reduce swelling of the spleen. Radiation can also help with bone pain caused by the leukemia spreading to the bone.

  • You’re having a stem cell transplant. Radiation therapy kills not only cancer cells, but also normal bone marrow cells. If you’re having a stem cell transplant, you may have total body irradiation (TBI). This sends radiation in equal doses to all parts of your body. That's because leukemia cells can be in any blood vessel in any part of your body. But most stem cell transplants for CML are done without the use of radiation. Talk about the options with your doctor. 

How is radiation therapy given?

A doctor who specializes in cancer and radiation is called a radiation oncologist. This doctor will work with you to determine what kind of radiation you need. This doctor will also determine the dose and how long you need the therapy.

You will receive radiation treatments either as an outpatient or as an inpatient. Outpatient means you go home the same day. Inpatient means you stay overnight in the hospital. For treatment directed at just a small part of your body, you can likely do this as an outpatient. If you’re getting ready for a stem cell transplant, you will have the treatments as an inpatient.

During a radiation treatment session

The treatment is a lot like getting an X-ray. You stay in the radiation room for about an hour. The radiation will take about 15 minutes.

You’ll lie on a table while the machine is placed over you. The radiation therapist will line up the machine exactly with your marked treatment fields. The radiation therapist will leave the room to turn on the machine. You will be able to talk to each other over an intercom. You may hear whirring or clicking noises. During the session, you will be able to talk to the therapist over an intercom. The procedure is painless. You will not be radioactive afterward.

During total body irradiation (TBI) 

If you’re having total body irradiation as part of a stem cell transplant, you will stand in a special machine or lie down on either your stomach or your back. Special shields protect your organs, such as your lungs, heart, and kidneys, from high-dose radiation. 

Possible side effects of radiation therapy

Radiation affects normal cells as well as leukemia cells. Because of this, you may have side effects from this treatment. The severity of side effects depends on the dose, frequency, and location of the treatments. For radiation only on a specific part of the body, the side effects are usually mild. Many people have no side effects. Side effects get better and go away when the treatment ends.

Tell your doctor if you have side effects. He or she may change the dose of radiation, or stop treatment until the side effects are gone. 

Short-term side effects may include: 

  • Nausea, vomiting, or diarrhea if your abdomen is treated

  • Tiredness

  • Hair loss in the area being treated

  • Skin irritation in the area being treated

  • Sore mouth (mucositis) if the head and neck are being treated

  • Low levels of blood cells

  • Easy bruising and bleeding 

Long-term side effects may not show up for several years after treatment is over. Long-term side effects may include:

  • Growth of another type of cancer in the treated area

  • Chronic skin problems, such as redness

The immediate side effects of total body irradiation can be more severe than for targeted radiation. They include an increased risk for infection from a reduction in white blood cells and from damaged skin and mucous membranes. 

Working with your healthcare providers

Talk with your healthcare providers about what symptoms to watch for, and when to call them. Make sure you know what number to call with questions, even on evenings and weekends.

It may be helpful to keep a diary of your side effects. Write down any changes you notice, how severe they are, and when they happen. A written list can make it easier for you to remember your questions when you go to your next appointment. It can also make it easier for you to work with your medical team to make a plan to manage your side effects. 

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