The treatment phase
The first step is to have treatment to:
- Destroy any cancer cells remaining in the body
- Make room for the new bone marrow
The specific chemotherapy you receive will depend on the type of disease you have and the type of transplant you will have. Members of the Blood and Marrow Transplant Program will talk to you about the treatment that is planned specifically for you.
The doses of chemotherapy and radiation therapy you will have are higher than the doses given to someone with the same disease who is not having a stem cell transplant.
Although there are common side effects, everyone experiences them differently. Nausea is the most common side effect during chemotherapy and during the few days following chemotherapy. The severity of side effects will depend on the treatment you get and, to some degree, your physical condition before starting treatment. The side effects can be severe for some people, but treatment is available to help control them. Your doctor, pharmacist and nurse will give you information about the treatment you will be having.
Total Body Irradiation (TBI)
Total body irradiation involves treating your whole body with radiation. It takes about 1.5 to 2 hours to complete. Most of this time is used to set up the procedure. You will be receiving radiation for about 40 minutes.
During the set-up, medical physics specialists, radiation therapists, and your radiation oncologist all work together to deliver your treatment.
Throughout set-up and treatment, you will be lying flat on a treatment bed with a perspex (clear hard plastic) box surrounding you. Additional slabs of perspex and bags of saline are packed around you to create a snug fit. This can be slightly uncomfortable and confining at times but is necessary for accurate distribution of radiation throughout your body. During treatment, you may feel extremely warm or cold. This is due to the packing material surrounding you, not the radiation.
After set-up is complete, all staff members leave the room to operate the treatment machine. You can talk to them through an intercom system. The staff can see you through a video camera which is focused on you at all times. If needed, the staff can re-enter the room quickly.
While the treatment is in progress, you will hear some noises. This is the normal operating sound of the machine.
The treatment is given in two parts. Once the first side (either left or right) is completed, the bed will be turned around, so that your other side can be treated. Each side can take up to 20 minutes to treat. Once the whole treatment is delivered, the packing will be removed, and you return to your room.
It is common to feel some side effects after TBI. You will be given medication before the treatment to prevent and lessen these side effects.
Some people have nausea and vomiting, fever and swollen neck glands. Tell your nurse if you have these symptoms. You can be given more medication if needed.
Later you may find that your skin is drier than normal. Moisturizing skin lotion can be used to lessen dryness.
Mouth sores may occur and are treated with special mouth rinses.
