Establishing a support network
Whether you have been newly diagnosed with acute promyelocytic leukemia (APL) or
you are attempting to come back from a relapse, it is helpful to have people in
your life to support your journey. People who have cancer often find that their
needs change because of their cancer. The tasks of daily life may become more challenging.
Feelings may be more intense. It is important to remember that you are not alone.
In addition to the doctors, nurses, and other members of your treatment team, your
support network may include:
If you are a caregiver for an APL patient, you are a big part of the support network.
>> Click here for information that may be helpful to you.
Sources of support
Family and friends can support you in many ways. But they may wait for you to give
them hints or ideas about what to do. Someone who is not sure if you want company
may call "just to see how things are going." When someone says, "Let me know if
there is anything I can do," tell this person if you need help with an errand or
a ride to the doctor's office.
Family members and friends can also:
- Keep you company, give you a hug, or hold your hand
- Listen as you talk about your hopes and fears
- Help with rides, meals, errands, or household chores
- Go with you to doctor's visits or treatment sessions
- Tell other friends and family members ways they can help
>> Click
here for more information from the National Cancer Institute about getting
the support you need.
Even though your family and friends help, you may also want to meet people who have
cancer now or have had it in the past. Connecting with other patients can provide
a source of encouragement, information, inspiration, and support. Often, you can
talk with them about things you can't discuss with others. People with cancer understand
how you feel and can:
- Talk with you about what to expect
- Tell you how they cope with cancer and live a normal life
- Help you learn ways to enjoy each day
- Give you hope for the future
Let your doctor or nurse know that you want to meet other people with cancer. You
can also meet other people with cancer in the hospital, at your doctor's office,
or through online message boards or support groups.
>> Click
here for more information from the National Cancer Institute about getting
the support you need.
Cancer support groups are meetings for people with cancer and those touched by cancer.
These groups allow you and your loved ones to talk with others facing the same problems.
Support groups often have a lecture as well as time to talk. Almost all groups have
a leader who runs the meeting. The leader can be someone with cancer or a trained
counselor. People in support groups often:
- Talk about what it’s like to have cancer
- Help each other feel better, more hopeful, and not so alone
- Learn about what's new in cancer treatment
- Share tips about ways to cope with cancer
Many hospitals, cancer centers, community groups, and schools offer cancer support
groups. You can call your local hospital and ask about its cancer support programs,
or look in the health section of your local newspaper for a listing of cancer support
groups.
>> Click
here for more information from the National Cancer Institute about getting
the support you need.
Information for caregivers
Caregiving can feel like a full-time job. Caregivers often help people with preparing
meals, food shopping, babysitting, bathing and dressing, transportation to medical
appointments, taking medications, and providing emotional support. As a caregiver,
you may experience feelings such as anxiety, fear, anger, sadness and exhaustion
because of the patient's diagnosis and treatment. While you are caring for others,
it is important to take time to care for yourself. Some caregivers find that keeping
a list or schedule of appointments helps them feel more organized. Having your own
support system can also be very helpful in reducing stress.
>> Click here for more information from the National Cancer Institute about
your role as a caregiver.
The American Cancer Society also offers helpful suggestions for supporting cancer
patients.
>>
Click here to learn how you can best support your loved one.
TRISENOX is indicated for induction of remission and consolidation in patients with APL who
are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose
APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression.
Serious adverse events, grade 3 or 4, were common. Those events attributable to TRISENOX in the Phase 2
study of 40 patients with refractory or relapsed APL included APL differentiation syndrome (n=3), hyperleukocytosis (n=3), QTc
interval prolongation (n=16), atrial dysrhythmias (n=2), hyperglycemia (n=2), and torsades de pointes (n=1).
In addition to QT interval prolongation, the most common drug-related side effects included leukocytosis, gastrointestinal events (nausea, vomiting, diarrhea, and abdominal pain), fatigue, swelling, hyperglycemia (an abnormal increased content of sugar in the blood), shortness of breath, cough, rash or itching, headache, and dizziness. Have your doctor review side effects with you.
In clinical trials, most patients taking TRISENOX experienced some drug-related toxicity, most commonly leukocytosis, gastrointestinal (nausea, vomiting, diarrhea, and abdominal pain), fatigue, edema, hyperglycemia, dyspnea, cough, rash or itching, headache, and dizziness. These adverse effects have not been observed to be permanent or irreversible, nor do they usually require interruption of therapy.
It is important to call your doctor if you experience any treatment side effects.
WARNING
Experienced Physician and Institution:
TRISENOX® (arsenic trioxide) injection should be administered under the supervision
of a physician who is experienced in the management of patients with acute leukemia.
APL Differentiation Syndrome:
Some patients with APL treated with TRISENOX have experienced symptoms similar to a syndrome called
the retinoic-acid-acute promyelocytic leukemia (RA-APL) or APL differentiation syndrome, characterized
by fever, dyspnea, weight gain, pulmonary infiltrates and pleural or pericardial effusions, with or
without leukocytosis. This syndrome can be fatal. The management of the syndrome has not been fully
studied, but high-dose steroids have been used at the first suspicion of the APL differentiation
syndrome and appear to mitigate signs and symptoms. At the first signs that could suggest the syndrome
(unexplained fever, dyspnea and/or weight gain, abnormal chest auscultatory findings or radiographic
abnormalities), high-dose steroids (dexamethasone 10 mg intravenously BID) should be immediately
initiated, irrespective of the leukocyte count, and continued for at least 3 days or longer until
signs and symptoms have abated. The majority of patients do not require termination of TRISENOX therapy
during treatment of the APL differentiation syndrome.
ECG Abnormalities:
Arsenic trioxide can cause QT interval prolongation and complete atrioventricular block. QT prolongation can
lead to a torsade de pointes-type ventricular arrhythmia, which can be fatal. The risk of torsade de pointes
is related to the extent of QT prolongation, concomitant administration of QT prolonging drugs, a history of
torsade de pointes, pre-existing QT interval prolongation, congestive heart failure, administration of
potassium-wasting diuretics, or other conditions that result in hypokalemia or hypomagnesemia. One patient
(also receiving amphotericin B) had torsade de pointes during induction therapy for relapsed APL with arsenic
trioxide.
ECG and Electrolyte Monitoring Recommendations:
Prior to initiating therapy with TRISENOX, a 12-lead ECG should be performed and serum electrolytes (potassium,
calcium, and magnesium) and creatinine should be assessed; pre-existing electrolyte abnormalities should be
corrected and, if possible, drugs that are known to prolong the QT interval should be discontinued. For QTc
greater than 500 msec, corrective measures should be completed and the QTc reassessed with serial ECGs prior
to considering using TRISENOX. During therapy with TRISENOX, potassium concentrations should be kept above 4 mEq/L
and magnesium concentrations should be kept above 1.8 mg/dL. Patients who reach an absolute QT interval value > 500
msec should be reassessed and immediate action should be taken to correct concomitant risk factors, if any, while
the risk/benefit of continuing versus suspending TRISENOX therapy should be considered. If syncope, rapid or irregular
heartbeat develops, the patient should be hospitalized for monitoring, serum electrolytes should be assessed, TRISENOX
therapy should be temporarily discontinued until the QTc interval regresses to below 460 msec, electrolyte abnormalities
are corrected, and the syncope and irregular heartbeat cease. There are no data on the effect of TRISENOX on the QTc
interval during the infusion.