Treatments for chronic lymphocytic leukemia (CLL) can effectively destroy cancer cells, but they can also damage normal cells. Chemotherapy drugs most often lead to side effects, but targeted therapies and immunotherapies can cause side effects as well.

The lining of the mouth, throat, stomach, and intestines are particularly vulnerable to damage due to chemotherapy. Many CLL treatments can also damage immune system cells, which can leave you at a higher risk of getting a serious infection.

The most common side effects of CLL treatment include:

  • nausea and vomiting
  • diarrhea
  • hair loss
  • changes in taste or smell
  • loss of appetite
  • constipation
  • fatigue
  • body aches
  • rash
  • mouth sores
  • lower blood cell counts, which can cause bleeding and bruising
  • fever and chills
  • reactions at the infusion site

Side effects can happen with any of the treatments for CLL, but everyone’s experience will be different. Along with these eight tips, your healthcare team can help you proactively manage the side effects of your treatment.

One of the most serious side effects of treatment is damage to the body’s immune system. Your doctor will monitor your blood cell counts often as you receive chemotherapy. It’s crucial that you take proper care of yourself to minimize your chances of getting an infection, whether caused by viruses, bacteria, fungi, or parasites.

Here are some steps you can take:

  • Wash your hands frequently and thoroughly with soap and water.
  • Avoid being around children and crowds of people.
  • Avoid using rectal thermometers, suppositories, and enemas as they may injure the rectal area and allow harmful bacteria to enter the body.
  • Cook all meats thoroughly and to the proper recommended temperature.
  • Wash all fresh fruits and vegetables well before consuming.
  • Talk to your doctor about getting vaccinations before treatment starts.
  • Wear a mask that covers your mouth and nose when in a public place.
  • Wash all cuts and scrapes right away with warm water and soap.

Exercise can help relieve fatigue, nausea, and constipation. It can also improve your appetite and overall mood. A little bit of light exercise can go a long way.

Some exercise ideas to consider include:

  • yoga
  • Qigong
  • walking
  • swimming
  • light aerobic or strength-training routines

Ask your healthcare team for a referral to a physical therapist or fitness instructor who knows about fitness programs for people with cancer. Local cancer support groups may also be able to help you find a fitness group. Always consult with your doctor before starting an exercise program.

Low platelets are another concern with CLL treatments. Platelets are needed to form blood clots, so low platelet levels can result in easy bruising and bleeding.

Take steps to protect yourself from injury by following these tips:

  • Brush your teeth with an extra soft toothbrush.
  • Use an electric shaver instead of a razor.
  • Avoid walking barefoot.
  • Avoid using aspirin or other medications that can cause bleeding problems.
  • Avoid contact sports or other activities with a high risk of injury.
  • Don’t drink alcohol without your doctor’s approval.
  • Take care not to burn yourself when ironing or cooking.

Chemotherapy often affects the digestive system. Nausea and vomiting are common side effects, though some people experience constipation and diarrhea as well.

Fortunately, digestive system side effects can be managed with effective medications. This includes antiemetics, anti-diarrhea medications, and medications for constipation.

At times, your treatments can be physically exhausting. But sleeping can be difficult due to stress and anxiety.

These suggestions may help improve your sleep quality and reduce fatigue:

  • Wind down properly before bedtime by taking a warm bath and listening to calming music.
  • Go to bed at the same time every night.
  • Keep the bedroom cool, quiet, and dark.
  • Invest in a comfortable mattress and bedding.
  • Avoid caffeine and alcohol before bedtime.
  • Use stress-relieving techniques like guided imagery, meditation, deep breathing, and muscle relaxation exercises before bedtime.
  • Avoid cell phone and computer screens before bed.
  • Avoid napping during the day; if you need to nap, try to limit naps to 30 minutes.

Many cancer treatments cause loss of appetite, nausea, vomiting, and inability to absorb nutrients. This can sometimes lead to malnutrition.

Due to low red blood cell counts, eating enough iron is vital. Try to eat foods high in iron such as green leafy vegetables, shellfish, legumes, dark chocolate, quinoa, and red meat. If you don’t eat meat or fish, you can help iron absorption by including a source of vitamin C, like citrus fruit.

If possible, meet with a nutritionist or dietitian to create a diet plan that ensures that you get enough calories, fluids, protein, and nutrients. Be sure to also drink plenty of water. Dehydration can make fatigue worse.

Talk to your doctor about what signs and symptoms warrant a visit to the doctor and what is considered an emergency situation. A fever, chills, or signs of infection like redness and pain can be serious.

Write down the number for your doctor’s office somewhere that can be easily accessed and also programmed into your cell phone.

Ask family or friends for help with difficult tasks. People often want to help, but don’t know what they can do for you. Give them a specific task to do around your house. This could include mowing the lawn, cleaning the house, or running errands.

Support groups can give you a chance to discuss your side effects with other people with CLL who are going through a similar experience. Contact your local Leukemia & Lymphoma Society chapter for a referral to a local support group.

As you begin treatment, it’s important that you communicate what you’re feeling to your healthcare team. This will help them tailor your therapy if needed and help improve your overall quality of life. Ask your hematologist or oncologist about possible side effects of your specific treatment regimen and how to manage them.