Role Of Surgery
Surgical intervention has a limited contribution to the treatment of a patient's acute lymphoblastic leukemia. Leukemia cells are cancerous cells that circulate in the blood throughout the entire body, so it is not possible to remove the malignancy using surgery. Surgical procedures are sometimes used to perform a biopsy on the patient's lymph nodes to confirm whether leukemia has invaded their lymphatic system. The primary role for surgical procedures in ALL is to place a central venous catheter or tube into the patient's body to administer chemotherapy in a safer and easier way. This type of catheter can also be referred to as a central line, a venous access device.
Another surgical procedure that can be used in the treatment of acute lymphoblastic leukemia is the placement of an Ommaya reservoir for the administration of intrathecal chemotherapy or chemo given directly into the fluid that surrounds the patient's spinal cord and brain. An Ommaya reservoir is a dome-like device that sits just under the patient's scalp that holds a catheter in place. This catheter inserts into the dome device, through a hole in the skull, and then empties into one of the ventricles.
Supportive Care Options
Some patients with advanced acute lymphoblastic leukemia or ALL that is not responding to treatment may choose to pursue supportive care or palliative care options. Supportive or palliative care is care that centers around the relief of symptoms caused by cancer that negatively impact an affected individual's life. Palliative or supportive care focuses on improving the quality of an acute lymphoblastic leukemia patient's life, but it is not intended to cure their condition. Supportive care can be provided with or without curative treatment or treatment intended to cure ALL.
This type of care helps with relief of uncomfortable and bothersome symptoms such as pain, breathlessness, nausea, and fatigue. It also aims to assist with a patient's spiritual and or emotional issues. This type of care may involve the use of drugs to control symptoms, and it may even include treatment that is the same as what is used in curative treatment for acute lymphoblastic leukemia. However, the use of chemotherapy or radiation to relieve symptoms is different than the use of it to actually cure cancer.