Finding out you have leukemia can be devastating. Learning about the disease and the advances in treatment can help you cope.

Every year, some 43,000 Americans learn they have leukemia, and almost 22,000 die of this deadly blood cancer.

Yet close to 260,000 people in the U.S. are living with or in remission from the disease, the Leukemia and Lymphoma Society says. The five-year survival rate is nearly four times higher than it was 50 years ago.

A 2010 study in the New England Journal of Medicine found that a decade of refinements in marrow and stem cell transplants to treat leukemia and other blood diseases has significantly reduced the risk for treatmentrelated complications and death.

Researchers compared transplant outcomes at a Seattle center in the mid-1990s with those a decade later. They found a 60 percent reduction in the risk for death within 200 days of a transplant and a 41 percent reduction in the mortality risk after a transplant at any time during the study.

The authors cited changes in medical practice that appeared to help reduce transplant risks. Medication doses can be carefully monitored and adjusted. New methods and tests aid early detection and treatment of infections. Experts also expect the number of transplants to rise due to more accurate matching of marrow or stem cell donors with unrelated patients.

If you or a loved one has been diagnosed with leukemia, knowing your options can help you make informed decisions about your care.

Treatment Options
Besides stem cell transplants, people with leukemia have other treatment choices, such as watchful waiting and radiation. Chemotherapy kills leukemia cells, while targeted therapy blocks their growth and biological therapy mobilizes the body's natural defenses against them.

People may receive more than one or even all these therapies. The choice depends on several factors:

• Your general health and symptoms
• The type of leukemia, its stage, and its rate of progression
• Whether you've had cancer or chemotherapy before
• The effect a treatment would have on your quality of life

You can also ask your doctor if treatment in a clinical trial is an option.

A person with leukemia should seek treatment at a medical center with doctors who are experienced with this kind of cancer. Specialists include hematologists, medical oncologists, and radiation oncologists.

Acute vs. Chronic
People with acute leukemia need treatment right away. The goal is to destroy the leukemia and send it into remission. Proper treatment can cure many people with acute leukemia.

People with chronic leukemia but no symptoms may not need immediate treatment. They can be treated if symptoms arise. Stem cell transplants are a potential cure for people with this type of cancer.

Questions to Ask
Leukemia treatment can be complex, with different effects on each person. The National Cancer Institute suggests you ask your doctor these questions before deciding on a treatment:

• What treatments do you recommend and why?
• What are the expected benefits, risks, and possible side effects of each treatment?
• What will the treatment cost, and how much will my insurance cover?
• How will each treatment affect my day-to-day activities?
• How often should I have checkups?

Finding out you have leukemia is frightening. Even so, the outlook for people with this type of cancer is improving--and new treatments are on the horizon.

Barbara Floria, senior writer for Vitality.

For more information, visit the Leukemia and Lymphoma Society at www.lls.org.

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