Your Care Instructions

Acute lymphoblastic leukemia (ALL) is cancer of the blood cells. It is the most common cancer in children. This type of leukemia is often very treatable and has a good chance of being cured.

In ALL, the body starts making abnormal white blood cells that can crowd out the healthy blood cells. This makes a child more likely to bleed, get infections, and not have enough red blood cells (anemia).

When you find out that your child has cancer, you may feel many emotions and may need some help coping. Seek out family, friends, and counsellors for support. You also can do things at home to make yourself feel better while you go through treatment. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

Chemotherapy or therapy with medicine is the main treatment, but radiation or bone marrow transplant also may be used. Your child may get medicine for the side effects of treatment, such as nausea and tiredness. You can do several things at home to help your child feel better and to prevent infections.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

How can you care for your child at home?

• Have your child take his or her medicines exactly as prescribed. Call your doctor or nurse call line if you think your child is having a problem with his or her medicine. Your child may get medicine for nausea and vomiting.
• Give your child healthy food. If he or she does not feel like eating, serve food that has protein and calories to keep up your child's strength and weight. Try a liquid meal replacement for extra calories and protein. Milk shakes are also good choices. Your child's appetite may be better early in the day. Try giving your child the main meal early.
• Let your child have plenty of time to play during the day. Cancer treatment can be hard, but children still need to feel like kids.
• Put your child to bed early enough to get plenty of rest.
• Give your child lots of fluids. This is very important if your child is vomiting or has diarrhea. Give your child sips of water or drinks such as Pedialyte or Gastrolyte. These drinks contain a mix of salt, sugar, and minerals. You can buy them at drugstores or grocery stores. Give these drinks as long as your child is throwing up or has diarrhea. Do not use them as a sole source of liquids or food for more than 12 to 24 hours. Call your doctor or nurse call line if diarrhea or vomiting lasts longer than a day.
• When your child is feeling better, give him or her clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Other good choices include dry toast, crackers, cooked cereal, and gelatin dessert, such as Jell-O.
• Try to keep your child away from people who have a cold, the flu, or other diseases that can be spread. Wash your hands often.

When should you call for help?

Call 911 anytime you think your child may need emergency care. For example, call if:

• Your child passes out (loses consciousness).
• Your child is breathing fast or has sunken eyes and no tears.
• Your child is confused, does not know where he or she is, or is extremely sleepy or hard to wake up.

Call your doctor or nurse call line now or seek immediate medical care if:

• Your child has a fever.
• Your child has any abnormal bleeding, such as:
  • Nosebleeds.
  • Bloody or black stools, or rectal bleeding.
  • Bloody or pink urine.
• Your child has signs of infection, such as:
  • A fever.
  • A cough.
  • Frequent or painful urination.
• Your child's stools are black and tar-like or have streaks of blood.
• Your child has signs of needing more fluids. These signs include sunken eyes with few tears, a dry mouth with little or no spit, and little or no urine for 8 or more hours.

Watch closely for changes in your child's health, and be sure to contact your doctor or nurse call line if:

• Vomiting has lasted longer than 24 hours and your child is not able to keep fluids down.
• Your child has severe diarrhea (large, loose bowel movements every 1 to 2 hours).
• Your child acts much more tired than usual.
• Your child gets a new rash.
• You or your child needs help for depression or anxiety, or both.