How treatment is planned
The first step is an accurate diagnosis. Blood counts, blood film, bone marrow examination, flow cytometry, cytogenetics and molecular tests define the disease and its risk. Imaging and sometimes a lumbar puncture complete staging. Fitness is assessed with heart, kidney, liver and infection screening, and fertility is discussed before treatment when relevant.
Treatment may aim to cure, to control the disease for years, or to relieve symptoms. Some blood cancers, such as chronic myeloid leukaemia, are treated with targeted tablets rather than classical chemotherapy. Others need intensive chemotherapy, sometimes with transplant. The plan should be explained in plain language before it starts.
Related: Haematology → · Dr. Sachita Baniya profile → · All conditions →
What chemotherapy involves
Chemotherapy may be given by mouth, by injection or through a central line. Some regimens need hospital admission, while others are given in a day-care unit. Each cycle has a schedule, blood tests before treatment and a plan for delayed side effects. Treatment is adjusted when counts are low, infection develops or organ function changes.
Not every patient receives the same regimen. Age, performance status, comorbidities, disease genetics and patient preference all influence the choice. A second opinion is reasonable when the diagnosis or the intensity of treatment is uncertain.
Side effects and supportive care
Chemotherapy affects dividing cells, so it can lower blood counts, cause nausea, mouth sores, hair loss, fatigue and increased infection risk. Some drugs affect nerves, the heart, the kidneys or fertility. Supportive care includes anti-sickness medicines, growth factors, antibiotics or antivirals when indicated, transfusion and nutritional support.
Fever during chemotherapy is an emergency and needs same-day assessment. Do not wait for the next appointment. The treating team should provide a written plan for what to do after hours, which medicines to avoid and when to call.
| Side effect | Support available |
|---|---|
| Low white cells and fever | Urgent assessment, cultures, antibiotics, growth factor when appropriate |
| Anaemia or low platelets | Transfusion support and treatment adjustment |
| Nausea or mouth sores | Anti-sickness medicines, mouth care and hydration |
| Nerve tingling or heart or kidney effects | Dose review, monitoring and specialist input |
Access and booking
Dr. Baniya consults at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, and also practises at Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital, Kathmandu, and Advanced Care Hospital. Appointments are arranged at the Durbar Marg clinic or through the respective hospital or cancer centre. Bring all blood counts, blood film, marrow, flow cytometry and molecular reports.