High-dose treatment with stem cell support can be used to treat a number of different cancers, including some types of lymphoma and leukaemia, myeloma and testicular cancer.

The high-dose treatment will destroy the cells in your bone marrow. Your own stem cells can be used to help ‘rescue’ you from this intensive treatment. Some of your own stem cells are taken and stored before you have high-dose treatment. After the high-dose treatment, your stem cells are given back to you through a drip into a vein (like a blood transfusion).

High doses of chemotherapy, and sometimes radiotherapy, are given to improve the chances of curing your cancer or prolonging a remission. It may be given when the cancer, leukaemia or lymphoma has not completely gone away after standard treatment. It can also be used when there is known to be a higher risk of the cancer returning or when the cancer comes back after initial treatment.

For high-dose treatment with stem cell support to be successful, it is important that there is no sign of any cancer cells in the bone marrow. So this treatment is usually given if the cancer has not spread to the bone marrow or has been cleared out of the bone marrow by previous chemotherapy treatment. Sometimes the collection of cells (harvest) is put through a type of cleaning process (purging) to try to remove any cancer cells that may still be present. Purging the cells in this way is still being tested to see if it is safe and effective, and so is not often used as a treatment in the UK. 

Although high-dose treatment with stem cell support is a serious procedure it is less complicated than using stem cells from a donor. There are fewer complications and recovery is usually faster. It is carried out in hospitals that have large cancer units.

The main problems occur during the time when your bone marrow is recovering. This is when you could have possible life-threatening infections and bleeding. Your doctor will take into account your age and your general health when considering high-dose treatment for you. The upper age limit is usually 65–70. This is because the intensity of treatment increases the risks of severe side effects or of dying from the treatment after that age. High-dose treatment can sometimes be given to people over 65–70, depending on their general health and the risk of the cancer coming back.

This treatment is both physically and emotionally demanding. You may need to stay in hospital for up to four weeks or longer, and there will be times when you feel very unwell.

You need to weigh up the benefits and risks of this treatment, including the possible side effects (especially serious infection or bleeding). It is important to discuss this in detail with your doctor and your family and/or the transplant counsellor at the hospital.

One issue that your doctor should discuss with you, if it is relevant for you, is fertility. Unfortunately, infertility is usually a side effect of this treatment, for both men and women. See life after high-dose treatment for more information.

If I do have high-dose treatment with stem cell support...

• What are the benefits for me?
• What are the risks?
• What are the long-term side effects?
• How will it affect the way I live?
• Will I be able to have children after treatment?
• How long will it be before I can start to live my normal life again?
• What happens if my cancer comes back after high-dose treatment?

If I don’t have high-dose treatment with stem cell support...

• What other treatments are there for me?
• What will happen with my cancer?
• Will I be able to go on living my normal life?

You do not need to feel that you have to rush into making a decision about whether to have high-dose treatment. Most doctors understand that you may want time to think about their recommendations and to discuss them with your family or other people close to you. Most hospitals have staff you can talk things over with, such as a nurse specialist, a transplant coordinator, a social worker and a counsellor.