Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Cancer Care

Fremont and San Leandro Medical Centers


Acute lymphoblastic leukemia (ALL) is a cancer that involves white blood cells (lymphoblasts). These infection-fighting cells are produced in the bone marrow, which is the spongy tissue inside large bones where all blood cells are made.

After tests show us the type and other important information about your ALL, we’ll talk together to develop a treatment plan that’s right for you. Because ALL grows quickly, it’s important to begin treatment immediately. 

ALL is usually treated in 3 phases.


Induction is the 1st phase. It kills as many leukemia cells in the blood and bone marrow as possible. The goal is to make ALL go into remission. This means: 

  • Blood and bone marrow contain no abnormal white blood cells.
  • Blood counts return to normal.
  • Signs and symptoms of ALL go away.
Consolidation (intensification)

Once ALL is in remission, treatment in this 2nd phrase kills any remaining abnormal cells. It also helps ALL stay in remission.


In this 3rd and final phase, treatment continues, usually at a lower dose, to keep the cancer from coming back. This phase of treatment takes the most time.

Treatment typically takes a total of 2 to 3 years. Treatment options include chemotherapy, targeted therapy, radiation therapy, and bone marrow transplant.


Chemotherapy uses drugs to kill cancer cells. It’s delivered through a vein (IV) or as pills, depending on the specific drugs used. 

Chemotherapy enters the bloodstream and attacks leukemia cells throughout the body. You’ll likely receive multiple chemotherapy drugs to kill the leukemia cells. 

To treat ALL that has spread to the brain and spinal cord, chemotherapy is injected directly into the spinal canal. This may also be used to prevent ALL from spreading to the central nervous system.

Side effects

Chemotherapy can cause mild to serious side effects, depending on the type, dose, and how long it’s given. You may have one or more of the following common side effects of chemotherapy:

  • Hair loss
  • Nausea and vomiting
  • Loss of appetite
  • Diarrhea
  • Mouth sores
  • Fatigue
  • Low blood cell counts, which increases risks of infection, anemia, and bleeding

We can help you manage any side effects. Be sure to let us know as soon as you develop any symptoms. Side effects typically go away after treatment ends.

Targeted Therapy

Targeted therapy uses drugs to block specific parts of the cancer cell that help it survive and grow.

About 1 in 4 people with ALL have a certain cancer mutation (called Philadelphia chromosome). If so, they might also receive a targeted therapy drug (tyrosine kinase inhibitor) in addition to chemotherapy.

Side effects

Targeted therapy attacks cancer cells, so there’s less damage to healthy cells. Side effects may include:

  • Swelling or bloating
  • Muscle cramps
  • Nausea and vomiting
  • Diarrhea
  • Rash

We’ll watch you closely for side effects. Let us know right away if you notice any symptoms.

Radiation Therapy

Radiation therapy uses high-energy radiation beams to kill cancer cells. The most common type is external beam radiation therapy, which delivers radiation from a machine outside the body.

Although rarely used, radiation therapy might be given when ALL has spread to the brain and spinal cord. It’s also sometimes used to treat the entire body before a stem cell transplant.

Side effects

The radiation beam is often aimed at a specific part of the body. Side effects depend on the area treated. Possible short-term side effects include:

  • Hair loss
  • Skin changes, such as redness
  • Nausea and vomiting
  • Diarrhea
  • Fatigue

Let us know if you develop any side effects, we can help manage them.

Stem Cell Transplant

If you have high-risk ALL, you may benefit from a bone marrow transplant, once you’re in remission. Your doctor will talk with you about the details if this is an option for you.

This treatment uses high doses of chemotherapy (and sometimes whole-body radiation therapy) to kill cancer cells in the bone marrow. After this, you’ll receive an infusion of healthy stem cells to restore your bone marrow. 

The healthy stem cells are usually obtained from bone marrow, blood, or a baby’s umbilical cord blood. 

The stem cells may come from another person (donor) who’s a close match to your tissue type (called an allogeneic transplant). 

Side effects

After receiving large doses of chemotherapy (or radiation), you’re at high risk of infections and bleeding. It can take weeks to months for the bone marrow to recover. 

With donor stem cells (allogeneic transplant), your body may attack tissues of the skin, digestive tract, and liver (graft-versus-host disease). We’ll monitor you closely for signs of GVHD. 

Clinical Trials

We’re always looking for new and better ways to treat ALL. Clinical trials are research studies that test new treatments or procedures that may prove better than standard treatments. 

We’ll talk with you about whether a clinical trial may be right for you.

Related Health Tools:

Prepare for Your Procedure

See more Health Tools »

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.