Some leukaemia or lymphoma patients might need to undergo a splenectomy. journey looks at the process and its implications

Patients with a blood or lymphatic cancer may need to have their spleen removed. Here we look at the reasons why and what happens following a splenectomy.

The spleen forms part of the lymphatic system. The lymphatic system acts as the body’s drainage network – it balances bodily fluids, acts as a filter and helps the body to fight infections. The spleen is about the size of a small fist and is on the upper left side of the body, above the stomach and under the ribs. The spleen filters and removes old and damaged red blood cells and other foreign matter such as bacteria which helps keep the blood clean and fight infections.

The spleen can become damaged, enlarged or stop working and might have to be removed, particularly in patients with some types of lymphoma and leukeamia. An operation called a splenectomy is required to remove the spleen either through traditional ‘open’ surgery or using ‘keyhole’ techniques.

Removing the spleen means that the patient will be at a higher risk of infection, as the bacteria are not being filtered out of the bloodstream. Some infections the body may still be able to cope with but in some cases serious infections may develop very quickly. Overall the risks of serious infection are low and there are steps that can be taken to help avoid the risks.

Steps to take

• make sure that people know that you do not have a spleen, especially doctors and dentists;
• carry an alert card or wear an identification bracelet at all times. Splenectomy cards are available from Leukaemia CARE;
• you will need to check you have had all the childhood vaccinations and boosters, especially the newer vaccinations, which you may not have received, such as: pneumococcous, hib, meningitis C and influenza. Check with your medical team which ones you need;
• you may have to take a low dose of antibiotics for some time after your operation, possibly for life, to help your body fight infections;
• you may need extra vaccinations if you are travelling abroad and also may need to take additional precautions in some countries;
• if you feel ill, even with something minor such as a headache or a sore throat, you will need to see a doctor immediately, as you may need early diagnosis and treatment;
• you will need treatment for any animal bites, especially dog bites, to prevent the risk of infection; and
• if you enjoy outdoor hobbies, such as walking or camping, you may need to take extra precautions and keep skin covered by wearing long trousers and long sleeves to reduce the risk from ticks and insects.