Friday, July 31, 2009

Addendum to "When to Treat"

It did dawn on me that for those who are 11q or especially 17p deleted at diagnosis might not have a watch and wait period, but might be given treatment shortly thereafter. Therefore, there is no trend to watch before the first treatment, but there may be a trend to watch before second treatment (if it is necessary).

There are other indications for treatment as well. I must confess that I am basing my recommendation on my own experience and what I believe to be accurate. It is based also on the experiences of others and conversations I've had with people, those with a medical background and those who are just careful researchers, as well.

I confess I don't know if a reputable oncologist would initiate a watch and wait patient simply on the basis of reported increase in fatigue. Or with bothersome night sweats. Or on the basis of Rai/Binet stage alone.

I suppose I should really say that it is my opinion that if one is tracking one's absolute lymphocyte counts, and they make a radical change north (as mine did), it's a sign things are changing. People I respect have concurred with me. But, as I've said, this is not a complete picture. Perhaps it's only good for a subset of CLL patients. (But remember that night sweats and other 'B' symptoms aren't always related to CLL. Other diseases or even coming off drugs for pain can lead to this problem. Or, I understand, even menopause?)

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