What is chronic lymphocytic leukemia (CLL)?
Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the blood and bone marrow. It’s a type of non-Hodgkin lymphoma that starts in the body’s infection-fighting white blood cells, called B cells. Normal B cells circulate in your blood and help your body fight infection. This cancer produces lots of abnormal white blood cells in the bone marrow and blood that can’t fight infection. As the number of cancerous B cells gradually increases, they crowd out normal lymphocytes.
Because Chronic lymphocytic leukemia is slow-growing cancer, some people with CLL won’t need to start treatment for many years after their diagnosis. In people whose cancer does spread, treatments can help them achieve long-term periods when there is no sign of cancer in their bodies. This is called remission.
Symptoms of Chronic lymphocytic leukemia progression
Symptoms of CLL can vary depending on the stage or extent of the disease. You may not have symptoms early on and their cancer may only be discovered during a routine blood test.
If you do have symptoms, they typically include:
- unexplained weight loss
- extreme fatigue and shortness of breath
- fever and night sweats
- frequent infections or illness
- enlarged spleen
- enlarged lymph nodes
- abdominal fullness
- abnormal lab tests
If this happens to you, you may feel painful lumps in your neck or a sensation of fullness or swelling in your belly. Make an appointment with your doctor if you develop any of the above symptoms. The sooner you receive a diagnosis, the better your outlook is.
Treatments for low-risk Chronic lymphocytic leukemia
If you have low-risk CLL, your doctor (usually a hematologist or oncologist) will likely advise you to “wait and watch” for symptoms. Your disease may not worsen or require treatment for years. Some people never require treatment. This approach is also called active surveillance.
Someone with low-risk CLL may not need further treatment and still, you’ll need to see a doctor for regular check-ups and lab tests. They may recommend treatment if you have:
- persistent, recurrent infections
- low blood cell counts
- fatigue or night sweats
- painful lymph nodes
Treatments for intermediate- or high-risk Chronic lymphocytic leukemia
If you have intermediate – or high-risk CLL, your doctor will probably advise you to proceed with treatment right away. Below are some treatments your doctor may recommend.
Chemotherapy, Immunotherapy and Targeted Therapy
Before a few years ago, people with Chronic lymphocytic leukemia had no treatment options beyond chemotherapy. Then, immunotherapy, which helps your body’s immune system find and kill cancer cells while targeted therapy, focuses on the specific genes, proteins, or tissues that contribute to the cancer cells’ survival. Began to change the outlook and dramatically extend the survival rate for people with CLL.
Bone Marrow or Peripheral Blood Stem Cell Transplant
If you have high-risk CLL and your cancer doesn’t respond to other treatments, this treatment may be an option. It involves taking stem cells from the bone marrow or blood of a donor — usually a family member — and transplanting them into your body to help establish healthy bone marrow.
This treatment may be risky because the donor cells could attack your healthy cells and this is a serious condition called graft-versus-host disease. And having a transplant also increases your risk of infection. Also, it doesn’t work for everybody with CLL.
Radiation
In this procedure, Radiation therapy uses high-energy particles or waves to help kill cancer cells. Also, this treatment isn’t often used for Chronic lymphocytic leukemia, but if you have painful, swollen lymph nodes, radiation therapy may help shrink them and relieve your pain.
Breakthrough Treatments
CAR T-cell therapy
One of the most promising future treatment options for CLL is CAR T-cell therapy. CAR T, which stands for chimeric antigen receptor T-cell therapy, is a special kind of immune therapy that uses your own modified immune cells to fight cancer.
First, immune cells called T cells are collected from your blood and altering your immune cells to better recognize and destroy cancer cells. When the modified T cells are placed back into your body, they seek out and destroy cancer cells.
Right now, CAR T-cell therapy is approved for a few other types of non-Hodgkin lymphoma, but not for CLL. This treatment has still undergone studies to see whether it could produce longer remissions or even a cure for CLL.
Clinical Trials
Clinical trials are studies that test out new drugs or combinations of drugs. These combinations make it more likely people may be able to do without chemotherapy altogether in the future. Non-chemotherapy treatment regimens are essential for those who can’t tolerate harsh chemotherapy-related side effects. Ask the doctor first who treats your Chronic lymphocytic leukemia if a clinical trial might be right for you.
Coping and Support for Chronic Lymphocytic Leukemia
Express your feelings
With everything you have going on, you may feel isolated and alone. But you’re not. Don’t keep your feelings bottled up inside. Expressing how you feel is the key to coping with the disease. Talk with your partner, friends, and family for reassurance and support, and allow yourself to grieve. It’s okay to cry. In most cases, you’ll feel better after an emotional release. Also, see a psychologist or counselor for solutions to problems you can’t overcome on your own.
Stay active
Physical activity is another way to cope with a Chronic lymphocytic leukemia diagnosis. Even though Chronic lymphocytic leukemia and its treatments can leave you so tired that it’s hard to even think about exercising. Exercise is important because activity increases your brain’s production of endorphins. These are the “feel good” hormones. Exercise improves your mental outlook. It can also boost your immune system and help you fight disease.
No single exercise program is best for CLL. Do what feels good to you. When you do exercise, go at your own pace and stop if you don’t feel well. Balance activity with rest and set aside time each day for a nap.
Take your mind off your disease
That said, It can be difficult to get your mind off cancer. Try not to let cancer take over every part of your world. It is manageable. One way to cope is to find enjoyable activities that can help you unwind and relax. Explore a hobby, such as photography, art, dance, or crafts. For relaxation, consider guided imagery meditation. This technique allows you to focus on positive images to help you relax and reduce stress. Try to stay as healthy as possible, and you should be able to live a full and fulfilling life.
Meet with a nutritionist
Chronic lymphocytic leukemia treatments can change the way food tastes and cause nausea and other symptoms that ruin your appetite. This can sometimes lead to malnutrition. It’s important to eat a balanced diet to keep up your strength and prevent weight loss.
Due to low red blood cell counts, eating enough iron is vital. Try to eat foods high in iron such as green leafy vegetables, legumes, dark chocolate, quinoa, shellfish, and red meat. If you don’t eat meat or fish, you can help iron absorption by including a source of vitamin C, like citrus fruit.
If possible, meet with a nutritionist or dietitian to create a diet plan that ensures that you get enough calories, fluids, protein, and nutrients. Be sure to also drink plenty of water.
The Takeaway
A cancer like Chronic lymphocytic leukemia can take over every part of your life. As of now, no treatment can cure CLL. The closest thing we have to a cure is a stem cell transplant, which is risky and only helps some people survive longer. But, you can manage your disease by following the treatment your doctor prescribed, but also take time to care for yourself. Eat right, exercise, and get support when you need it.
As you begin treatment, you must communicate what you’re feeling to your healthcare team. This will help them tailor your therapy if needed and help improve your overall quality of life.
