Patients learn to live with incurable blood cancer

How doctors treat Chronic Lymphocytic Leukemia

PEMBROKE PINES, Fla. – Julia Warren has always been proactive about her health. The 74-year old Pembroke Pines woman has never missed an annual physical, which always includes a comprehensive blood screening.

In 2007, the results came back abnormal.

"The doctor called me and told me to take this test again," Warren said.

The results of the follow-up led to a diagnosis of a blood cancer called Chronic Lymphocytic Leukemia, or CLL.

"I had no symptoms. I had no idea,"  she said.

Cleveland Clinic oncologist Dr. Wessam Ahmed said that's not unusual with the disease.

"More than 80 percent of the patients diagnosed with CLL don't have symptoms at diagnosis," he said.

Even more confounding for patients is being told that CLL can't be cured and, without symptoms, there's no reason to even treat it.

"It's not that we don't want to do anything, but there was enough research done that showed trying to treat these patients in the early stage did not change the outcome, so we'd be exposing the patients to treatment with side effects without benefit," Ahmed said. 

Even if it becomes symptomatic, Ahmed said CLL is actually a type of leukemia that most people live with, rather than die from. 

"They will die of old age, heart attack, a car accident, but they will not die from CLL," he said.

If and when blood work shows the cancer is becoming aggressive, doctors can then plan a treatment strategy.

"There are some genetic abnormalities that will give us an idea of what type of treatment we can choose and what type of response we should expect," Ahmed said.

When Warren became symptomatic several years ago, she went through traditional chemotherapy and now takes one oral dose of the drug every day.

"I know that this is not a curable thing," she said. "You just have to be hopeful, and I am very, very hopeful."

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