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Chronic Lymphocytic Leukemia
WHAT YOU SHOULD
KNOW
Chronic lymphocytic (LIM-fuh-SIH-tik) leukemia is a
cancer of the lymphocytes, a type of white blood cell.
Manufactured in the bone marrow, white blood cells have the
task of defending the body from germs and other foreign
invaders. In chronic lymphocytic leukemia, production of the
lymphocytic variety of white blood cell goes haywire, leading
to a surplus. There are two kinds of lymphocytes: B cells and T
cells. This disease usually affects the B
cells.
Causes
There is no known cause. However, we do know that the
disease is more likely if others in your family have developed
it or you smoke cigarettes.
Signs/Symptoms
There are usually no symptoms during the early stages of
disease; the cancer is usually discovered when you have blood
drawn for other reasons.
Later in the disease, symptoms begin to appear as excess
lymphocytes collect in areas outside the bloodstream. Typical
signs include:
-
Increased
fatigue
-
Increasing inability to
exercise
-
Excess sweating
-
Night sweats
-
Weight loss
-
Enlarged lymph nodes,
especially in your neck, around your collar bone, and in
your armpits
-
Enlarged spleen or liver,
possibly causing abdominal pain or discomfort
-
Anemia (too few
red blood cells)
Care
Many people live for years without symptoms and without
the need for treatment.
To find out what stage the cancer has reached, your
doctor will order a number of tests, often including a bone
marrow biopsy (examination of a bone-marrow sample), a lumbar
puncture (examination of a spinal-fluid sample), an abdominal
ultrasound exam, a CAT scan, and special x-rays to check
various organs. The results of the tests will help you and your
doctor choose a treatment plan. You may not need immediate
treatment, but the doctor will watch you closely and begin
treatment when symptoms appear. The major options
include:
-
Chemotherapy: In this type of therapy, called
"chemo" for short, various potent drugs are given to kill
new cancer cells and shrink cancerous lymph nodes. The
drugs are given by mouth, shot, or IV. You will probably
need frequent blood tests to determine how your body is
doing and how much chemo you need. The drugs can produce
many side effects, and may leave you susceptible to
infection for a while.
-
Radiation: X-rays or gamma rays can kill cancer
cells and help prevent the disease from spreading. They can
be effective in reducing pain, controlling bleeding, and
shrinking cancerous tumors. Doctors also use this type of
therapy on cancerous lymph nodes. Radiation and
chemotherapy are often used together. Radiation is also
used after surgery to kill any cancer cells that may have
been missed.
-
Leukophoresis (LEW-kuh-for-E-sis): In this form of
treatment, blood is drawn from the body, cleansed of white
blood cells, and returned to the body minus the excess
cells. This treatment is sometimes combined with
chemotherapy.
-
Surgery: If other treatments have failed to remedy
an enlarged spleen, you may need to have it surgically
removed. Lymph nodes are also sometimes removed to prevent
the cancer from spreading to other parts of the
body.
Risks
Because chemotherapy and radiation have severe side
effects, treatment can be delayed as long as you're free of
symptoms. Eventually, however, it will be needed to prevent the
cancer's spread. The treatments won't cure this disease, but
they are your best hope of keeping it under
control.
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