[ Englisch] Watch and Wait: Why Isn’t My Cancer Being Treated Right Away?

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Topics include: Treatment and Understanding

Renowned chronic lymphocytic leukemia (CLL) expert Dr. Susan Leclair, from the University of Massachusetts Dartmouth, helps patients understand the purpose of the watch-and-wait strategy, how the cancer cells are behaving during this time and signs that the condition is becoming more aggressive. Watch now to learn more.

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

Susan, you commented on it when you said you look at the cells and in some a cases they're not doing much. It's not an aggressive cancer. Many of us are familiar, unfortunately, and our families and friends with people who maybe had more aggressive cancers, or where it was treated more aggressively.  Woman has breast cancer, I want it out.  Somebody has lung cancer, maybe you're going to start treatment right away, whatever it is.  You have skin cancer, we're going to cut it out.   

But something happens right away, but there's this approach in CLL for many, for me it was four-and-a-half years, watch and wait.  So what are we watching, Susan?  What are we watching?  Because for us it's unnerving.  

Dr. Leclair:

Yeah, and I think I'm going to change that.  Physicians will tell you, other healthcare providers will tell you watch and wait. I think the correct term is watch and worry.  

Andrew Schorr:

Right.  

Dr. Leclair:

Because no matter how strongly you believe in your physician walking out that first day with someone saying to you, yes, you have leukemia, and I'll see you in about six months. Maybe four, I don't know.  It's not really exciting yet.  You are clanned psychologically to the get it out. Well, you can't get out a leukemia. There's no place to get it, because it's in your blood, and it's in the lymphatics, and it's in other places, so it's very hard to deal with that.  

And having said that, because I wanted to say something about watch and worry I've forgotten your question, so could you just...

Andrew Schorr:

...what are we watching for? 

Dr. Leclair:

Okay.  

Andrew Schorr:

So in other words Dr. Thompson or another doctor may say, okay, you don't have to see me for a while, but I want you to go get a blood test.  I'll get the results, whatever, but we're not doing anything now.  Okay? 

Dr. Leclair:

Okay.  That's kind of, that one at least is a relatively easy—unless you ask why—item to explain.  These cells live on their own.  They have decided that they're not going to answer any control mechanisms that the normal cell responds to.  As long as they sit here and do nothing, like a 16-year-old in the summertime, I guess, we're not going to be overwhelmingly afraid of them because they're not moving, they're not acting out.  

But at some point they will start to increase in number, or they will change in morphology, and either one of those suggests that there's some movement, there's some activity going on. May not be anything overwhelming. Could be you have a cold.  

Maybe something even, I don't know, you got a bruise because you fell, or it could be that B cells are continuing to become destabilized and are becoming more assertive.  It takes them a while to become aggressive.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on January 11, 2019