watch and wait

my 88yr old mother was diagnosed 3/2/2014 early stage cll.being sent for an ultrasound scan(abdomen).her blood readings are wcc14.2/ lymphocytes6.3 with monocytes 0.8.she suffers night sweats and has develped a cough(mucus).she will be sent for in 2/3 months.my question is ,if treatment is necessary,will she be rationed drugs.she is currently seeing a haemotologist,is it advisable to seek a 2nd opinion? unsure as to whether she should wait or be seeking treatment? thanks in advance for any advice

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  • Hi there chrismac

    Welcome to the forum.

    There will be others here who will be along who can help you understand the blood counts, it also might help to know your location city/country as this can be a factor in your options, if/when treatment is needed etc.

    I too am in early stage - watch & wait - diagnosed in 2006, and as yet have not had to have my cll treated.

    I have only had the night sweats when I have been really ill - cold/flu/infection etc, and I am a continuous catarrh factory, but without having a cough.

    When in early stage cll, it is the norm to have to see the haemotologist at intervals of 2 - 3 - 6 months to check on any progression, so hopefully, treatment if any, will not be anytime soon.

    There is a wealth of cll experience here, and I hope that you will feel free to use it ... there are no stupid questions, and the people on here are only too willing to help in any way that they can.

  • much appreciated,saw gp yesterday..was reassured,before didn"t fully understand the complaint/implications,but getting more info is very helpfull thanks a lot..ps:i haver to use library computer,explains the delay in replying..still in the stone_age..thanks chris

  • Hi Chrismac,

    It is always a good idea to seek a second opinion, particularly in the case of elderly patients like your mother, where co-morbidities (other health conditions) become increasingly common and complicate the decision on whether and how to provide treatment, should it be required.

    I assume the ultrasound has been ordered to check for any large abdominal nodes? It is more ususal to have a CT scan for this purpose.

    With respect to your mother's blood readingsand how her CLL may be impacting them, red blood cells, haemoglobin, platelets and neutrophils are the important tests, rather than the monocytes. (From your stated WCC and Lymphocyte levels, it looks like her neutrophils are OK.) Low platelets along with night sweats and enlarged nodes are among the factors consided in deciding whether to start treatment, as is Absolute Lymphocyte Count (ALC) doubling time, but that is only considered when it exceeds 30, so isn't relevant in your mother's case.

    From the limited information you have provided, it is probably more important to find out to what degree your mother's CLL is affecting her ablility to recover from her cough, which sounds like it is not clearing up?

    Hope that helps,

    Neil

  • thanks a lot..info coming in..much appreciated knowledge is forewarned forearmed...thanks chris

  • I agree with Neil. It would help to know what country you are in, since CLL is treated somewhat different in different countries.

    Certain the cough is something that needs investigating immediately. It is not probably CLL related, however respiratory infections must be taken seriously in CLL patients. At the very least they should do a throat and nasal swab/culture, to know if it is caused by.

    ~chris

  • thanks for the advice..much appreciated chris

  • At 88 years, I would definitely do the watch and wait; My friend's mother was diagnosed in mid-life (her 60's, like me) and lived to be 94 with no issues ad no treatment! 94! At 88 there'd be No Way I'd start chemo or heavy meds and make my remaining years miserable! But....that's just me.....

  • thanks for the help,saw gp yesterday he is reassured by figures,just waiting for ultrasound,result and next blood test..now i understand what it is i am dealing with..seems to be all about immune system..thanks chris

  • Hi a second opinion would be a good idea but also think about pallative care as in the UK this has some very good care. Best wishes

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