Treatment for CLL depends on both the patient and their lifestyle preferences, and the stage of the disease. Your doctor will help you select the treatment that is the best fit for you. Currently, there are five main treatment options, including chemotherapy, monoclonal antibodies, target therapy, supportive therapy, and stem cell transplant.
Chemotherapy is when anti-cancer drugs are given either as pills, or injected directly into the bloodstream. This allows the medicine to reach all parts of the body, and attack cancer cells. This is great for leukemia, as the cancer cells are already moving throughout the bloodstream. The anti-cancer drugs focus on destroying cells that rapidly divide, so they also destroy hair follicles, and cells that line the mouth and intestines. This can often cause nausea and vomiting, making the patient feel very sick. Chemotherapy also attacks the cells in the bone marrow, where the cancer starts, and thereby puts the patient at a higher risk of infection due to lower numbers of white blood cells, and being very tired, due to low numbers of red blood cells.
Monoclonal antibodies are injected into the patient's bloodstream and target a protein on the cancer cells. They are man-made versions of your own immune system cells and work just like your own immune system. While the drug is being injected, you may experience uncomfortable side effects such as itching, nausea, vomiting, rashes and headaches. It is possible to have more serious side effects such as a racing heart, swelling of the tongue, and trouble breathing. A nurse will carefully monitor you for these and the infusion will stop immediately if any of them occur. Other drugs can also be given beforehand to prevent these serious side effects.
Targeted therapy is fairly new, and involves drugs that attack cancer cells by looking for something specific to the cancer cell. This specific thing could be a change in the cell's genes for example. The drug targets that piece of DNA and then kills all cells that look like that. Possible side effects include diarrhea, fatigue, nausea, swelling of the feet and hands, body ache, and rash.
Supportive therapy does not involve treating the cancer itself, but focusing on the side effects. For example, people with CLL are at higher risk of infection since their white blood cell count is affected by the leukemia. We can give them antibodies (disease-fighting agents) from a donor by injection into the bloodstream. This does not help the cancer but can make the patient much more comfortable. For the same reason, it is very important that people living with CLL get all of their vaccines, as they are higher risk of getting sick and staying sick if they catch the flu, or other, more serious viruses like Hepatitis.
All of the above treatments do not actually cure the leukemia - they help to slow the progression and moderate the symptoms. These treatments can do a very good job of this, and give someone many more years to live. However, the stem cell transplant is an attempt at getting rid of all of the places that the cancer can start to grow, and putting in brand new stem cells from another person who does not have cancer. While this treatment can be extremely effective, it is also very complicated. It can take awhile for the leukemia patient's body to adapt to the new stem cells, as they are "foreign" at first. During this transition period, the leukemia patient may be very sick, and see their doctor frequently. There is also the chance that it may not work.
In summary, there are many, many options to treat chronic lymphocytic leukemia! Your doctor will be your best resource, as they are familiar with your case. It is also a good idea to get a second opinion, just to make sure you are getting the treatment that will help you the most. For the most part, doctors will respect your wish to get a second opinion, and be interested to hear what the other doctor thinks, whether they are in agreement or not.
References:
Chemotherapy for chronic lymphocytic leukemia. 2015. Retrieved April 4, 2015 from http://www.cancer.org/cancer/leukemia-chroniclymphocyticcll/detailedguide/leukemia-chronic-lymphocytic-treating-chemotherapy
Monoclonal antibodies for chronic lymphocytic leukemia. 2015. Retrieved April 4, 2015 from http://www.cancer.org/cancer/leukemia-chroniclymphocyticcll/detailedguide/leukemia-chronic-lymphocytic-treating-monoclonal-antibodies
Targeted therapy for chronic lymphocytic leukemia. 2015. Retrieved April 4, 2015 from http://www.cancer.org/cancer/leukemia-chroniclymphocyticcll/detailedguide/leukemia--chronic-lymphocytic-treating-targeted-therapy
Supportive care for chronic lymphocytic leukemia. 2015. Retrieved April 4, 2015 from http://www.cancer.org/cancer/leukemia-chroniclymphocyticcll/detailedguide/leukemia--chronic-lymphocytic-treating-supportive-care
Stem cell transplant for chronic lymphocytic leukemia. 2015. Retrieved April 4, 2015 from http://www.cancer.org/cancer/leukemia-chroniclymphocyticcll/detailedguide/leukemia-chronic-lymphocytic-treating-bone-marrow-stem-cell-transplant
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