Doctors usually wait until there are signs the CLL is progressing before suggesting you have treatment. Monitoring means delaying treatment until it is needed.

Only a small number of people with chronic lymphocytic leukaemia (CLL) need to start treatment straight away. Doctors usually wait until there are signs the CLL is progressing before suggesting you have treatment. There is no evidence that starting treatment before this helps, and it can cause side effects.

CLL usually develops very slowly, so you may not need treatment for months or years. Some people will never need treatment.

Monitoring is used when you do not need to start treatment straight away. It is also called watch and wait. Your GP or haematologist monitors you regularly to check for any swollen lymph nodes and check your blood cell count.

They usually see you at least twice in the first year of being diagnosed. If your blood cell count changes or you develop symptoms, your doctors will think about whether you need to start treatment.

If you are worried about not having treatment, here are some helpful tips from people who have experienced monitoring:

  • Make sure you understand why your doctor is recommending watch and wait. If you have any worries, talk to your doctor.
  • Think of your time without treatment as an opportunity to make the most of your quality of life. Use it to do things you enjoy, and to get as fit and healthy as you can.
  • Try to focus on the present rather than what might happen in the future.
  • Talk about how you feel. You could do this by talking to family and friends, or joining a support group or online forum.

Watch and wait can be difficult to adjust to at first, but many people find it gets easier with time. We have more information about treatment for CLL.

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