From an interview with James C. H. Smith, MD McLeod Oncology & Hematology Associates
The many advances in treatments for Leukemia make this one of the most survivable cancers. McLeod Oncologist Dr. James Smith explains treatments for the two most common types of Leukemia – Chronic Lymphocytic Leukemia (CLL) and Chronic Myeloid Leukemia (CML).
Here are highlights of Dr. Smith’s comments:
Although the treatments have evolved a good bit in CLL, the majority of patients present in a very slow moving fashion. We pick up a number of these from routine blood work. There are even situations where our initial approach is to follow those patients and not have them on active treatment. In situations where patients do not have symptoms, the side effects of treatment outweigh the benefit of treatment.
At the point it’s decided that treatment is necessary or indicated there are significant advances that have been made in the treatment of CLL. These are very effective treatment options with good response rates that have evolved from some of the stronger, harsher chemotherapy we had years ago to agents that are much better tolerated and can be tolerated by patients, who also suffer from other medical issues, in addition to the leukemia.
CML is the type of leukemia, where the treatments target DNA changes. In CML, the goal is to achieve a so-called “molecular remission,” which means after treatment you cannot find that DNA disruption that drove the process. However, it is still thought that the treatment needs to continue so those patients would require life-long or indefinite treatments.
CML is usually treated with what would be called a “targeted” treatment or a directed treatment that would be taken by mouth. In CLL, the most common treatments are by injection or combination chemotherapy treatments that are given on an intermittent basis.
CML is kind of the “poster child” of cancer treatments, where it’s evolved from fairly ineffective treatments with considerable side effects to one where you have very effective treatment options, which are generally well tolerated. Today’s patients have a quality of life that allows them to get out day-to-day and do what they want without symptoms related to the underlying disease.
For years chemotherapy treated ALL dividing cells in the body. Targeted treatment is geared more toward specific changes in a cancer cell that disrupt the cell division. Targeted treatment in theory spares normal cells in the body. The harm to normal cells in traditional treatments brought about side effects that we all think of with chemotherapy.
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