Medical and alternative for various stages

People with a CLL diagnosis who are not experiencing symptoms may not require treatment yet. But there are several treatment options that a doctor may discuss with a person living with CLL.

Several medical treatments can cause side effects. A person should talk with their doctor if they experience unpleasant side effects related to their treatment.

The following are some of the current medical treatment options a doctor may recommend.

Immunotherapy

Immunotherapy helps strengthen the immune system against leukemia. Typically, doctors administer this medication through an IV.

There are several approved medications, including monoclonal antibodies.

Immunotherapy may cause side effects in some people. Side effects can include:

Chemoimmunotherapy

Chemoimmunotherapy involves using both chemotherapy and immunotherapy to treat CLL. Doctors rarely recommend chemotherapy on its own to treat CLL, but combined with immunotherapy, it can be an effective treatment.

A person may experience side effects of either chemotherapy or immunotherapy during this type of treatment.

Learn the 10 most common chemotherapy side effects here.

Targeted therapy

Targeted therapy works by only targeting the cancer cells, meaning it causes less damage to healthy cells than treatment methods such as chemoimmunotherapy.

Doctors usually recommend it for people whose cancer has a del(17p)/TP53 mutation. This means it has a type of mutation that responds to targeted therapy.

Targeted therapy can usually control CLL well, which means a person may not need some other types of treatment immediately.

A person can take targeted therapy medication in pill form. But for it to work effectively, a person needs to take the medication exactly as the doctor has prescribed.

Learn more about alternatives to chemotherapy here.

Radiation

Radiation therapy uses high powered X-rays to help kill cancer cells and stop them from spreading. It can help reduce pain associated with swollen lymph nodes and the spleen.

Doctors may also use radiation therapy during stem cell transplants to make room for healthy cells.

Stem cell transplants

In stem cell transplants, a donor provides healthy bone marrow that will help produce healthy cells. Alternatively, doctors may remove and store stem cells from the same person undergoing treatment. The stem cells can then help to destroy the cancerous cells and help the body recover from aggressive treatment.

Before a stem cell transplant, a person will typically undergo chemotherapy or radiation to destroy cancerous cells and make room for the transplanted cells. A person may experience side effects from radiation, chemotherapy, or from the transplant itself.

Clinical trials of new treatments

Clinical trials are research studies that look at the effectiveness of new medications or treatments in treating conditions, such as CLL.

Clinical trials have different stages based on where they are in their testing process. In general, the later the stage of the trials, the closer the medication is to being approved for use in the general population.

Not everyone qualifies or would be interested in joining a clinical trial. Those that are can speak with their doctor about any upcoming trials and discuss whether they would be a good candidate. They can also search for upcoming trials through ClinicalTrials.gov.

Chimeric antigen receptor (CAR) T cell therapy

CAR T cell therapy is a treatment technique used in other blood cancers. It is going through clinical trials to see if it could be effective for CLL.

CAR T cell therapy involves removing some of a person’s T cells, modifying them in a lab to attack cancer cells, and then returning them to the person’s blood. If successful, the T cells would attack the cancer cells responsible for CLL.

Learn more about CAR T cell therapy here.

In addition to medical treatments, a person may find that alternative and natural treatments may be helpful. These treatments should not replace medical treatment. Instead, they can be useful in conjunction with medical treatment to help ease symptoms and improve a person’s quality of life.

Before starting an alternate or natural treatment, a person should discuss their plans with their doctor. They can help determine what treatments may work best and help the person avoid negative interactions with their current medications.

Some common alternative and natural treatments for CLL include:

Supplements and vitamins

A person may make use of vitamins, supplements, foods, and other natural healthcare products to help treat symptoms related to CLL. Though some people may find success, many natural supplements and vitamins do not have clinical approval.

For example, one 2014 clinical trial found beneficial effects of green tea in people with CLL.

The Food and Drug Administration (FDA) does not regulate the production of supplements or nutrition for CLL, so a person should look for third-party reviewed supplements.

In addition, there are potentially severe drug interactions that can happen if a person takes supplements or vitamins alongside chemoimmunotherapy or targeted therapy without first talking with their doctor.

Mind and body interventions

Mind and body interventions may help decrease stress, which may then help the body to function better. It can also help people improve their quality of life.

Examples of mind and body interventions include:

Energy-based therapies

According to the Leukemia & Lymphoma Society, energy-based therapies focus either on the body’s energy or on harnessing magnetic fields or other outside energy sources.

The goal is to channel good energy into the body to promote healing. As with other alternative therapies, there is no definitive evidence to support its use.

Learn about a form of energy-based therapy called Reiki here.

Manipulative body-based therapy

Manipulative body-based therapy involves moving the body in certain ways to promote health and well-being. This type of therapy may help treat stress, pain, or anxiety.

Examples of this type of therapy include chiropractic treatments, reflexology, or therapeutic massages.

Learn more about natural treatments for leukemia here.

Some evidence exists that suggests diet can have a positive or negative effect on CLL. For example, according to a 2018 study comparing the Western diet, Mediterranean diet, and prudent diet, a person following a Western diet had a higher chance of developing CLL.

The Western diet generally includes:

• high fat foods and dairy products
• fast food and other processed foods
• sugary foods and drinks
• refined grains
• processed meats
• salty and sugar-filled snacks

The prudent and the Mediterranean diets focus on fresh vegetables, fruits, low fat dairy, whole grains, and lean proteins.

Regardless of diet, a person should always try to stay hydrated. This helps to protect the kidneys and flush out excess drugs in the system if a person is receiving treatment for CLL.

See our guide to following the Mediterranean diet, including meal plans, here.

A doctor will likely tailor a person’s treatment based on their age and overall treatment goals. They will also take into account how well a person is responding to other treatment and any notable health history they may have.

A younger person may prefer a more aggressive approach to help prolong their life. This might include therapies such as chemoimmunotherapy, which may cause more severe side effects.

An older person’s body may not be able to handle certain treatment options as well. They can discuss the pros and cons of these treatments with their doctor, and balance them against their quality of life.

Asymptomatic CLL often does not require formal treatment. Instead, a doctor may recommend a watch-and-wait approach. Once symptoms start, a doctor may work with the person to develop a treatment plan that works for them.

In the meantime, a person may want to make dietary or lifestyle changes with the approval of their doctor.

A person should talk with their doctor about any unusual symptoms they experience. They may be a result of medication side effects or complications related to CLL, such as if it spreads to other tissues in the body.

Since a person with a CLL has a higher chance of infection, a doctor may recommend the use of antibiotics. If fatigue is an issue, a doctor will help find the source of fatigue and treat that as well.

A person may wish to note down extra symptoms they are noticing before doctor’s appointments. This can help them to have a more productive discussion with their doctor.

CLL treatments involve several methods that can help ease a person’s symptoms and slow the progression of their cancer. These include immunotherapy, targeted therapy, and stem cell transplants.

A person’s age, stage, symptoms, and overall health can affect their treatment. A person should talk with their doctor about the best treatment option for their condition.