Shared Decision-Making in CLL Care
- Chronic lymphocytic leukemia (CLL) treatment today is highly individualized, with oncologists and patients working together to choose therapies based on medical factors, lifestyle needs, and personal values.
- There have been incredible developments in CLL treatment in recent years, with the approval of different targeted therapies.
- Picking a treatment path with depend on factor’s like the patient’s overall health and preferences when it comes to monitoring requirements and time-limited vs. continuous therapy.
- “It’s very much a shared decision between the patient and the physician,” Dr. Cole Sterling, an oncologist who specializes in hematologic malignancies at Johns Hopkins Medicine, tells SurvivorNet.
- Healthy habits like balanced eating and staying active support overall well‑being, but research shows CLL progression is driven by genetic and molecular factors, not patient behavior.
“It’s very much a shared decision between the patient and the physician … It depends on the individual patient in front of you,” Dr. Sterling tells SurvivorNet.
Read MoreFactors That Influence Treatment Choice
According to Dr. Sterling, several factors will be considered before making treatment decisions, including:- Comorbidities (such as heart disease, kidney function, autoimmune conditions)
- Patient preferences (related to infusion vs. oral therapy, time-limited v. continuous treatment, and other impacts)
- Quality of life priorities
“[Treatment choices] depend on their willingness and interest in coming in for infusions or close monitoring and how taxing that is in their life,” Dr. Sterling adds.
The goal is to choose a therapy that treats the cancer effectively while supporting the patient’s overall well‑being.
Understanding What Patients Value
Dr. Sterling stresses that part of the process is understanding what matters most to each patient.
“Doctors really need to sit down and talk with the patient and learn what the patient values… and how we can best honor that while effectively managing their cancer,” he explains.
Regular communication between patients and their doctors is also important to track if the cancer is progressing.
This reflects a broader shift in CLL research: recent studies presented at the American Society of Hematology’s annual meeting have shown that patient-reported symptoms, like fatigue and insomnia, can actually signal disease progression, reinforcing why patient input matters clinically.
Dr. Sterling says open communication can also help patients cope better emotionally.
“We want to keep them safe, keep them healthy, and have them not focusing too much on the cancer and have them out living their life,” he explains.
Healthy Habits While Living With CLL
Many patients ask whether diet, exercise, or lifestyle changes can influence the course of CLL. Currently, there’s no data proving lifestyle factors have a significant impact.
Dr. Sterling says, “We don’t have any real compelling data to say that anybody needs to be following a particular type of diet or particular exercise regimen.”
He adds that no clinical trials have shown that specific diets, supplements, or exercise programs alter CLL biology or slow disease progression. However, healthy habits still matter for overall well‑being.
Expert Resources for CLL Patients
- CLL Treatment Decision Making — Exploring All Your Options To Find What’s Right For You
- CLL Treatment: The Side Effects to Expect & Why Reporting All New Symptoms is Crucial
- CLL is Not Considered Curable So Treatment May Resume Years Later
- ‘The Eye of the Tiger’ — Why Mindset and Lifestyle are So Important During Treatment for CLL
- “Game Changing” New Treatment Gives Hope to Relapsed “CLL” Leukemia Patients
“We encourage people to try to maintain healthy lifestyles… stay active… eat a balanced diet,” Dr. Sterling explains, adding that it’s understandable that patients would want to have control over their cancer in some way.
However, he stresses that CLL progression is not caused by patient behavior. “There’s only so much patients can do here, and it’s really not under the patient’s control,” Dr. Sterling explains.
CLL’s onset and progression are understood to be driven by genetic and molecular changes within blood cells — such as specific chromosomal abnormalities and mutation patterns — not by diet, exercise, or other lifestyle choices.
Personalized, Collaborative Treatment
CLL treatment is not dictated by a single rulebook.
The factors that go into your medical plan include:
- Your overall health
- Personal preferences
- Lifestyle considerations
- Quality‑of‑life goals
- Evidence‑based options
Patients are encouraged to live their lives fully while partnering with their oncologist to choose the therapy that best fits their needs.
Questions To Ask Your Doctor
- What treatment option do you recommend?
- Are there other options we should consider?
- What are the next steps if side effects become difficult?
- What are my options if my cancer progresses?
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