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What does it mean to watch and wait?

What does it mean to watch and wait?

Sometimes doctors may feel that the best course of action for a person with CLL is to ‘watch and wait’.

In other words, the doctor's behavior is to wait and monitor the progress of the disease with periodic checks at a hematology specialist center. During this time, a doctor will monitor symptoms and take regular blood tests to determine when treatment is needed.  The treatment of chronic lymphocytic leukemia at present uses several drugs with different mechanisms of action and side effects. The term "adhesion" refers to precisely the behavior through which the patient fails to comply with the information provided to him by doctors. In particular, reference is made to doses of medication to be taken, the frequency of administration and the time at which the medication needs to be taken (e.g. in relation to meals or the interval between one dose and the next). Therefore, to be "adherent" is the first step, because a therapy will work.
Not infrequently such "grip" is reduced and this fact is related to various causative factors such as:
  • the long duration of therapy for CLL
  • age and social context to which the patient belongs
  • the help from family / friends
  • the numerous possible concomitant therapies employed
  • the difficulty ingesting the drug
  • fear of side effects
  • the improvement of symptoms linked to leukemia which is followed by a less careful approach to the treatment in place
  • the lack of clear instructions by the specialist about how to behave in case you forget doses
  • the lack of understanding about the status of the disease that affects you
  • the lack of understanding about the drug's mechanism of action
To be able to remain adherent to prescribed therapies, especially to long-term therapies, it is therefore essential to be constantly motivated, having well including those that are the goals of therapy and the benefits that can be achieved. A practical tip to help you to remember to take your medicine is to combine it with an activity carried out as part of the normal everyday daily routine (such as after a meal, or after an action carried out routinely every day). Also setting visual or audible reminders can be a real help.
When following a therapy for CLL, it is essential to the understand the pathology of the patient which has been affected, the prognosis in the long term, the possible risks connected to it and the consequences of a failure to start of treatment. These factors should be assessed together with the possible medical treatment options and, once established, the most appropriate medication; try to understand the mechanism of action and possible and common adverse effects.
Things you should know about therapies:
  • Times when you have to take the medication
  • If you can take with other medicines
  • When you need to stop taking the medicine
  • If you have to take it on a full or empty stomach
  • Where should you store your medication
  • How long it will take
  • What are the side effects and who to contact in the event of side effects
  • What to do when you forget to take a dose or the dosage is not clear