Chronic lymphocytic leukemia (CLL) is a type of blood cancer in which the bone marrow makes too many lymphocytes, a type of white blood cell. CLL can affect people of any age or gender but is more common in older adults and in men.
Chronic lymphocytic leukemia (CLL) is often slow-growing and may not cause symptoms in its early stages.
Older men are
Some treatments for CLL may not be safe for older adults, especially those who have certain health conditions or low general fitness. A doctor can help a person who has CLL understand their treatment options.
Read on to find answers to some of your most pressing questions about CLL in older men.
According to the American Cancer Society,
The
- 6.3 out of 100,000 males per year received a new diagnosis of CLL
- 3.3 out of 100,000 females per year received a new diagnosis of CLL
The median age at diagnosis was 70 years.
Experts do not know exactly why CLL is more common in men than in women.
Men are more likely than women to die from CLL, although many live for years after getting a diagnosis.
The
- 1.6 out of 100,000 males per year died from CLL
- 0.7 out of 100,000 females per year died from CLL
The median age at death from CLL was 82 years.
Most men and women with CLL survive for years after getting a diagnosis.
The
- 94.9% of men and 94.6% of women with CLL survived for at least 1 year after diagnosis
- 84.2% of men and 85.5% of women with CLL survived for at least 5 years after diagnosis
- 70.0% of men and 74.5% of women with CLL survived for at least 10 years after diagnosis
These are relative survival rates, which means they describe the survival of people with CLL who do not die from other causes, such as heart disease or stroke.
More research is necessary to learn why CLL outcomes are worse for men than for women.
It is possible that sex- or gender-related differences in biology, lifestyle habits, or treatment play a role.
A person’s outlook with CLL depends on many factors, including:
- the stage of the cancer
- whether there are certain gene changes in the cancer cells
- whether there are high levels of certain substances in the person’s blood
- whether the person’s white blood cell count is quickly increasing
- whether the person’s platelet and red blood cell counts are low
- how the person’s body responds to treatment
- the person’s age and overall health
CLL is often slow-growing and may not cause symptoms until it has progressed.
Some people develop a more aggressive form of CLL that grows more quickly. Sometimes CLL transforms into another type of cancer, such as non-Hodgkin’s lymphoma or prolymphocytic leukemia.
Many older adults with CLL also have other health conditions, such as:
- diabetes
- chronic lung disease
- chronic heart disease
Certain health conditions or low general fitness may negatively affect survival or quality of life in older adults with CLL.
These factors can also increase the risk of some complications, such as cancer-related infections, and increase the risk of serious side effects from certain treatments, such as organ damage due to chemotherapy drugs.
A person’s primary care doctor or general practitioner will refer them to an oncologist (a cancer specialist) to manage CLL.
The oncologist can help develop a management plan that fits a person’s needs and priorities. The risks of starting cancer treatment may outweigh the benefits, especially for older adults with certain health conditions or low general fitness.
It is also important for people with CLL to get treatment for any other health conditions they may have and to maintain healthy lifestyle habits.
Additionally, having a strong social support network may help a person manage the challenges of CLL.
Individualized management plan
Treatments for CLL may cause potentially serious side effects and do not always improve survival or quality of life, which is why it is important to weigh the possible benefits against the risks.
A person’s oncologist will:
- order tests to learn about the cancer cells
- evaluate the person’s overall health and fitness
- discuss the person’s treatment goals and priorities
- help the person learn about the potential benefits and risks of different treatments
The oncologist might recommend watchful waiting if CLL isn’t growing quickly or isn’t causing serious symptoms. Watchful waiting involves carefully monitoring the cancer without treating it.
The oncologist may prescribe treatment if CLL is growing quickly or causing symptoms that are getting worse. The treatment plan may include one or more of the following:
- targeted therapy, such as:
- ibrutinib (Imbruvica)
- acalabrutinib (Calquence)
- zanubutinib (Brukinsa)
- pirtobrutinib (Jaypirca)
- idelalisib (Zydelig)
- duvelisib (Copiktra)
- venetoclax (Venclexta)
- immunotherapy, such as:
- rituximab (Rituxan)
- obinutuzumab (Gazyva)
- ofatumumab (Arzerra)
- alemtuzumab (Campath)
- chimeric antigen receptor (CAR) T-cell therapy
- chemotherapy
Some of these medications may not be safe for older adults, particularly those who have certain health conditions or low general fitness. A person’s oncologist can help them learn which treatments may be safest for them.
A person may need to try a new treatment if their current treatment is not working well to slow the growth of CLL or is causing side effects that are serious or difficult to tolerate.
A doctor may prescribe additional treatments to help a person manage symptoms or complications of CLL or side effects of cancer therapies.
Overall health and fitness
Taking steps to manage their overall health and fitness may help older adults with CLL improve their survival or quality of life.
For example, it is important for older adults to do the following:
- Attend regular checkups with a doctor and let them know about any health changes.
- Get any health screening tests their doctor recommends.
- Follow their treatment plans for any health conditions they have.
- Eat a well-balanced and nutrient-rich diet.
- Get regular exercise.
- Get enough sleep.
- Manage stress in healthy ways.
An oncologist who treats CLL is generally not the same doctor who treats other health conditions.
A person may need to visit a primary care doctor or general practitioner to get treatment for other health conditions. The primary care doctor may refer them to a specialist if necessary.
The person should let their cancer care team know about any changes in their overall health or new treatments they have been prescribed. These changes may affect their CLL management plan or outlook.
Social support
Receiving a cancer diagnosis can be stressful.
A person may feel a variety of emotions after their diagnosis and throughout treatment.
They may also face practical challenges related to treatment, daily living, or finances.
Support from friends and family members may help a person cope with these challenges.
People with CLL may find it helpful to connect with other sources of support, such as a mental health specialist or a cancer support group.
The Leukemia & Lymphoma Society offers a variety of support services.
A person can also speak with their cancer care team to learn about support resources.
CLL is a common type of blood cancer that affects older men more often than younger men or women. Older men are also more likely to die from CLL, although many live for years after getting a diagnosis.
CLL is often slow-growing and may not cause symptoms in the early stages. An oncologist may recommend watchful waiting if CLL is growing slowly and not causing serious symptoms.
The oncologist may recommend treatment if CLL is growing quickly or causing symptoms that are getting worse. Some treatments may be safer for older adults than others.
It is also important to manage other health conditions, maintain healthy lifestyle habits, and seek support from other people.