Skip to Content

How do you slow down CLL progression?

The chronic lymphocytic leukemia (CLL) is a type of cancer that affects the blood and bone marrow. In CLL, the body produces too many abnormal lymphocytes (a type of white blood cell) that do not function properly, leading to the weakening of the immune system. The slow progression of CLL is crucial because it can help prevent the disease from advancing and causing more damage to the body.

The following are some of the ways to slow down CLL progression:

1. Regular monitoring: The first step towards slowing down CLL progression is to regularly monitor the disease’s progression. This can be done through blood tests and imaging scans to evaluate the number and size of the malignant cells in the body. Keeping a close watch on the disease’s progression can help healthcare professionals make informed decisions about the appropriate treatment options for the patient.

2. Lifestyle modifications: Making some healthy lifestyle changes can also help slow down CLL progression. A healthy diet rich in fruits, vegetables, and whole grains can help boost the immune system and reduce the risk of cancer progression. Regular exercise can also help keep the body healthy and reduce the chances of cancer progression.

3. Treatment options: Several treatment options are available to slow down CLL progression, including chemotherapy, radiation therapy, and stem cell transplant. Each treatment option has its benefits and risks, and the patient’s healthcare professional will recommend the most appropriate option for the patient’s individual case.

Some newer targeted therapies, including monoclonal antibodies and kinase inhibitors, have shown promising results in slowing down CLL progression.

4. Clinical trials: Participating in clinical trials can also be an option to slow down CLL progression. These trials test new medications, therapies, and approaches to treat cancer and may offer the patient access to newer and more effective treatments for CLL.

5. Emotional support: Finally, it is crucial to have emotional and social support to manage the stress and anxiety that comes with living with CLL. Support groups, counseling, and other services can help patients and their loved ones cope with the impact of the disease and improve their overall quality of life.

Slowing down CLL progression requires a combination of regular monitoring, lifestyle modifications, appropriate treatment options, participation in clinical trials, and emotional support. With the help of healthcare professionals and a supportive network of family and friends, patients with CLL can lead a healthy and meaningful life.

How can you prevent CLL from getting worse?

Chronic Lymphocytic Leukemia (CLL) is a type of cancer that affects your blood and bone marrow. While there is no one-size-fits-all approach to treating CLL, there are several things you can do to prevent the disease from getting worse:

1. Maintain a healthy lifestyle: A healthy lifestyle can play a crucial role in preventing the progress of CLL. It is important to maintain a healthy diet, exercise regularly and avoid smoking and alcohol consumption.

2. Stay up-to-date with treatments: Your healthcare provider will discuss the different treatment options available, including chemotherapy, immunotherapy, or stem cell transplant. Stay up-to-date with your treatment schedule and follow the treatment plan as prescribed by your doctor.

3. Monitor your symptoms: It’s essential to be aware of the symptoms of CLL, such as swelling of the lymph nodes, fatigue, or unintentional weight loss. If you notice any changes in your symptoms, it is essential to report them immediately to your healthcare provider.

4. Attend regular follow-ups: Regular check-ups will help your healthcare provider monitor the progress of the disease and make any necessary changes in your treatment plan.

5. Take medication as prescribed: Medication is an important component of CLL treatment. It’s crucial to take the medications as prescribed by your doctor and not to skip any doses.

6. Manage stress: Stress can have a severe impact on your immune system and can make managing CLL more difficult. Find ways to manage stress such as relaxation techniques, yoga, or meditation.

While there is no cure for CLL, you can take steps to manage the disease and prevent it from getting worse. It is essential to discuss your options with your healthcare provider, maintain a healthy lifestyle, monitor your symptoms, and attend regular follow-up appointments. By doing so, you can improve your quality of life and potentially slow the progression of the disease.

How can I improve my CLL?

Chronic Lymphocytic Leukemia (CLL) is a type of cancer that affects the blood and bone marrow. It is caused by the overproduction of abnormal lymphocytes in the body. There is no definite cure for CLL, but there are several ways to manage the disease and improve your overall health condition. Here are some of the ways that you can improve your CLL:

1. Stay healthy: Staying healthy means making healthy choices in your lifestyle. This includes being physically active, eating a balanced diet, getting enough rest, and avoiding stress. Physical activity not only keeps you physically fit but also improves your mood and reduces stress. Eating a healthy diet that is rich in fruits, vegetables, whole grains, and lean proteins can help boost your immune system and ward off illnesses.

2. Manage symptoms: CLL can cause a variety of symptoms, including fatigue, fever, night sweats, and swollen lymph nodes. To manage these symptoms, you can take medications prescribed by your doctor, such as pain relievers or antibiotics. You can also use alternative therapies like massage, acupuncture, or meditation to help you relax and relieve stress.

3. Get regular checkups: Regular checkups with your doctor are essential to manage CLL. These checkups will include blood tests to monitor your blood counts, physical exams, and imaging tests. Your doctor might also recommend additional treatments like chemotherapy, radiation therapy, or stem cell transplantation, depending on your condition.

4. Participate in clinical trials: A clinical trial is a research study that tests new treatments for CLL. Participating in a clinical trial can give you access to new therapies that are not yet available to the public. Moreover, you will be closely monitored by medical professionals who are experts in the field.

5. Seek emotional support: Living with CLL can be challenging, and it can be helpful to have emotional support. You can join support groups or seek counseling to help you cope with the disease. Talking to others who have experienced the same thing as you can be comforting and reassuring.

While there is no definitive cure for CLL, there are many ways to improve your overall health condition and manage the symptoms of the disease. Staying healthy, managing symptoms, getting regular checkups, participating in clinical trials, and seeking emotional support are all valuable resources for improving your CLL.

By taking an active role in your health care, you can live a fulfilling life despite the presence of CLL.

How do you prolong CLL life?

The treatment of Chronic Lymphocytic Leukemia (CLL) largely depends on the stage and severity of the disease, the patient’s age, and overall health. While there is no cure for CLL, there are certain strategies that can help in prolonging the life of patients with CLL.

The initial approach to managing CLL is watchful waiting, especially in the early stages of the disease. This strategy involves regular monitoring of the patient’s condition without initiating any treatment unless there is significant progression of the disease or symptoms worsen. This helps in maintaining the patient’s overall health and quality of life, and also delays or reduces the need for more aggressive treatments like chemotherapy.

Chemotherapy is a common treatment option for CLL when it progresses to advanced stages. While chemotherapy can be effective in reducing the size of the tumor and managing symptoms, it can have adverse side effects such as weakened immune system, hair loss, and fatigue. However, newer chemotherapy regimens and targeted therapies like BTK inhibitors have shown great promise in CLL treatment, with fewer side effects and better outcomes for patients.

Stem cell transplantation is another potential treatment option for CLL patients, particularly those with high-risk disease or relapsed after prior treatments. This involves replacing the patient’s bone marrow with healthy cells from a donor, which helps to rebuild the immune system over time. However, the procedure is associated with significant risks and complications such as graft-versus-host disease, infections, and organ damage.

Additionally, maintaining a healthy lifestyle is important in managing CLL and prolonging life. This includes regular physical activity, a balanced diet, and avoiding smoking and excessive alcohol consumption. Vaccinations against infections like influenza and pneumonia can also help protect against complications that can occur due to a weakened immune system in CLL patients.

While there is no guaranteed way to prolong the life of CLL patients, a combination of various treatment strategies and healthy lifestyle choices can help in managing the disease, controlling its progression and ensuring a better quality of life for patients. regular monitoring and prompt management of symptoms, and open communication with healthcare providers are also essential in this regard.

What are the signs that your CLL is getting worse?

Chronic Lymphocytic Leukemia, also known as CLL, is a type of cancer that affects the blood and bone marrow. It progresses slowly and may not show any noticeable signs in the early stages. However, as the disease progresses, certain signs and symptoms may start to appear, indicating that the CLL is getting worse.

One of the most common signs that your CLL is getting worse is the presence of enlarged lymph nodes. CLL starts in the bone marrow and then spreads to the lymph nodes, causing them to swell. As the disease progresses, the lymph nodes will become increasingly enlarged, and they may start to feel hard and tender to the touch.

Fatigue is another sign that your CLL is getting worse. Chronic fatigue is a common symptom of CLL, but as the disease advances, you may feel more and more tired and weak. This is because the cancerous cells are replacing the healthy red blood cells, leading to anemia.

Fever and night sweats may also occur as the CLL progresses. These symptoms are signs of infection, which is more common in people with weakened immune systems due to cancer or cancer treatments. As the CLL progresses, the immune system becomes weaker, making it difficult for the body to fight off infections.

Unexplained weight loss is yet another sign that your CLL is getting worse. The cancerous cells may cause a loss of appetite, leading to weight loss. Additionally, the body may be using more energy to fight the cancer, which can also lead to a reduction in body weight.

Finally, if your CLL progresses to an advanced stage, you may experience organ failure. This can happen when the cancerous cells infiltrate other organs such as the liver or spleen, causing them to malfunction. This can lead to swelling in the abdomen, fluid buildup in the legs or lungs, and difficulty breathing.

There are several signs that your CLL is getting worse. These include enlarged lymph nodes, chronic fatigue, fever and night sweats, unexplained weight loss, and ultimately, organ failure. If you experience any of these symptoms, it’s important to inform your doctor immediately to determine the best course for treatment.

What foods to avoid if you have CLL?

If you have Chronic Lymphocytic Leukemia (CLL), maintaining a well-balanced diet is crucial to help support your immune system and overall health. While there are no specific foods that are prohibited, there are certain foods that you should limit or avoid to manage your symptoms and improve your quality of life.

1. Processed Foods: Processed or packaged foods, including chips, frozen meals, and sweetened beverages, contain high amounts of added sugars, sodium, and unhealthy fats. These foods can contribute to inflammation and have a negative impact on your overall health, especially if you have CLL.

2. Saturated and Trans Fats: Saturated and trans fats are commonly found in fried foods, baked goods, and processed snacks. Consuming these types of fats can increase your risk of developing cardiovascular disease and stroke, which can be especially harmful for individuals with CLL who already have a weakened immune system.

3. Alcohol: Alcohol can suppress the immune system, making it harder for your body to fight off infections. Consuming alcohol can also impact your liver function, making it harder for your body to filter out harmful toxins.

4. Raw Sprouts: Raw sprouts, including bean, alfalfa, and clover sprouts, can harbor harmful bacteria that can cause infections. If you have CLL, it is best to avoid consuming raw sprouts, and make sure to thoroughly cook any sprouts before eating them.

5. Certain Types of Fish and Seafood: Certain types of fish and seafood, such as shark, swordfish, and king mackerel, can contain high levels of mercury, which can be harmful to your health. If you have CLL, it is best to limit your intake of these types of fish and seafood and opt for lower-mercury options such as salmon and shrimp.

Maintaining a well-balanced diet is crucial for individuals with CLL. While there are no specific foods that are prohibited, it is important to limit or avoid processed foods, saturated and trans fats, alcohol, raw sprouts, and certain types of fish and seafood to manage your symptoms and improve your overall health.

Make sure to speak with your healthcare provider or a registered dietitian for personalized dietary recommendations that fit your individual needs and health goals.

What is the vitamin for CLL?

There is no specific vitamin that can treat Chronic Lymphocytic Leukemia (CLL), which is a serious form of cancer that affects the blood and bone marrow. However, a healthy and balanced diet is important to support the immune system and overall well-being of the patient.

One important nutrient that has shown some promise in supporting immune function is Vitamin D. Studies have shown that Vitamin D may help to reduce inflammation, support the production of immune cells, and may help to prevent the growth and spread of cancer cells. However, more research is needed to determine the exact role that Vitamin D plays in cancer prevention and treatment.

Other vitamins and minerals that may support the immune system include Vitamin C, Vitamin A, Zinc, Selenium, and Iron. These nutrients can be obtained through a healthy diet that includes a variety of fruits, vegetables, whole grains, and lean proteins.

It is important to note that while a healthy diet and the supplementation of certain vitamins and minerals may support the overall health of individuals with CLL, they are not a replacement for medical treatment. Any treatment plan should be discussed between the patient and their healthcare professional.

What is a poor prognosis for CLL?

Chronic Lymphocytic Leukemia (CLL) is a type of blood cancer that affects the lymphatic system, which is responsible for maintaining the body’s immune function. The prognosis for CLL depends on a variety of factors such as age, overall health, the stage of cancer, the presence of certain genetic mutations, and response to treatment.

A poor prognosis for CLL refers to a situation where the patient’s cancer is unlikely to be cured, and where the disease is expected to progress rapidly or become resistant to treatment.

One of the most critical factors affecting the prognosis for CLL is the stage of cancer at the time of diagnosis. There are two primary staging systems used for CLL, namely the Rai and Binet systems. These staging systems are based on the number of lymph nodes involved, the size of the spleen or liver, and the number of blood cells affected by cancer.

Patients diagnosed at higher stages of cancer have a poorer prognosis since the cancer is likely to have spread to other parts of the body, making treatment more challenging.

Another factor that may influence a poor prognosis for CLL is the presence of certain genetic mutations. Mutations in certain genes such as TP53, ATM, and BIRC3 are linked to more aggressive cancer types and reduced response to treatment. Patients with mutations in these genes are more likely to experience disease progression and have a poorer prognosis.

CLL patients who are older and have underlying health conditions such as heart disease or diabetes may also have a poor prognosis. In such cases, treatment options may be limited, and the side effects of treatment may be more significant, making it difficult to tolerate the therapy.

Finally, CLL patients who fail to respond to initial treatments or develop drug resistance will have a poor prognosis. In such cases, the cancer is likely to progress rapidly, and treatment options become limited.

A poor prognosis for CLL is multifactorial, and a combination of several factors such as the stage of cancer, genetic mutations, age, and underlying health conditions contribute to the poor outcome. Early diagnosis and treatment, along with appropriate personalized care, can help patients achieve a more favorable prognosis.

Consultation with an experienced oncologist can provide the best guidance for CLL patients and their families, helping them understand the disease, the potential risks, and possible treatments.

Can you live a normal life span with CLL?

Chronic Lymphocytic Leukemia (CLL), despite being one of the most common types of leukemia among adults, does not necessarily mean that the affected individual cannot live a normal life span. CLL is usually diagnosed in older people and progresses slowly in most cases, with its severity varying from person to person.

Therefore, it is possible for someone with CLL to lead a normal life span with proper management of their disease.

The treatment for CLL depends on the stage of the disease and the symptoms of the patient. Instead of curing the disease, the treatment aims to control the symptoms and improve the quality of life. Furthermore, some people with CLL might not even need any treatment, to begin with and can follow a watch and wait approach, where they are closely monitored by their doctor at regular check-ups.

In addition to treatment, leading a healthy lifestyle can also help to manage CLL better. Regular exercise, a balanced diet rich in fruits and vegetables, and enough rest can help improve one’s overall health and may decrease the risk of complications.

Social and emotional support from family, friends, and support groups can also play an important role in managing the disease. It may be challenging to deal with a chronic illness like CLL, and having a support system to rely on can be extremely helpful in coping with the emotional burden of the disease.

In essence, while CLL is a chronic disease and cannot be cured, many people with the condition can still lead normal and fulfilling lives. Proper medical care, a healthy lifestyle, and emotional support can all contribute to managing CLL effectively and increase the chances of living a normal life span.

It is crucial for individuals diagnosed with CLL to work with their healthcare team to develop a customized treatment plan and to follow it closely to manage their disease and maintain their quality of life.

Can CLL improve without treatment?

The course of chronic lymphocytic leukemia (CLL) is highly variable, and it has been observed that many patients will experience long-term remissions without treatment. Research suggests that 30-40% of CLL cases can remain without progression or symptoms for up to two decades without any treatment at all.

In addition, some studies have found that both positive and negative prognostic indicators may be reversible over time.

Therefore, it is possible for CLL to improve without treatment, though the duration of remission is usually unpredictable and cannot necessarily be expected to last indefinitely. Improvements can also depend on the particular diagnosis, treatments and interventions which have been utilised, or are planned to be employed.

Favourable prognostic indicators include; favourable genetic features, slow disease progression, low white blood cells count and good response to treatment.

When managing CLL effectively, it is important to make sure that risk factors for progression (such as infections, other illnesses or high lymphocyte count) are avoided or treated promptly. Patients should also be regularly monitored for signs of disease progression and receive frequent, regular check ups with their healthcare team.

Patients may also benefit from participating in clinical trials to help further our knowledge and access new therapies that may provide improved outcomes.

How do you treat CLL naturally?

Chronic Lymphocytic Leukemia (CLL) is a type of cancer that affects the blood and bone marrow. It causes the production of abnormal lymphocytes, which are a type of white blood cell responsible for fighting infections. CLL is generally treated using traditional methods such as chemotherapy, radiation therapy, and stem cell transplantation.

However, some people prefer to explore natural remedies to complement the conventional treatment. Here are some ways to treat CLL naturally:

1. Diet: Nutrition can play a significant role in strengthening the immune system and fighting cancer. Eat a diet that is rich in fruits, vegetables, whole grains, and lean proteins. Avoid processed foods, red meats, and high-fat foods as they can increase inflammation in the body. Include foods that are high in antioxidants such as berries, green leafy vegetables, and nuts.

2. Exercise: Regular physical activity can help in managing the symptoms of CLL. Exercise increases blood circulation and oxygen flow, which helps in reducing fatigue and improving overall wellbeing. Exercise helps in boosting the immune system and helps the body fight against cancer cells.

3. Herbal supplements: Some herbs have been found to have anti-cancer properties. Examples of these herbs include curcumin, garlic, ginseng, and green tea. However, Before taking supplements, it is important to talk to your doctor or a licensed herbalist to ensure that they are safe and interact well with your medications.

4. Meditation and stress reduction: Chronic stress has been linked to a weakened immune system, which may increase the risk of developing cancer. Try relaxation techniques, such as meditation, deep breathing, or yoga. These practices can help to reduce stress and anxiety levels, and positively impact overall wellbeing.

5. Get enough sleep: People with CLL often experience fatigue and tiredness. Sleep is essential in repairing and replenishing the body’s cells, and ensuring that the immune system is functioning optimally.

Natural remedies can be used alongside traditional treatments for CLL to help manage symptoms, improve energy levels and promote a better quality of life. Consult with a qualified healthcare professional to determine which natural remedies are suitable and safe for you Specifically.

Can CLL patients live 20 years?

Chronic Lymphocytic Leukemia (CLL) is a slow-progressing cancer of the blood and bone marrow. The prognosis for CLL varies widely depending on several factors such as age, overall health, and stage of the disease. CLL patients can live 20 years or more, but it depends on several aspects.

Firstly, the stage of CLL at the time of diagnosis plays a significant role in determining the life expectancy of an individual with CLL. Earlier stage CLL patients have a more favorable prognosis than those with a more advanced stage. If CLL is diagnosed in the early stages when the cancer cells are in the bone marrow or lymph nodes, treatment, and management are easier, and the patient has a more favorable prognosis than patients diagnosed in later stages of the disease.

Secondly, age is another essential factor that affects the prognosis of CLL patients. Older patients have a worse prognosis than younger patients. The immune function and overall health of the patient usually decrease with age, and therefore, the age of the patient has a significant impact on how aggressive the treatment plan must be.

Third, the presence of other medical conditions, or comorbidities, can also affect the survival and life expectancy of CLL patients. If an individual has other significant medical conditions or underlying health issues, their ability to tolerate treatment for CLL may be compromised, affecting their prognosis.

Lastly, the effectiveness of the treatment plan is another important factor in assessing the survival rate of patients with CLL. Several different treatment options for CLL exist, including chemotherapy, immunotherapy, and targeted therapy. Depending on the stage of the disease, the patient’s age, and other medical conditions, the treating physician will help determine the ideal treatment plan.

The efficacy of CLL treatments varies depending on factors unique to each patient, but with effective treatment, patients can live well with the condition for many years.

While there is no definitive answer to whether CLL patients can live 20 years, several factors can affect the prognosis of patients with CLL disease. Therefore, individual cases must be assessed on a case-by-case basis. However, with effective treatment and appropriate management of the disease, many patients with CLL can lead fulfilling lives for many years.

Research in treating CLL progresses with every passing day, providing hope for patients living with this condition.

How do I know if my CLL is getting worse?

Chronic lymphocytic leukemia (CLL) is a type of leukemia that primarily affects older adults. It is a slow-growing type of cancer that may not cause any symptoms in the early stages. To determine if your CLL is getting worse, there are several factors to consider.

The first step to determine if your CLL is getting worse is to schedule regular check-ups with your doctor. Blood tests and physical exams can help monitor your CLL and detect any changes in your blood counts or lymph nodes. Your healthcare provider may also perform a bone marrow biopsy if they suspect your CLL has progressed.

Symptoms of progressing CLL may include fatigue, weakness, fever, night sweats, weight loss or loss of appetite, and increased susceptibility to infections. Some people may also experience swelling in the lymph nodes, spleen, liver, or other organs.

If you experience any of these symptoms, it is important to let your doctor know. They may adjust your treatment plan or recommend additional tests to determine the cause of your symptoms.

Changes in your CLL treatment may also indicate that your disease is progressing. For example, if your doctor increases your medication dose or adds additional treatments, it may indicate that your CLL is becoming more aggressive.

The best way to determine if your CLL is getting worse is to stay in communication with your healthcare team. Regular check-ups and open communication can help ensure your CLL is monitored closely and any changes are addressed promptly.

What is the most common cause of death in CLL?

CLL or chronic lymphocytic leukemia is a type of cancer that affects the white blood cells called lymphocytes. The disease progresses slowly and it is diagnosed mostly in elderly people. Although patients with CLL can have a good quality of life for many years, there are a few factors that can determine the prognosis and life expectancy of patients, such as the stage of the disease, the age of the patient, the presence of certain mutations, and other medical conditions.

One of the most common causes of death in patients with CLL is infection. This is because the abnormal lymphocytes that are present in the patient’s blood are not able to fight off infections as effectively as healthy lymphocytes. As a result, patients with CLL are at an increased risk of developing bacterial, fungal, and viral infections.

Another common cause of death in CLL is the progression of the disease itself. Although CLL progresses slowly, it can eventually lead to complications such as anemia, thrombocytopenia, and autoimmune hemolytic anemia, which can significantly affect the health of patients.

Furthermore, some patients with CLL may develop a more aggressive form of the disease called Richter’s transformation, in which the abnormal lymphocytes transform into a more aggressive type of cancer, usually lymphoma. Richter’s transformation is associated with a shorter life expectancy and a poorer response to treatment than CLL.

Treatment-related complications can also contribute to the mortality of patients with CLL. Chemotherapy, radiation therapy, and other treatments used to manage the disease can have side effects that can lead to organ dysfunction or other medical conditions. Additionally, patients with CLL are at an increased risk of developing secondary cancers.

Infection, disease progression, Richter’s transformation, treatment-related complications, and secondary cancers are all potential causes of death in patients with CLL. Close monitoring, appropriate treatment, and good supportive care can help manage these complications and improve the quality of life of patients with CLL.

How do you know what stage of CLL you are in?

Chronic Lymphocytic Leukemia (CLL) is a type of cancer that affects the lymphatic system. It is usually diagnosed through blood tests or biopsy. Once diagnosed, the stage of CLL is determined to identify its extent and severity.

The stage of CLL is determined based on various factors, including the number of cancer cells present in the blood, the size of the lymph nodes, and the presence of enlarged organs. The stage is used to determine the best possible treatment plan for the individual.

The most commonly used staging system for CLL is the Rai stage. The Rai system uses lymph node size, white blood cell count, and anemia to determine CLL stages. There are five stages in the Rai system: 0, I, II, III, and IV.

In stage 0, there is an increase in the number of lymphocytes, but the lymph nodes are not enlarged. In stage I, the lymph nodes are enlarged, but the spleen and liver remain the same size. Stage II involves enlargement of lymph nodes and spleen along with an increase in the number of white blood cells.

In stage III, the red blood cell count decreases, and liver/spleen enlarge. Finally, in stage IV, there is a decrease in the red blood cell count along with other symptoms such as weight loss and fever.

A more recent staging system called the CLL International Prognostic Index (CLL-IPI) uses five factors, namely age, blood test results, the number of big lymph nodes, and the stage of the disease as determined by the extent of damage to specific organs such as the bone marrow, spleen or liver. The CLL-IPI system identifies five risk groups, each with different survival rates and expected outcomes in treatment.

Cll can be staged using various systems to help determine the extent and severity of the disease. Patients can discuss with a healthcare professional to determine the most appropriate staging system that best suits their individual situation, and the ideal treatment plan to manage the disease’s symptoms and impact.

Resources

  1. Case Report of Unexpectedly Long Survival of Patient … – NCBI
  2. CLL symptom progression: How might it develop?
  3. Can Diet Help With Chronic Lymphocytic Leukemia? – WebMD
  4. Chronic lymphocytic leukemia (CLL) in adults … – UpToDate
  5. Chronic Lymphocytic Leukemia Treatment (PDQ®)–Patient …