Hello everyone!
A standard approach after the diagnosis of leukemia is immunosuppression and later on transplantation of donor cells.
A doctor may state that "if we do not start therapy immediately, you (the patient) will die within weeks."
What evidence is there for this statement? What research exists that studies no intervention (watchful waiting)?
Thank you
Before the 1950s there was no effective treatment for leukemia. So the standard behavior was to make patients life confortable and blood transfusions. Patients with acute leukemia died in a short time. The evidence on this sense is overwhelming. We do not need to study "no intervention". We saw what happened with this patients. Ask any physician who was in practice in the 1960s.
Hello Thomas! Thank you for your answer. So there is evidence spread via word to mouth. But really no written statistic or report from those period available? I also wonder, did every patient die in a short time, or how many patients did survive for longer periods. I state all these rather fundamental questions, because I just discussed a case were the patient upon retrospect had rather died after his diagnosis than gone through all todays modern therapies. These cause him lots of suffering too. So this brings in the aspect quality of life versus quantity of life.
I have been in oncological practice for exactly 50 years now. I do not need double blind placebo controlled large studies to know that acute leukemia kills patients in short notice and with no life quality.
In hematopoietic cancers standard treatments have a high rate of success. And quality of life is much better than without treatment.
Only a few cases require bone marrow transplant.
All this said, I am a stern critic of many of the cancer treatments used nowadays. However the best results in cancer were achieved in leukemia, lymphoma and Hodgkin. Therefore, I would never think in leaving one of these patients without treatment.
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CHRONIC LYMPHOCYTIC LEUKEMIA
According to WHO, chronic lymphocytic leukemia is expected to be more prominent in the developed world due to genetic factors. Exposure to certain chemicals is the primary cause of all the types of chronic lymphocytic leukemia. Global incidence of chronic lymphocytic leukemia was 94,960 in 2008 in the developing countries. Total 123,379 new cases were recorded in 2010 with 199,472 and 282,683 as the predicted new cases for 2015 and 2020
Dear Gamal
I think you have put in numbers the idea that leukemia should not left untreated.
Your statistics are overwhelming. Thank you.
Tomas
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