NCCN Guidelines for Patients® | Chronic Lymphocytic Leukemia
15 NCCN Guidelines for Patients ® : Chronic Lymphocytic Leukemia, 2018 2 Treatment planning Medical history | Physical exam Doctors plan treatment with many sources of information. One of these sources is tests of your health and the cancer. Part 2 describes who should receive which tests before treatment. Some of these tests are repeated during and after treatment. Besides tests, Part 2 describes other types of care that are important to receive before cancer treatment. Everyone does not need to start CLL treatment right away. Part 2 ends with explaining how doctors decide when treatment should be started. Medical history Your medical history includes any health events and medicines you’ve taken in your life. You will be asked about illnesses, injuries, health conditions, and more. Some health problems run in families. Thus, your doctor may also ask about the health of your blood relatives. Some signs and symptoms of CLL are enlarged lymph nodes, tiredness, a feeling of fullness in your belly, and getting sick. CLL may also cause “B symptoms.” It’s important that your doctor knows if you have them. These symptoms include fevers, chills, night sweats, and weight loss without dieting. A medical history is one of the tests needed for treatment planning. See Guide 1 on page 16 for a complete list of care that is recommended prior to treatment. Some types of care are for anyone with CLL while others may be useful for some people. Physical exam Doctors often give a physical exam along with taking a medical history. A physical exam is a exam of your body. Your doctor may listen to your lungs, heart, and intestines. With your permission, your doctor may also feel different parts of your body to see if organs are of normal size, are soft or hard, or cause pain when touched. For example, your doctor may feel your belly area (abdomen) to check for signs of disease. He or she will also measure the size of your liver and spleen if it can be felt. Results of your medical history and physical exam will be used to rate your performance status. Performance status is your ability to do daily activities. It indicates a person’s general level of fitness. Along with labs, other studies, and your history, it is used by doctors to assess if you can undergo certain treatments. Your medical records: ü Your doctors will order tests and schedule visits to talk about your care plan. ü It is helpful to keep track of your test results at all times. Ask your doctors questions about the results.