Visit our guides to best cancer care webpage for consumer guides. Visit our OCP webpage for the optimal care pathway and instructions on how to import these guides into your GP software. Endorsed by: ALLG <www.allg.org.au> ANZTCT <www.anztct.org.au> Cancer Council <www.cancer.org.au> HSANZ <www.hsanz.org.au> Leukaemia Foundation <www.leukaemia.org.au>  

Palliative care Consider a referral to palliative care. Ensure an advance care directive is in place. Communication The lead clinician’s responsibilities include: being open about the prognosis and discussing palliative care options with the patient establishing transition plans to ensure the patient’s needs and goals are considered in the appropriate environment. Checklist Supportive care needs…

Detection Most relapsed or progressive disease will be detected via routine follow-up or by the patient presenting with symptoms. Treatment Evaluate each patient for whether referral to the original multidisciplinary team is appropriate. Treatment will depend on the features of disease, previous management and the patient’s preferences. Advance care planning Advance care planning is important…

Provide a treatment and follow-up summary to the patient, carer and GP outlining: the diagnosis, including tests performed and results treatment received (types and date) current toxicities (severity, management and expected outcomes) interventions and treatment plans from other health professionals potential long-term and late effects of treatment and care of these supportive care services provided…

Treating asymptomatic early-stage CLL does not improve survival, so an initial ‘watch and wait’ approach is recommended. Disease-directed therapy should not start unless there are disease-related symptoms or evidence of disease progression. Establish intent of treatment Curative Anti-cancer therapy to improve quality of life and/or longevity without expectation of cure Symptom palliation Systemic therapy has…

Diagnosis for CLL will be confirmed based on full blood count and a thorough physical examination, including all lymph node areas, spleen and liver. Investigations for baseline assessment and to inform prognosis include: detailed blood chemistry tests, chest radiograph and viral serology. The following investigations are only recommended under certain circumstances: marrow aspirate and biopsy…

Most patients are asymptomatic when they are diagnosed because CLL is often found in routine blood tests. When present, symptoms can include: painless swelling of lymph nodes (often around the neck) that may fluctuate in size but don’t completely resolve (within 6 weeks) unexplained weight loss of ≥10 per cent of body weight within the…

Prevention The cause of CLL is unknown and there are currently no effective prevention strategies. At present, there is no evidence linking lifestyle or behavioural factors to prevention of CLL. Risk factors The risk factors for developing CLL include the following: age (occurs mainly in people aged over 60) gender (CLL is more common in…