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How Do CLL Specialists and Community Oncologists Collaborate?

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Published on August 2, 2019

How can a chronic lymphocytic leukemia (CLL) specialist help with a retreatment plan? Noted CLL expert Dr. Nitin Jain, from The University of Texas MD Anderson Cancer Center, joined Patient Power to discuss ways community CLL doctors and academic medical centers can collaborate to provide the best care to relapsed CLL patients. Watch now to hear Dr. Jain’s expert knowledge.

This program is sponsored by Pharmacyclics. This organization has no editorial control. It is produced solely by Patient Power.

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Transcript | How Do CLL Specialists and Community Oncologists Collaborate?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:        

Dr. Jain, just confirm this for us. So, again, we’re talking about people who have relapsed; their remission has ended. They may come see you or go to a major center like yours at MD Anderson, or UC San Diego, where Dr. Kipps sees James, and several other major centers around the world, actually.

But, it also may be that their community doctor calls you—and, I’m sure you get calls like this all the time—and says, “I have Carol Preston out here in Maryland. Here are test results.” You may say, “Fax me that”—I don’t know about faxing anymore—“Send me that.” Maybe you’d wanna examine Carol yourself, but the point is you as a CLL subspecialist could be an architect of a retreatment plan, correct?

Dr. Jain:                     

Yeah, that’s absolutely correct. So, a lot of patients—we see several, as Carol mentioned—are coming for a consultation. A lot of patients I see here are newly diagnosed CLL, and obviously, it’s a scary diagnosis, and the local doctor appropriately will tell the patient they need to be watch and wait, as was the case with James’s situation. Again, it’s a bit counterintuitive. You have a leukemia on one hand, and the doctor is saying to you, “Hey, we don’t need treatment.”

I can tell you that the single most common reason I see patients here is as a new patient where they’re coming for a second opinion, but I think the second opinion—and, I will probably tell the same thing to the patient, “What your doctor said is correct.” But, I think it certainly gives a peace of mind. And then, we discuss with them what the feel of CLL is, how it’s moving, because they also wanna know what will happen maybe five years down the line. “If I need treatment five years down the line, what are the treatments I’m looking at?” 

So, we can give that comfort, provide that feedback, and maybe build on the knowledge the local doctor may have provided to them. So, that certainly is true. The other aspect is patients who really need treatment—patients who have relapsed CLL, or patients who are first-line CLL, as was the case with Carol. On day one, it’s like, “You need treatment.” I think in that situation, certainly, if the patients were to come to us, we would treat them here, but I really very much encourage the viewers and the listeners here that me and my colleagues here are always available. 

Even if you cannot come here physically from logistics, financial, whatever reason that might have been, you can have your doctor call us, or you can just send me or my colleagues an email, and our email address is publicly available on the website of MD Anderson, and we all do our best to reply to your email right away or within 24 hours with what we may think is the appropriate strategy, maybe. 

So, at least, we are not far, and I think we are always available, and I just said we are available by email, which is obviously easier for some patients, or if you wanna come here, come to MD Anderson, UCSD, or other major med centers in the U.S., I think all of the CLL docs are very willing to work with your local doctor for ongoing care.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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