Patients will be seen by a Hematologist or Medical Oncologist during their first clinic visit. Other team members who may participate in the patient's initial evaluation include a Surgical Oncologist, who performs biopsies to help in diagnosing the disease, a Pathologist, who interprets biopsies, a Radiologist, who interprets radiographic studies, and a Radiation Oncologist, who plans radiation therapy.
Depending on the individual's situation, the patient may have additional blood tests either before or after seeing a physician. X-rays, CT scans, and/or MRI scans may be ordered. Some patients may be asked to have a bone marrow aspiration and biopsy during this visit. Patients should be prepared to spend up to two or three hours for a full evaluation in the clinic. On rare occasions, we recommend that patients be admitted to the hospital that same day for immediate treatment.
If patients have tests during their initial visit, they may be asked to return at a later date for additional consultation. This allows time for the results of these tests to be studied. Often appointments are made during the first visit for the patient to return for chemotherapy, radiation therapy, or for a surgical procedure.
Patients may be offered the opportunity to participate in a clinical trial during their evaluation if it seems that this would be a good option.
Arrangements may be made for the patient to meet support service providers. These might include a social worker, a financial counselor, a chaplain, a patient counselor, or a nutritionist, depending on the patient's needs and interests. These health care professionals are readily available to assist patients with their needs and concerns throughout their care at UNC.
Patients will have an opportunity to visit the Cancer Patient/Family Resource Center where they can obtain information about their diagnosis and learn about support groups and resources for individuals with cancer.
Diagnostic Procedures and Treatment Information
Hematologic malignancies can be very different from each other. Thus, there are a number of possible treatment options. These may include:
- Careful observation over time
- Treatment with chemotherapy or radiation therapy alone
- Treatment with both chemotherapy and radiation therapy
- Bone marrow transplantation
- New therapies and drugs offered through clinical trials
Many patients can be cured with conventional treatments, but for some other options need to be considered. These include cases where standard treatment does not have a good success rate, cases in which standard treatment cannot be given, or cases where standard therapy was tried and failed. These types of patients can often be considered for treatment with new drugs and unique combinations of therapies offered through clinical trials. These trials are treatment plans that are carried out in a carefully designed and organized fashion with close monitoring of the results. The goals of clinical trials are to evaluate new chemotherapy drugs and new combinations of drugs, to increase survival, to provide better quality of life, and to reduce treatment-related side effects. Our program offers clinical trials to treat many types of hematologic malignancies. Though these trials are not for everyone, for some patients they offer additional treatment options that are not available elsewhere.
After Cancer Treatment
After their treatment, patients are followed regularly by their managing physician in the Leukemia Clinic. Though the frequency varies depending on each patient's case, a common schedule would be every 3 to 4 months for the first and second years, every six months for the third to fifth years, and yearly after that. During these visits, blood tests and x-rays may be ordered. Occasionally bone marrow aspirates or biopsies may be needed as well.