Watch & ACT

When you heard that you had chronic lymphocytic leukemia (CLL), many thoughts may have run through your head. Then you were told that treatment wasn’t recommended at this time. Maybe you were relieved to learn you didn’t have to treat. You might have been concerned that not enough was being done. The time between being diagnosed with CLL and beginning treatment is often called watch & wait, but it may feel more like watch & worry.  Uncertainty can be scary,  but what if you could reduce your worry and focus on the things that matter most to you?  You can. You can Watch & ACT.1,2,3

Do More Than Watch & Wait. ACT

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Watch & ACT is being aware of how you feel physically and emotionally and turning that awareness into action to help you live with CLL.4 ACT stands for Acknowledge, Communicate, and Track. Together, these 3 actions may help you better understand your CLL, prepare for conversations with your doctor, and take a more active role in your care—so you can keep moving and living your life.5 Let’s get started.


Living with cancer can bring a range of emotions. Acknowledging means recognizing those emotions and learning how to address them, so they’re not getting in the way of your day-to-day life. It’s not often that we pause to reflect on our emotions, but doing this is the first step to addressing them. Notice your emotions, see what might be causing them, and recognize how they’re affecting you.6-9

Acknowledging your emotions may help you feel more prepared to talk with your doctor and others on your team. Once you’ve uncovered those emotions, you can start thinking about healthy ways you can address them. Looking for healthy ways to deal with difficult emotions? Watch this short video to listen in on a discussion between people living with CLL. They share the different ways they cope, so you can see what might work best for you.


Communicating is very important when you are living with CLL. Your healthcare team and loved ones want to help, but they need to know what you need. You have a lot to cope with, but you don’t have to do it alone. Your oncologist and healthcare team are good resources for information. Share your preferences, concerns, symptoms—anything that can help them provide you with the care and support you need. They can also help you decide when it’s time for treatment.10-13

It’s not just your healthcare team. Remember, there are other people around you who want to help, including your family, friends, and members of your support groups. Keep those lines of communication open, too.

Think about who is on your care team. Who has been there with you through it all? Who can you call when you need a helping hand? Reach out to them and be open about your needs. You may find that you’re better able to manage CLL when you have support from the people who care about you.

Discover support and communication tips for approaching conversations with your doctors and loved ones when you get our discussion guide (English / Español).

You might not be ready to discuss CLL with friends and family just yet, and that’s OK. Hear from someone who felt the same way after being diagnosed. Watch this short CLL video to find out why they decided to open up and how care partners can help.


Tracking helps you understand where you are and plan for where you want to be. It gives you a picture of how you’re doing, so you can work with your doctor to address anything that needs attention. You can track your test results and your symptoms. Your doctor can help you understand how your tests change over time. When you track your symptoms, you can share them with your doctor to spot any patterns. This may help you partner with your doctor and feel more involved in your journey.1,5,10,14,15

You can track any way you want. It’s all about what’s convenient and easy for you. Make a list on your phone, keep a journal, make a video diary or whatever works for you. That way you can see any patterns and share them with your doctor.14

Remember, since tracking helps you notice changes and patterns over time, it’s a good idea to track regularly.

Watch this short video to see how real people with CLL track their symptoms and test results—and why they stick with it.

Acknowledge. Communicate. Track. Three actions that you can do now and that can make a big difference in how you feel about your life with CLL. So don’t just wait. ACT.

To learn how to apply ACT to your everyday life, sign up for ACT On CLL.

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Get communication tips and help approaching conversations with your loved ones and doctors when you download the discussion guide.

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Focus on What Matters

Live the life you want. ACT On CLL helps you take an active role in your care, improve your coping skills, and learn more about your CLL.

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Know Your CLL

What makes your CLL experience unique? Find out by answering a few questions. It may help you better understand your CLL and make decisions with your doctor.

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Wondering what to do when it’s time to begin treatment?

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  1. The Leukemia and Lymphoma Society. Chronic Lymphocytic Leukemia. White Plains, NY: The Leukemia and Lymphoma Society; 2014. Publication No. PS34 40M.
  2. Shanafelt T, Bowen D, Venkat C, et al. The physician-patient relationship and quality of life: lessons for chronic lymphocytic leukemia. Leuk Res. 2009;33(2):263-270.
  3. American Cancer Society. Managing Cancer as a Chronic Illness. American Cancer Society website. Updated February 12, 2016. Accessed January 7, 2022.
  4. Kim C, Wright F, Hong N, et al. Patient and provider experiences with active surveillance: A scoping review. PLoS One. 2018 Feb 5.
  5. The Leukemia and Lymphoma Society. Chronic Lymphocytic Leukemia. White Plains, NY: The Leukemia and Lymphoma Society; 2017. Publication No. PS48 25M.
  6. American Cancer Society. How do you know when your stress level is normal or more serious? American Cancer Society website. Updated June 8, 2015. Accessed October 8, 2018.
  7. National Institute of Health. A Guide for Older People: Talking With Your Doctor. National Institute on Aging website. Published December 2016. Accessed January 7, 2022.
  8. American Cancer Society. Talking with Your Doctor. American Cancer Society website. Updated November 17, 2015. Accessed January 7, 2022.
  9. American Cancer Society. Telling Others About Your Cancer. American Cancer Society website. Updated April 28, 2016. Accessed January 7, 2022.
  10. Referenced with permission from the NCCN Guidelines for Patients®: Chronic Lymphocytic Leukemia V.2.2022. © NCCN Foundation®. 2022. All rights reserved. Accessed January 7, 2022. To view the most recent and complete version of the guideline, go online to NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
  11. American Cancer Society. Chronic Lymphocytic Leukemia. American Cancer Society website. Updated May 10, 2018. Accessed January 7, 2022.
  12. American Cancer Society. The Doctor-Patient Relationship. American Cancer Society website. Updated October 18, 2016. Accessed January 7, 2022.
  13. IOM (Institute of Medicine). 2013. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. Washington, DC: The National Academies Press.
  14. Vernooij R, Willson M, et al. Characterizing patient-oriented tools that could be packaged with guidelines to promote self-management and guideline adoption: a meta-review. Implement Sci. 2016;11(52): doi: 10.1186/s13012-016-0419-1.
  15. National Institute of Health. A Guide for Older People: Talking With Your Doctor. National Institute on Aging website. Published December 2016. Accessed January 7, 2022.