Confused And Need Guidance

Hi,

 My father was diagnosed with Lymphoma 10 years ago and was told to that the best course of action was to wait and watch.  This seemed like good advice since he was age 73 at the time and a cardiac patient with two double by-pass surgeries.  Well, now he is 83 and has been suffering chest pain, itchy skin, and night sweats a few nights a week.  Because the chest pain was the most prominent symptom he was having he was going back and forth to his cardiologist trying to get help for what he thought was angina.  After doing a stress test and an angiogram, the cardiologist determined that his heart is just fine.  During the angiogram the doctor noticed fluid on his right lung and he ended up draining it and running tests on it.  I will quote the test results here:

"The cytospin preparations are cellular and consist of predominantly small lymphocytes.  Histocytes are noted in the background.  Occasional multinucleated cells are seen.  A single multinucleated atypical cell is observed.  The cell block preparation shows similar findings. 

Diagnosis: Atypical population of lymphoid cells consistent non-Hodgkin Lymphoma, which is consistent with patient history. "

 Ok, so here's what I need help with.  My dad isn't interested in going through any kind of treatment for this.  My mom died a year ago, he's 83, and just pretty much miserable.  He wants to go on hospice and just remain as comfortable as possible.  I'm fine with that, but I am wondering if he would benefit from seeing an oncologist incase there are treatments that could make him feel better and less miserable and ultimately make him want to go on living.  I'm not sure he is even hopsice approrpriate.  This guy will be 84 next month, and like I said, he's just not happy anymore since my mom passed away, he's told me that he wants to go be with her.  Physically, given his condition and age, is there something that can be done for this lymphoma diagnosis?  Is hospice appropriate?  We can't see his GP until next week and my dad is saying that the GP is always trying to "be a hero" and probably won't let him go on hospice.  Any insights are greatly apprecaited.

 

On 3/14/2007 Onegoofyfoot wrote:

Hi,

 My father was diagnosed with Lymphoma 10 years ago and was told to that the best course of action was to wait and watch.  This seemed like good advice since he was age 73 at the time and a cardiac patient with two double by-pass surgeries.  Well, now he is 83 and has been suffering chest pain, itchy skin, and night sweats a few nights a week.  Because the chest pain was the most prominent symptom he was having he was going back and forth to his cardiologist trying to get help for what he thought was angina.  After doing a stress test and an angiogram, the cardiologist determined that his heart is just fine.  During the angiogram the doctor noticed fluid on his right lung and he ended up draining it and running tests on it.  I will quote the test results here:

"The cytospin preparations are cellular and consist of predominantly small lymphocytes.  Histocytes are noted in the background.  Occasional multinucleated cells are seen.  A single multinucleated atypical cell is observed.  The cell block preparation shows similar findings. 

Diagnosis: Atypical population of lymphoid cells consistent non-Hodgkin Lymphoma, which is consistent with patient history. "

 Ok, so here's what I need help with.  My dad isn't interested in going through any kind of treatment for this.  My mom died a year ago, he's 83, and just pretty much miserable.  He wants to go on hospice and just remain as comfortable as possible.  I'm fine with that, but I am wondering if he would benefit from seeing an oncologist incase there are treatments that could make him feel better and less miserable and ultimately make him want to go on living.  I'm not sure he is even hopsice approrpriate.  This guy will be 84 next month, and like I said, he's just not happy anymore since my mom passed away, he's told me that he wants to go be with her.  Physically, given his condition and age, is there something that can be done for this lymphoma diagnosis?  Is hospice appropriate?  We can't see his GP until next week and my dad is saying that the GP is always trying to "be a hero" and probably won't let him go on hospice.  Any insights are greatly apprecaited.

It sounds like your dad had an indolent NHL,  perhaps follicular that required no treatment and that now his symptoms have worsened and treatment options must be considered.  At his age, agressive chemo and stem cell transplants are not options.  He probably is a candidate for single agent Rituxan which may help some with symptoms.  I think an oncologist should be consulted at this stage.  In the end, his treatment should be up to him, assuming he is capable, and doing nothing at 84, is an option.

Thanks for your quick reply.  He really doesn't want to seek any treatment.  You sound very knowledgable.  Does this diagnosis sound as if the lymphoma has spread to his lungs?  That's how I am interpreting it since the fluid was removed from the cavity around the lungs.  With the information I have given, which is really all the info I have, If he doesn't seek treatment would you have any idea how long he might live?  Thanks for your time and sharing your knowledge.

Sometimes , lymphoma can be well treated with very lite chemo and go into remission if it is a favorable histology.  If it can be done this simply with few side effects, it can make him feel much better and maybe change his outlook. I think even given his age it may be worth a try.

I am being treated for a recurrence.  First treatment was CHOP/R and was horrible.  This time I took BEXXAR and woulr recommend it to everybody.  Side affects were very minumal and from what I can tell the cancer is gone, will have PT scan next month to verify this. 

Please ask your doctors about BEXXAR before any Chemo is given to you. 

 

PLEASE check out this website before considering BEXXAR. http://www.bexxar.com/ I am a senior citizen who also has(had) non Hodgkin's lymphoma, diagnosed in May 2004 and have had great success using ONLY alternative treatments. You could send me a private message if you are interested in knowing more. Blessings Shemay

On 3/15/2007 Onegoofyfoot wrote:

Thanks for your quick reply.  He really doesn't want to seek any treatment.  You sound very knowledgable.  Does this diagnosis sound as if the lymphoma has spread to his lungs?  That's how I am interpreting it since the fluid was removed from the cavity around the lungs.  With the information I have given, which is really all the info I have, If he doesn't seek treatment would you have any idea how long he might live?  Thanks for your time and sharing your knowledge.

 

On 3/15/2007 Onegoofyfoot wrote:

Thanks for your quick reply.  He really doesn't want to seek any treatment.  You sound very knowledgable.  Does this diagnosis sound as if the lymphoma has spread to his lungs?  That's how I am interpreting it since the fluid was removed from the cavity around the lungs.  With the information I have given, which is really all the info I have, If he doesn't seek treatment would you have any idea how long he might live?  Thanks for your time and sharing your knowledge.

Well, sort of.  It sounds like a pleural effusion caused by the lymphoma.  Generally, the presence of malignant cells in the effusion is associated with a poor prognosis. 

 

On 3/19/2007 Gregb wrote:

I am being treated for a recurrence.  First treatment was CHOP/R and was horrible.  This time I took BEXXAR and woulr recommend it to everybody.  Side affects were very minumal and from what I can tell the cancer is gone, will have PT scan next month to verify this. 

Please ask your doctors about BEXXAR before any Chemo is given to you. 

 

Keep in mind that Bexxar is not indicated for front line treatment of NHL.  Its only used for recurrent or relapsed disease.  I agree CHOP-R might be too much for an 84 yo, but Rituxan alone should be an option with fewer side effects.

 

Right now it is only approved for a recurrence, but there is a push on to make it the fisrt line treatment.  It is just as effective as CHOP.  The problem is the cancer doctors are fighting against making it the first line treatment because they cannot administer it in their office and they would lose tons of money they receive from giving CHOP treatments.  Most cancer doctors are looking out for their own wallets rather than what is best for their patients.  This is straight out of the mouth of my doctor.