Hodgkin's Disease Archive Questions

Below are Dr. Kimball’s answers to Hodgkin's Disease questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 5 of 5.

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Q : 1 05/14/2010	What is the traditional treatment protocol for stage Ib follicular lymphoma? The best treatment is radiation. Early stage (stage I or II) follicular can be cured with radiation therapy. If the follicular lymphoma becomes stage III or IV, there is no longer a good treatment option that can give the possibility of cure. Lymphoma physicians have a lot of different opinions. I hope that you find one who offers you a possibility of cure. Chemotherapy just slows down follicular lymphoma, but it always comes back.
Q : 2 04/27/2010	I have a swollen area to the left of the base of my neck, near the clavicle. I am very overweight too. Should I be concerned about that area? Signs to worry about are if the swollen area is tender or enlarges, or if you develop fever or night sweats. If the area has been the same for a long time, it may not be anything to worry about. If it is new, a CT scan to look for pathologically-enlarged lymph nodes and consideration of a lymph node biopsy would be good first steps.
Q : 3 03/02/2010	Within the past year my health has been on an intense roller coaster ride. I started off having multiple organ failure (kidneys and liver) which as far as I know I have recovered from, to recently finding lumps in my breast, neck and inner bicep near my armpit. I am scheduled to have a biopsy done on the lump in my breast. Along with the lumps I have been extremely tired, have pain in my back that started off on the left lower side but has now radiated to my entire back, pain in my arms and legs, a constant low grade fever, and small red patches on my stomach and left side. I haven't had much of an appetite either but I'm not sure if that's stress related. In your experience, what are the chances that these symptoms are something other than lymphoma? My doctor seemed very insistent upon doing a biopsy but wouldn't give me much information. Anything you could tell me would be greatly appreciated. I can understand why your doctor is strongly recommending a biopsy, and also why he is not giving you very much information. Whenever a person has masses in several places, we worry about cancer. We can't know that it is cancer until we take a piece of the tissue - a biopsy - and evaluate it under the microscope. If it is cancer, it could be one of several kinds - a breast cancer, a lymphoma, or some other carcinoma. The prognosis, and the way that we treat each of these is very different. I hope that you are going to a doctor that you trust. You probably are not seeing a cancer doctor, because you aren't known to have cancer. Most non-oncologists are not comfortable talking about cancer diagnoses because it is outside of their specialty and they don't want to give you any false information. This is the most difficult part of the process - thinking that something is wrong and not knowing what is is. If you do learn that you have a cancer diagnosis, I encourage you to see 2 different oncologists for an initial opinion, one at a center of excellence. If they agree - that's great - choose who you like. Sometimes there is disagreement about what to do first, and patients miss important opportunities.
Q : 4 02/17/2010	I was wondering about my life expectancy. I have Non-Hodgkin's lymphoma and currently am in remission. My NHL is low-grade and was stage 2 when detected. My chemo ended a year ago and I am in fair health at the age of 59. This is a difficult question. Lymphoma is a disease that is quite variable in it's behavior. Different kinds of lymphoma behave differently. Even when two patients have the same kind of lymphoma, they often have a difference in how well their disease responds to the same chemotherapy. When you say "low grade," I'm guessing that you mean indolent. We think about the lymphomas as being either aggressive or indolent. Aggressive (Diffuse Large B-cell Lymphoma, and others) tend to grow quickly and be rapidly fatal if not treated. With chemotherapy they can be cured. Indolent lymphomas (Follicular lymphoma, Nodal Marginal Zone and others) tend to grow slowly. They don't always need to be treated right away. When they are treated, we expect chemotherapy to control them for a period of time, but not forever. After treating indolent lymphoma, we monitor patients carefully because we know that it is likely that the lymphoma will come back and need to be treated again. When it does come back there are quite a few treatment options available. It is often a good idea to get two medical opinions before going forward with the second therapy.
Q : 5 01/31/2010	My mom is 84 and has Stage 4b Hodgkin's lymphoma. She has an enlarged spleen and excessive coughing; not willing for any chemo or radiation. Removal of spleen considered. Liver, lungs and heart all OK. Is there anything to help her with the cough? Chronic cough can be a very troubling symptom. Usually we address this problem by trying to determine and treat the underlying cause. In your mothers' case, it is probably Hodgkin Disease in the chest that is pressing on nerves and airways that is causing the cough. Since she is not willing to undergo therapy for her Hodgkin Disease, we are left with attempting to control the symptom. Several medications act centrally, to reduce coughing. These include Codeine, Morphine, or dextromethorphan. I'd try one of these. I would also recommend including Prednisone. This is an anti-inflammatory agent that can reduce airway inflammation and also can shrink the enlarged lymph nodes. If Prednisone together with Codeine or dextromethorphan don't work, there are other medications in different classes that you can try adding in. I encourage you and your family to consider accepting Hospice Care. Hospice practitioners are quite adept at helping relieve uncomfortable symptoms.

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