Hodgkin's Disease Archive Questions

Below are Dr. Zimrin’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 15 of 44.

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Q : 1 12/02/2009	I am 31-years-old and healthy aside from having aggressive non-Hodgkin's lymphoma, stage IV. I was treated with conventional chemo of 4 Cycles(A & B). After 6 months, I relapsed and was under ICE Protocol for three Cycles. PET CT is clear without the lymphoma. The doctors have suggested a bone marrow transplant as an option but we would rather opt for another three cycles of chemotherapy. Is this a option good, or is BMT a must? In general, a bone marrow transplant offers the best chance of being cured after a relapse of aggressive lymphoma.
Q : 2 11/19/2009	If you had a choice as to where to seek treatment for lymphoma, would you go with private practice or a university hospital? Personally, I would be inclined to go to a university hospital, at least for a second opinion. Lymphoma therapy is changing rapidly, and I would be afraid that I would get outdated advice. Some people might find that the convenience of a private oncologist (close by, good parking) outweighs this. Others go for a second opinion to put their mind at ease, then choose based on what feels right to them. It's a personal choice.
Q : 3 09/06/2009	In a case with NHL associated with increased liver enzymes & total bilirubin due to liver infiltration, what is the appropriate chemotherapy and its dose? In general, if the liver disease is thought to be secondary to the lymphoma, we go ahead with full doses. If the liver disease is thought to be secondary to something else (hepatitis, cirrhosis), we have to cut back on the doses of some drugs, or possibly omit them altogether.
Q : 4 09/04/2009	My mom was diagnosed with non-Hodgkins lymphoma. She is 72 and is otherwise healthy and active. Her doctors say she needs a bone marrow biopsy, CT scan of her lungs, and MRI to diagnose stage. She is schedule to have these tests done in several weeks. Is it OK to wait this long? The speed with which you need to get started depends in part on the type of non-Hodgkin's lymphoma. With the aggressive types, it is important not to waste time. With the slower growing types, speed is not so important.
Q : 5 07/15/2009	Can you help me understand the severity of Burkitt's syndrome as it relates to lymphoma? Burkitt lymphoma is one of the most aggressive forms of non-Hodgkin's lymphoma. If a disease is labeled as aggressive, it means that the disease spreads rapidly. It is still curable in some patients, but the treatment involves a course of chemotherapy that is relatively intense.
Q : 6 06/19/2009	I am 30 years old with follicular lymphoma and I am considering immunotherapy. What is the rate of improvement for patients who have chosen immunotherapy? The first patient who was treated with immunotherapy did very well, which encouraged the oncology community to pursue this type of therapy. Since then, the results have been mixed. Occasional patients have an antibody response which might translate into better results. Unfortunately, for many patients the treatment is of no benefit.
Q : 7 05/17/2009	I have an enlarged lymph node in my neck to the right of my trachea. My doctor wants it to be checked for cancer. When I went to the surgeon, he wants to pull a lymph node out of my groin and check it because he said it will be easier and less dangerous. Should the lymph node in question be the one to be checked? Assuming it is cancer, if it has not spread to the one in my groin and that test comes back negative, then it could go undetected. I am just a little worried and wanted some advice. I can't tell you what would be the best approach for you. Groin nodes are easier to access, but since normal people have nodes that can be felt in the groin, sometimes a biopsy of a node there is not helpful. A lymph node in the neck is a little harder to reach, but more likely to provide a diagnosis (if it is enlarged).
Q : 8 04/22/2009	My husband was told 2 weeks ago that he'll need to start treatment for low-grade, follicular non-Hodgkin's lymphoma. He has stage II and it is localized to one area. His oncologist wanted to start treatment next week, but due to a business trip we have pushed it back another week. Could this effect his chances for complete remission? No, postponing treatment for a low-grade lymphoma for a week is not going to make a difference in his response.
Q : 9 03/16/2009	My grandfather is 75 years old had open heart surgery in Jan and was recovering wonderfully. Then he developed a fever that wouldn't go away. After many tests, they diagnosed him with Hodgkin's lymphoma, stage 4. He is bedridden, has trouble speaking, is extremely weak, and is not eating much. He just started his first week of chemo and they want to put a tube in for it, but my mother feels that it may be too much for him. Have you ever seen someone his age recover from being so sick? I have seen patients older than your grandfather who have done well after treatment for lymphoma. Chemotherapy for Hodgkin's lymphoma, in particular, is generally well-tolerated, especially if the patient in question does not have other significant medical issues. If the lymphoma is going to respond, you would generally see a significant improvement within two months.
Q : 10 02/18/2009	Is Hodgkin's lymphoma curable at stage 4? Chemo has already been started. Yes, Hodgkins lymphoma is curable at all stages. The likelihood of cure is less for patients with stage 4 disease, though, compared to the lower stages. A rough estimate of cure is in the range of 60-80%. A more exact estimate for an individual patient can be made by using the number of "risk factors" present. These risk factors include things like age and the results of various blood tests.
Q : 11 11/18/2008	As a stage III, indolent follicular NHL patient, is my prognosis greater or less than 10 years? I'm 40 years old, and am in remission from my initial bout of B-cell follicular lymphoma. I responded well to R-CVP. It has been very difficult for me to get even speculation on this matter. Is this because the oncologists are withholding information from me or because they really don't know? I just want to be prepared; it will affect how I live out my future. The answer is that no one can really say with confidence. We can get average life expectancies from studies that have been done in the past, but for each individual patient there are factors that might influence that number (for example, you are younger than the average patient with indolent lymphoma, therefore likely to do better). Also, as we develop new therapies, the life expectancy is slowing improving. No one knows to what extent the therapies we are instituting today will impact on the survival of our patients.
Q : 12 10/13/2008	My 84-year-old mother was diagnosed with Mantle Cell Lympoma. She has been to an oncologist who does not recommend chemotherapy due to her age. He recommended we consider letting nature take its course or alternatively pursue a less aggressive treatment that at best would buy her a few months -- grim outlook in either case. Prior to this recent episode my mother was very active and independent, not your average 84-year-old. Questions we have include: What treatment options are there? How aggressive is Mantle Cell Lymphoma? Are there treatments that can put the disease into remission, even if only a short time? Is her oncologist correct in stating that chemotherapy should not be considered for an 84-year-old even though my mother was quite healthy up to this point? There are treatment options for mantle cell lymphoma, even in elderly patients. One possible combination that has recently been published is rituximab and bendamustine, a regimen that has been used in Europe and is now available in the US. The range of patients in the published study was up to 84 years.
Q : 13 09/29/2008	I experience an intense aching in my neck when I consume alcohol. It usually happens within the first few sips that I take and then disappears even if I finish the beverage. I never drank alcohol until about 2 years ago and do so only rarely now, partly because of this pain. I decided to Google "neck pain and alcohol" and almost all of the results made reference to Hodgkin's disease. However, I don't know how reliable those sites are. When I checked web sites dedicated to Hodgkin's I found very little related to my question. I did find one article that seemed to be from a peer reviewed journal that discussed the phenomenon at length. (http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1010854&blobtype=pdf) I am wondering if I there is anything to the idea that what I am experiencing may be an early indicator of Hodgkin's. Do I need to get this checked out? Is there anything else that may explain my sore neck? Thank you for your consideration. I am aware of the phenomenon, and I have seen it in patients with Hodgkin's lymphoma. I don't know, however, what else could cause it. One approach would be to make an appointment with your primary care doctor or internist for a general physical and some basic lab work. I think that would help clarify the situation.
Q : 14 06/23/2008	My husband has been diagnosed with stage 2 follicular lymphoma. He's had no treatment suggested by his oncologist, only blood tests. What would they be watching to change in these tests? Some of the things that are followed with blood tests in patients with lymphoma are blood counts (the numbers of red cells, white cells and platelets present), kidney function, sometimes liver function. Another test that can sometimes be helpful is lactate dehydrogenase, which can be elevated in more aggressive or advanced lymphomas. Your husband's doctor would be able to tell you more exactly what his plans are.
Q : 15 04/08/2008	There seems to be an increase in deaths from Non-Hodgkin's lymphoma in recent years. Is this true, and if so, why? Are you able to do anything for people with this disease? There is an increased number of deaths from NHL, which is chiefly a result of an increase in the age of the population. Older people are much more likely to get NHL. There had also been an increase in "age-adjusted" incidence of NHL, partly because of an increase in people with compromised immune systems (AIDS, for example), partly for reasons we don't understand. The age-adjusted incidence seems to be leveling out though. As for your second question, we are doing a lot for patients with the disease. For NHL patients as a group, the survival has been increasing, according to a recent overview. Many patients can be cured or put into a long-term remission, and there are a number of very promising drugs on the horizon.

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