8 R-CHOP sessions, is it safe for 68 years old patient?

Mother

Qmomani,

Sorry your mom is having to deal both with NHL and chemo.

The number of cycles a patient is scheduled for is based on extensive statistical analysis regarding what has worked best on "average" patients in the past.  It is the ideal norm for a patient to be moving significantly into remission, and sometimes even full remission, long before the treatements are over.  But the treatments continue to treat remaining cancer cells or tumors which are too small for a CT or PET scan to detect ( a situation called "micro-metastatic").  It is common to want to end the misery of chemo before all scheduled cycles are given, if it appears that the patient is "'cured."  Don't do it.  The good news is that the drugs (according to the scan results) ARE WORKING.

Fatigue, even extreme fatigue, are normal on chemo, but fatigue by itself is not dangerous (assuming she does not drive, or have to cook for herself).   I was 53 during my treatments and slept about 18 hours per day, able to get up only to go to the bathroom and eat. Toward the end, I quit eating, and could take only breakfast drinks and liquids, and lost a lot of weight, but the drugs I got did not contain Prednisone, or any other steroids, which stimulate appetite.   And very generally side-effects are usually expected to be worse the older an individual is, and the longer treatment continues, but as Rocquie noted in her response, this is not true of all patients.   But side-effects are almost always less serious than cancer.  I took as my personal motto during treatments: I'd rather have side-effects than cancer.   Side-effects cause inconvenience or pain; cancer causes death.  The chance of relapse statistically does increase when ending therapy before recommendation.

I would finish all cycles, even if it meant hospitalization for her. Obviously, her oncologist believes she should do all cycles as well, but ask him what you have asked us.  No reasonable doctor minds being asked these sorts of very reasonable questions. There are cases where chemo does have to be discontinued.

Regarding the PET comments on the liver, etc. 

A cancer, no matter where it is at in the body, is based upon where it originated at (determined by cell type).  Because her cancer is lymphoma, even if she has tumors on or near the liver or other organs, it is still the lymphoma, not "liver cancer" or other forms of organ cancer, and it is still exclusively treated as lymphoma.   You mentioned "in the gastric trac," which may mean that she is indeed Stage IV, because of intestinal involvement.

You can determine this yourself by looking at her initial diagnosis.  If she is Stage III or lower, then the disease is near, but not in, those organs. If she is Stage IV, then she does have lymphoma in some other organ, and the report should specify where.  Or, that is another question you can call and ask the doctor or her doctor's nurse.

Most Stage IV lymphomas go first into the bone and or lungs first, but it can go anywhere in the body.   But as I mentioned, the treatments virtually always remain the same as they would for lower-state disease.  When I was prepping for my bone marrow biopsy, I asked the doctor what a positive biopsy would imply, and he said "It would slightly reduce your chances of a cure, but would not change your treatments at all."

I had huge nodes all over, from the lower neck, under both armpits, down both sides of my chest and abdomen, into the groin region.  The first CT said nodes were wrapped all around my escophagus and a major vein (the superior vena cava), and they were pressing against the walls of my heart also.   Regardless, I have been lymphoma-free for over five years now.  Lymphoma is nearly always very treatable or even curable, and the PET results sound like your mom is doing very well.

Good luck to the both of you,

max

 

Qmomani said:

Thank you

Thank you very much Max for your Great information, and thanks for God on your recovery and ward off disease.

 

I want to share the last PET scan report for my Mother with you, and will be thankfull if you can tell me what does it mean in both 2nd and sixth points in the findings in the report, I know you are not a Dr, but maybe these were explained for you when you were under treatment, the problem here is all Doctors are always veru busy and you can't find enough time to set with the Dr ans ask everything you want.

 

Thanks again

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Follow up

Qmomani,

The editors pulled what was apparantly a link from you, probably for confidentiality reasons, which is understandable. If you want to e-mail me some of the particulars of her PET result, you can do so privately with the "CNS Email" feature.

Please do not send a link.   Actually, if you do, I will not open it. It is very important to safeguard privacy and confidentiality here. And as you note, no one on this Board is a doctor or medical professional.  You may want to schedule a "Consultation" appointment with her doctor, which means the visit will be just for the purpose of explaining things in greater detail to you, with time set aside to answer yor questions. Consultations are normally CHARGED office visits, but may be well worth it to you.

Thank you for your kind reply,

max

girliefighter said:

Physiological activities

I just wanted to note that the comments that read "physiological activity" means that the organs in fact are working, it does NOT mean that the organs are involved in the disease. The Doctor reading the scan and commenting is just noting that there is physiological activity in those organs, which there should be. Don't worry about some of the notes and comments on these scans, it is put there or them to reference at a later date, they compare scans when they check to see if there is a response to chemotherapy. They have to have a baseline to go off from and some of the notes will just be about the uptake of the radionuclides with glucose tracers into the organs and such, this is supposed to happen.

I hope all is well

Carie

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