Lymphoma vs Sarcoid

Hang in there

and keep calm. Just be prepared for either possibility.

 

Glad to read your news

That is - comparatively - good news, in that you will be treading on a well-known path. Classic Hodgkin's has the highest cure rate of all, so there is plenty of hope for you at the end of this tunnel.

Have a good weekend, and keep us posted on your treatment plan when you find that out. Those who have been through the same may have some advice for you.

PBL

cHL ("Classical HL")

TN,

With PBL, I must agree that cHL is comparatively good news, about as good a lymphoma diagnosis as is possible.   In nearly all cases, oncologists regard cHL as readily curable, regardless of stage, especially in patients older than 18 and younger than 50.   'Curable,' in today's parlance, means 'long-term NED,' or 'no evidence of disease'.  The word 'cured' is mostly avoided in clinical oncology today.   But, a rose by any other name....etc.

There are 5 forms of HL of which 4 are dubbed 'classical.'  The remaining one form of HL is NLPHL, which is what I had; NLPHL is very indolent and much like follicular NHL, and like follicular is regarded as incurable, but easily controlled.    The cHLs are also the most easily-diagnosed lymphomas, in that they contain no, or extremely few, CD-20 cells.  The presence of Reed-Sternberg cells (which are absent in all NHLs) makes confirming cHL relatively easily for pathologists.  The defining attributes of NLPHL is abundant CD-20, and no Reed-Sternbergs.  In contrast, the W.H.O. now recognizes over 60 forms of non-Hodgkin's Lymphoma (NHLs); many of these are aggressive and have poorer prognosis than cHLs.

Stage 1 or 2 cHL is usually addressed with 3 or more cycles (equals roughly 3 months of infusion appointments) of ABVD or CHOP, but in the last ten years or so, there has been a movement toward experimenting with lower-toxicity combinations.  A couple of these are AVD, B&E, etc.    Because cHL has no CD-20s, Rituxan-only maintenance is NOT an option.   Active Survellance is somemtimes used, but A/S is essentially a clinical waiting process, and is not employed toward curative effect.  Plainly stated, it will delay chemo side-effects, but will not move the patient into NED.

Stages 3 or 4 are usually addressed with 6 cycles of  the same combinations mentioned above (six months of infusions).   As Shady mentioned a few days ago, radiation is almost never employed against the cHLs, except in the very earliest (incipient) cases of Stage 1.

Based on what you have shared as of July 16, you are very likely looking at complete and non-relapsing NED.

I scanned your thread, and cannot see which cancer center you have decided upon, but Vandy (I was born in Murfreesboro), Mayo, and MD Anderson are all among the best in the world.  You cannot get better than any of those for most cancers.   In the SE United States, only Duke and Emory compare in quality.  The other best centers in the US are The Cleveland Clinic, Sloan-Kettering (NYC), Johns Hopkins, Stanford, and City of Hope (Los ANgeles).

 

max

TNgirl111619 said:

Onward

So treatment should start Monday. I have to have pfts done Wednesday and a port put in Friday. I will have 2 cycles of abdv chemotherapy. then they will do a pet scan at that point. I will also see an oncologist at vandy to determine if we should continue that chemo regimen or remove one of the drugs and do some radiation. Considering things go as planned, it will be a total of 6-7 months. Also, it is stage II. Will continue to post updates! 

Very good

The '2 cycles' will be four infusions, or two months worth of treatment; the PET is of course to verify that the drugs are working as they should.  Adjustments can then be made, but the easiest result is for them to be working very well, and continue with the original plan.  As discussed above, ABVD is still today the Gold Standard for cHL.   

All of the results that you have provided thus far suggest that you will move directly into NED, and have all of this behind you soon.

TNgirl111619 said:

Chemo

Currently receiving chemo. I'm on the Bleomycin. Everything going well so far!

Chemo

Hi Lauren,

I have been reading your story all along. And here you are in the "chair". Your great attitude is going to take you far. A general public attitude toward chemo seems to be of some mysterious, medieval, torturous treatment. Oh no, not chemo!  I say, chemo saved my life. Now, 8-plus years later, I look back affecionately at my chemo days. I felt like an honored queen and the nurses were angels. Go ahead and let people pamper you, you will need it.

Wishing all the best,

Rocquie

 

Here is hoping things are

Here is hoping things are going well after your treatment this past Monday.

So happy to hear this

Vandy is a great hospital system. You are in good hands at Vanderbilt!