CSN Login
Members Online: 5

You are here

Some information please

Srashedb
Posts: 482
Joined: Dec 2013

by way of introduction, I normally post on the kidney cancer board since my husband has renal cancer.

my question is for my daughter-in-law; her mom was recently diagnosed with stage 4 lymphoma (has spread to her bones). My daughter-in-law said it is slow-growing and treatment will be radiation only at this time. Her mom has very limited English so am thinking that there has been some lapse in understanding.

i would love to help but don't want to intrude; is anyone familiar with slow-growing stage 4 and how radiation would be if it is in the bones. She had a bone marrow biopsy.

thanks in advance, 

Sarah

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3518
Joined: May 2012

Srashedb,

I am sorry you have two stricken by cancer at once.

There is too little detail provided to say much about your daughter-in-law's mother.  There are over 40 common forms of lymphoma, and all are different.  Slow-moving cancers are also called "indolent."  These are usually beaten back fairly easily by drugs, but have a tendency to reoccur later, even many years later.

Generally, even stage 4 lymphoma is usually treatable, often with high rates of success. But, this is virtually always with chemotherapy.  If she is being given radaition only, it may be an indication of poor prognosis.  Radiation for Stage 4 lymphoma is almost always given for palliative effect, or to minimize tumor pain.  I have never heard of it given to a a Stage 4 patient (without chemo) for curative effect, meaning with the intent of curing the disease, or putting it in to complete remission.

This is a generality, but is as much as I can say, with out more detail regarding her condition.

Be aware that ORGAN cancers, like bladder, are often treated in a wholly differnt manner from systemic cancers, like lympohoma and leukemia.  I learned this by having both lymphoma and prostate cancers myself.   Lymohoma is approached totally differently, and a wholly differnt way of speaking and thinking is involved.

I hope your patient loved ones do well during this holiday season,

max

Srashedb
Posts: 482
Joined: Dec 2013

thank you for your response, Max; it struck me as strange to have just radiation since it is systemic and has moved to the bones.

i  tend to research and have come across  many , many types of lymphoma but that is an area left blank. All i know is that the visit was routine, bloodwork suspicious, CT scans showed nodules and bone marrow biopsy showed it in the bones. My question to daughter-in-law was where will they radiate and apparently she doesn't know.

thanks, Sarah

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3518
Joined: May 2012

Decades ago, lymphoma was sometimes fought with "field radiation," meaning a node, or localized set of nodes, were radiatied across an area. The problem with that is that the radiation also damages healthy tissue and possible adjacent organs. And this shows why lymphoma all over the body cannot be radiated:  You are saturating everything, everywhere, with harmful radiation.  Early-stage lymphoma is still radiated by some good doctors at good cancer facilities, but virtually all studies in the last ten years or so suggest that even Stage 1 lymphoma also receive at least a few cycles of chemotherapy also, to prevent recurrance.

Radiation therapy today against organ cancer is micro-precise in delivery: It can differentiate areas as small as 2 mm in some cases, and even compensates for things like breathing.  Radiation used agains prostate cancer compensates for the amount of urine in the bladder !!   GPS transmitters are placed inside the organ, to tell the guidance computers of any microscopic movements.  If a sudden movement is detected (like the patient coughing), the machine shuts off automatically, to prevent damaging adjacent tissues. The same is true of radiation used in lung cancer. I studied this material when deciding how to get my own prostate cancer treated.  IGRT ("Image Guided Radiation Therapy") and Cyberknife are two of the current radiation systems commonly used to radiate in this manner.

Terminal patients in palliative care for advanced prostate and other cancers sometimes have individual, huge nodes radiated to reduce pain and extend life a litlle, but at that point, there is no concern with radiation dosages, because the patient has very little time left anyway. In prostate cancer, the first site for metastasis is almost always the bone, and tumors can get large enough to cause fractures; this bone damage is one of the main causes of severe pain in dying prostate cancer patients. A dear friend of mine died of prostate cancer in this manner two years ago in September: the tumors in his legs caused large deformaties his last few days.  The lungs are another early site for metastasis in prostate and breast cancers. A friend is currently in her last weeks with breast cancer, and is having to have a drain shunt installed in her abdomen to drain her lungs in hospice, for instance.

Only a relative with medical authorization can ask and learn why the mother-in-law's doctors are doing this. We are left with guesswork and speculation, which is really not fair to anyone.

Rocquie's picture
Rocquie
Posts: 839
Joined: Mar 2013

There is a treatment for lymphoma called Zevalin, which is a radioimmunotherapy. For this treatment, a monoclonal antibody is linked with a radioactive Yttrium-90. Since you are a researcher, you should be able to easily find information about this treatment online. 

A couple of years ago, I met a man who had this treatmentt (only) and has been cancer free for 14 years. There are also a couple of people here, in our group, who have had Zevalin. 

Best wishes to you and your family,

Rocquie

 

illead's picture
illead
Posts: 863
Joined: Aug 2012

I am not well versed in other lymphomas except my husband's type, but I have never heard of lymphoma being in the bones per se.  If she had a bone marrow biopsy, is it possible she has it in her bone marrow?  I am thinking that would be more common and I am pretty sure that would be dealt with with chemo.  Like I say though, I am definitely no expert,  Max and Roquie know more than me.  I do think a 2nd opinion or a better explanation is in order.

My best to all of you also,

Becky

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3518
Joined: May 2012

Great observation/question, Becky.

When most people discuss metastatic cancer that has "gone into the bone," they are usually speaking loosly, and not differentiating between per se "bone cancer," or cancer of the marrow.  In other words, they are interchangable in lay parlance.

Other organ cancers that metastasize into what is dubbed "bone" often actually go into "bone" ( My friend's prostate cancers was in "bone" itself, not in the marrow).  Finally, there is true 'Sarcoma.  That is, cancer that BEGINS in the bone tissue, not else where in a foreign organ. 

Of course, a cancer is always defined by where it begins; liver cancer begins in the liver. But liver cancer in the stomach is not "stomach cancer," it is rather "liver cancer in the stomach," and so forth.  When we were waiting for my bone marrow biopsy to come back, I asked my oncologist what a postive result would mean.  He said, "In terms of treatment, it would change nothing at all. But it would make total remission harder to achieve."   Sarcomas are seldom seen in adults, mostly occuring in youth and teens (the article says <10% in adults).  We have a Shriner's Hospital near me, and it seems the toddlers with cancer usually have either bone cancer or brain tumors, for some reason.   A high school student in our area died of true "Bone Cancer" here a few years ago.  A hope this helps. 

The second section, Types of Bone Tumors , is what most directly addresses your question.  Click also on Bone Metastasis.  

Regarding Bill specifically, I am 99.9% certain that bone metastasis with MCL would mean cancer in the marrow, and only the marrow.

max

 

http://www.cancer.org/cancer/bonecancer/detailedguide/bone-cancer-what-is-bone-cancer

Srashedb
Posts: 482
Joined: Dec 2013

Is it possible to have lymphoma metastasize ONLY to the bone marrow? She had a positive biopsy and maybe having another biopsy (language issue).

still trying to get more info but it's a challenge

my husband's kidney cancer was already in two spots on his spine when he was dx; and , it was clearly identifiable so that it could receive cyber knife radiation. My daughter-in-law says that her mom's is like that. Clearly, bone marrow and "bones" is not the same as 2 identifiable spinal mets and disease that is not systemic.

Sarah

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3518
Joined: May 2012

Sarah,

Cancer spreading can do virtually anything, and go virtually anywhere. Yes, lymphoma can spread just to the bone marrow, without going elsewhere (into additional organs). Or, it can go to ten other organs.  

In very general terms, most strains of lymphoma are hesitant or slow to spread into other organs, but when it does, the first secondary organ is statistically very likely to be the bone marrow. This is why a bone marrow biopsy is virtually universal for newly-diagnosed lymphoma patients.  (The next most common secondary site for metastatic lymphoma is the lungs.)

As I stated above, organ cancer and lymphomas are in many ways very different, and commonalities between a bladder cancer and lymphoma are going to be rare.

Srashedb
Posts: 482
Joined: Dec 2013

if the lymphoma is slow-growing and IF the bone marrow biopsy was positive, would just radiation to the bone marrow possible? 

After reading these posts and doing some research, the above is the only plausible theory for my daughter-in-law's statement.

i spoke to her mom (and, as I mentioned there is a language issue); she told me that she was told to be happy and get more blood tests. After that conversation , I came away with the sense that there is also a cultural difference. She babysits our granddaughters who are preschoolers and "germinators"; with a weakened immune system, this is a concern.

Sarah

Subscribe to Comments for "Some information please"