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What to expect from an active 86 year old woman with new diagnosis

markallen11
Posts: 2
Joined: May 2016

My grandmother is 86, and has been very active her whole life. She is still active, and sharp. She was diagnosed with diffuse large b-cell lymphoma. We have no treatment scheduled yet, but they are going to do a mild form of  R-CHOP, that will exclude vincristine because my mother does not want to put her through a harsh treatment because she is so old.

Do we know if she has a good chance of a cure? Will they have to put in a port for treatment? 

Thanks,
Mark

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3294
Joined: May 2012

Mark,

Ask that they do for certain use a port. It makes life much easier and safer for a chemo patient. Some of her drugs (in CHOP) are VESICANTS (blister agents), and most clinics require that patients receiving vesicants use a port.  Vincristine is probably the least toxic drug in CHOP, so I am intrigued as to why it would be deleted.  Its worse side-effect is usually neuropathy (the inability to feel the hands and feet).  She can expect to get weaker, loose all of her hair, and possibly have a dozen or so fairly common side-effedcts.  Nausea is usually well-controlled and not too bad.  Blood counts (especially WBC) may get out of wack, respriatory issues can arise. But each patient is different, and side-effects are really not predictable.  You mention her clarity of mind. While that is valuable in getting her to cooperate in her treatment, the effectiveness of chemo is unrelated to mental clarity

Another factor is AGE, and receiving CHOP for an 86 year is undoubtedly going to be a challange. It can be difficult for a 20 year old.  There are too many variables to guess on an outcome, but her doctor will give you this or her overall assessment and prognosis.  Most oncologists are quite blunt and direct, and much better equipped to answer that question for you than anyone here can.  

I wish her a full recovery.

max

Data regarding CHOP: http://chemocare.com/chemotherapy/acronyms/chop-r.aspx

.

Prognoisis for a cure varies with many factors, including staging. The lower the staging, the better the liklihood of curative effect.

markallen11
Posts: 2
Joined: May 2016

Thanks Max,

My mother had though we would not use the vincristine because I think she thought that was the drug with the worst side effects in the cocktail. Thanks for clearing that up. They have not worked out a treatment with the oncologist yet because they did not get enough tissue in the first biposy to get the finer details of her diagnosis. Our main question is are there elderly survivors out there who had success with this treatment? We have debated palliative versus full blown treatment due to her age. That said, she is a tough woman who is very active.

 

 

Best.

Mark

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3294
Joined: May 2012

Mark,

Of the five drugs in R-CHOP, the "R" is Rituxan, which is not a conventional chemo, but rather a monoclonal antibody; a relatively new way of fighting cancer. While it can be hard for some patients, it is less toxic than most cytotoxic (cancer killing) drugs. It does not cause hair loss, and usually does not induce bad nausea.  The "P" is Prednisone, a steroid. It also is not a conventional chemo, and is given to NHL patients for energy and appetite promotion. It also is a sort of catalyst, making the other drugs work more effectively.  Among the other three, all are pretty harsh, all cause hair loss and nausea, and a variety of other things (see the link I sent).

I am sure the doc has to sign off on anything your mom chooses to delete, but doing so can weaken the effectiveness of the combinations.

If her disease is an indolent (slow moving, non-aggressive) form, and if it is not immediately threatening organs, careful pallative monitoring, called "Active Survellance" or "Watchful Waiting" is indeed sometimes a wise and reasonable choice.

OO7's picture
OO7
Posts: 282
Joined: Sep 2014

Dear Mark,

I'm sorry for your grandmother.  Max has given you excellent information and I will not repeat anything but rather share with you something from my most recent experience.

My father was diagnosised in May of 2014 with advanced stage mantel cell lymphoma at the age of 77.  He did one round of RCHOP and almost died.  He survived but became someone else.

Be very careful and do your homework, get second opinions and stress quality of life. 

My father did die 15 months later and his quality of life was poor.  My doctor at Dana Faber (I was diagnosed with NHL three months before my father) was surprised that they gave my father RCHOP at his age.  This Saturday my 95 year old grandmother passed away to Bladder cancer.  She too was in advanced stage and my uncle wanted to do and try everything.  I went to three different oncologists with him, all of them recommended no treatment and stressed her quality-of-life would not be good.  Even still my uncle and other family members wanted to do something but then there was my father's memory.  He has only been gone eight months now and it still very raw to me.

My grandmother amazed all the doctors at her sharp cognitive skills and activitiy level but for her and her type of cancer we decided not to treat.  My  grandmother did well right up until the very end.

 I do hope she has an indolent form of cancer and no major organs have been threatened.  Hoping for the best, there are amazing doctors doing incredible things to treat cancer may she be restored to good health soon.

Blessings.

 

 

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3294
Joined: May 2012

007,

I knew the story regarding your father, but not your grandmother. Geeze, what a triple whammy.  I hope you continue in your emotional recovery from all of that.  It is a lot....

 

 

OO7's picture
OO7
Posts: 282
Joined: Sep 2014

Indeed it has been a bit much, personally I think I'm ready for a heart transplant.  Mine is broken.  It's my mother I worry about now (again, still).

Suddenly there is more meaning to each sunrise and sunset.  Finding peace where ever it may be.

thx

 

po18guy
Posts: 994
Joined: Nov 2011

Sorry to hear of this. If you are in the US, I would strongly suggest consulting with a hematologist one one of the National Cancer Institute's designated cancer centers. They are the best and brightest and doctors at one of them may even be able to suggest  a different regimen, based on their experience. Find the nearest one here: http://www.cancer.gov/research/nci-role/cancer-centers/find

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