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Had stage IV Follicular Lymphoma. Spleen is removed and nodes in neck are affected. Due for chemotherapy. How bad is the situation?

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My sister has stage IV Follicular Lymphoma (B Cell Complex). Her spleen has been removed and nodes in her neck are also affected, She is 46 and has been fatigued for well over a year and a half. She is starting (6) months of chemotherapy next week. First (3) rounds scheduled to be (2) hours in length. I have no other information. I really want to have an accurate, realistic understanding of her chances of survival. All I can find are general bits of information. I realize that nobody wants to say she will likely die, but I lost my brother to AIDS and I better knowing the true reality of the situation. Please tell me honestly, based on your experience, how "good" or "bad" this situation really is. Thank you
Posted Fri, 8 Nov 2013 in Cancer
 
 
Answered by Dr. Anjana Rao Kavoor 1 hour later
Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi XXXX XXXXXXX
Thanks for writing in to us.

I have read through your query in detail.

Sorry to hear about your sister's condition and that you lost your brother sometime back.

For patients with advanced forms of follicular lymphoma (ie, stages III and IV disease), the average survival is more than 10 years. Despite its slow-growing nature, most cases of follicular lymphoma are not curable with currently available therapies.

Researchers have developed a way to estimate how long a person with lymphoma is likely to live based on what they call "The Follicular Lymphoma International Prognostic Index" (FLIPI). This index takes into account five factors that affect prognosis. The index can also help doctors identify which patients will benefit from specific chemotherapy treatments.

The five factors involved in the FLIPI are:

Age older than 60 years
Stage III or IV disease
Low red blood cell count
More than four involved lymph node areas
Lactate dehydrogenase level higher than normal (lactate dehydrogenase is a protein found in blood whose levels increase when tissues have been damaged)

On average, the more of these risk factors a person has, the worse his or her prognosis. Please note we are talking about average survival and this usually depends on the general condition of the patient and response to treatment.

I hope this helps.
Do write back in case of doubts.

Dr.A.Rao Kavoor
Above answer was peer-reviewed by
 
Follow-up: Had stage IV Follicular Lymphoma. Spleen is removed and nodes in neck are affected. Due for chemotherapy. How bad is the situation? 13 minutes later
Thank you. I guess that I would have to have more information from the oncologist, but I am not the patient so it is tricky. I do not know about blood cell counts or the lactate d.... levels. I do know that she was to only receive a vaccination at first and, within a three week period it changed to (6) months chemotherapy. I assume it moving rapidly and is aggressive, do you agree? XXXXXXX
 
 
Answered by Dr. Anjana Rao Kavoor 28 minutes later
Brief Answer:
Please find detailed answer below

Detailed Answer:
Hi XXXX XXXXXXX
You are welcome and thanks for writing in to us.

I agree that your sister is being given aggressive treatment as mentioned by you. Such change in treatments are made depending on the patient condition, disease stage and response to earlier treatments. I might add that treatment is intensified in patients who have a better chance of survival on many occasions.

The treating oncologist will be in a much better position to inform you on the expected outcome of treatment.

Wishing your sister a speedy and complete recovery.

I hope this helps.
Do write back in case of doubts.

Dr.A.Rao Kavoor
Above answer was peer-reviewed by
 
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