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Diagnosed with CLL. Lymph node below the surgery site got enlarged and is painful. Biopsy suggest to have SCC. What can be done?

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My husband was diagnosed witc CLL in 1998, in August, 2012 he had 2 MOHs surgeries for squamous cell carcinoma, one on his head, one on his upper chest by his armpit. The lymph node below the head surgery became enlarged & painful as did the lymph nodes in his neck, biopsies showed both areas to have scc. He had a head/neck resection XXXXXXX 2013 and is scheduled for radiation & chemo soon. No one will tell us what his prognosis is, even though we have asked for the honest facts, can you tell yes more? He does have a nodule in his lungs but they don't seem to be worried about it. He has smoked for 60 years.
Posted Sat, 17 Aug 2013 in Digestion and Bowels
Answered by Dr. M Y Shareef 35 minutes later
HI ! I am Dr Shareef answering to your query.

It is but natural to worry about the prognosis of your husband's illness by you. It is also not easy on the part of the doctor to predict on the prognosis of such patients.

Usually the cutaneous cancers developing in a patient of CLL are more aggressive and metastatic than those occurring in otherwise normal individuals. That is why your husband developed lymph nodes on his neck, which possibly were metastatic, for which neck dissection was performed on him.

It will be difficult to prove the source of the nodule in the lungs without a histopathological test. Considering his smoking history for last 60 years, it can not be ignored. At the same time, the treating doctor must be weighing the benefits of going for a histopathological test ( biopsy ) of the lung nodule against the risks involved in performing this test specially in this age group with obvious low immunity status. Therefore, they have planned for the radiotherapy and chemotherapy instead of any other invasive procedure for him.

Even though the prognosis in such cases may be guarding, I am hopeful that he will get symptomatic relief with the treatment schedule planned for him by the treating doctor. I would also suggest you to look at the situation with more positive attitude so that you can give him better care and look after him well.

I hope, this answers your question as such. If you have got any further query, please feel free to ask. Wishing good luck to both you and your husband.
Above answer was peer-reviewed by
Follow-up: Diagnosed with CLL. Lymph node below the surgery site got enlarged and is painful. Biopsy suggest to have SCC. What can be done? 5 hours later
Dr. Shareef, thank you for your quick response. I am a positive support for my husband, however, being diagnosed with Stage IV SCC & having CLL, you can Imagine our concern. You say his condition is guarding, are we just treating symptoms at this point or do you feel there is a chance he will be free of SCC with the treatments. My husband is very concerned as well and interested in what typically is seen in a case like his. He watched his father die of lung cancer in 4 months without having time to get hs life in order and he doesn't want to find out too late what his prognosis is when the quality of his life has diminished. Thanks again
Answered by Dr. M Y Shareef 3 hours later
Hi XXXXXXX ! It is good to see your concern about your husband's health.

Well, at this juncture of the disease I would suggest you to accept the reality that one can not forecast the exact time or duration of recurrence of the disease as it is in stage IV. Also you will agree with me that it is not possible to forecast the future by any human being, doctor being one of them. However, he (the doctor) can give you an idea on the possible prognosis based on the statistical data and his own experience.

I will suggest that your husband must give up smoking immediately if he has not done this so far. One can not have any excuse for not being able to leave smoking which is definitely a stimulating factor for the growth of lung lesion, and the CLL itlself with its complications.

Once one knows that the problem he has can give rise to serious health concerns any time which can not be predicted with accuracy, he should be advised not to leave any legal, financial, or any other social issue pending with him.

Now that you are keen to know in detail, as per the statistical data, the disease may linger from a few years to more than a decade depending on the stage and virulency of the CLL with periods of remissions and recurrences.This can only just be approximated by the doctor who is treating the patient which can be a difficult task for him, as every day research is going on and the prognosis may vary anytime with advent of a new modality of treatment. One such example of new modality which is in progress is a bone marrow transplant and you can discuss with your treating doctor about the suitability of your husband to undergo this treatment which also has got its own problems.

The doctor can treat the symptoms as and when they come, and he just can not eradicate the disease with the treatment options available at present.

I hope I have answered your question up to all possible extent. I must compliment you again for taking so good care of your husband and being so practical about his problem. If you have got any other query, please do not hesitate to ask, otherwise you can close the discussion with rating the response.Thanks and wishing you and your husband all the luck.
Above answer was peer-reviewed by
Follow-up: Diagnosed with CLL. Lymph node below the surgery site got enlarged and is painful. Biopsy suggest to have SCC. What can be done? 49 minutes later
Thank you nery much, your comments have been very helpful.
Answered by Dr. M Y Shareef 40 minutes later
Hi ! Thanks for being so prompt in your response. Good luck.
Above answer was peer-reviewed by
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