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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Had Non Hodgins Lymphoma. Diagnosed with Burkitt Diffuse Large B Cell Lymphoma Double Hit in pelvis. Help?

Answered by
Dr.
Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1506 Questions

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Posted on Wed, 9 Oct 2013 in Cancer
Question: My husband had Non Hodgins Lymphoma for 10 years. Recently he has been diagnosed with Burkitt Diffuse Large B Cell Lymphoma Double Hit. It is in the pelvis.
The Dr. Has given him a few months to live. He says that he can give him Chemotherapy, but it may make him sick although it could possibly give him a few more months. Right now he has no pain, and is still walking. The tumour was detected on May 1, 2013 and the diagnosis was confirmed on July 16, 2013. It took 10 weeks to confirm the type of cancer he has.
He is 77 years old, slim build, always ate healthy, an active XXXXXXX that bikes, hikes, gardens, deer hunts, and is a handy man. Not a rocking chair XXXXXXX
Do you think with this type of cancer there is any hope that treatment could give him more time, or do you feel the above diagnosis and treatment are accurate. I have the feeling that there is something that we are not being told. Maybe it is just wishful thinking, but I would like another opinion of what this type of cancer can do good, bad, or different.

Thanks for you help
Audrey McQuarrie
doctor
Answered by Dr. Indranil Ghosh 5 hours later
Brief Answer:
This is an aggressive lymphoma

Detailed Answer:
Hi
Thanks for your query. It appears that he had lowgrade lymphoma for years and now he has developed this aggressive type of lymphoma. Though it can be treated, treatment is a very aggressive form of chemotherapy which he is unlikely to tolerate at this age. I know that he is fit but once that type of chemo is given, his blood counts will crash along with other problems like diarrhea, oral ulcers, etc. Probably this is the reason why the docs have not recommended it.
Even then, the likelihood of cure is low. But anyways, the docs who are treating him are the best judge. I can't comment on the diagnosis from here without having a look at the patient or the reports, biopsy slides, etc but I can definitely say that this is a plausible diagnosis. If you want a second opinion, please go ahead. It may give you more confidence.

I am sorry I could not add much. I will be available to answer any further followup queries.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh 1 hour later
The doctor has offered him a low grade of chemo, but even that makes my husband concerned about the problems it may cause with nausea. The doctor says it would be just to make him feel more comfortable, but could make him feel worse before he feels better, if he feels better. What is your opinion on a low grade of chemo? Do you think it would be of any benefit to him, or is the doctor just going through the motions to make it look like he is doing something to help?

We live in Canada, so our health care is run through the government, which is good at times, but it gives a person less of a selection of health care providers. During this crisis he has been seen by a hemotoligist, who is very difficult to communicate with, and doesn't really listen to anything he says. This makes it very difficult to understand the process. Unfortunately it he is the only specilists in the city, and my husband isn't in any condition to travel. We did try to get a second opion from his former doctor were we use to live 200 miles away, but he wouldn't take a look at his case.

All the other health care professionals we have dealt with, nurses, nurse practitioners, and doctors for special tests etc. have beem wonderful. It is just unfortunate we have be subjected to this doctor that doesn't have a very good bedside manner to say the least. At this point we have no other choice.

Thanks for any insight you can give us to this possible treatment of a low grade of chemo.

Sincerely
XXXXX
doctor
Answered by Dr. Indranil Ghosh 6 hours later
Brief Answer:
Low grade chemo may offer palliation

Detailed Answer:
I agree that low grade chemo, which may be oral also can be tried to give him some benefit, but as he does not have much symptoms now, it can be kept for a bit later also. It would not change the prognosis.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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