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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Lymphoma, chemotherapy, no radiation, bedridden, spreading cancer. Recourse?

Answered by
Dr.
Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1506 Questions

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Posted on Sun, 27 May 2012 in Lymphoma
Question: Dear Doctor,

My father is having lymphoma. He has been given six cycles of chemotherapy at Tata Memorial Hospital Parel and as his count is very low so radiation is not been given. What is the recourse for treatment now as the cancer is spreading to other areas in the body. Can we consult any doctor, patient is bed ridden.

Regards,

K G XXXXXXX
doctor
Answered by Dr. Indranil Ghosh 6 hours later
Hi,

Thanks for the query.

Overall, it seems that disease has relapsed and he is now only on palliative treatment. However, I need to know a few more things which would help me in suggesting you better:
1. May I know the type of lymphoma (on biopsy) eg, diffuse large B cell, follicular, T-cell, etc?
2. Was he in remission after six cycles (as assessed by CT or PET scan)?
3. What was the intent of Radio therapy, consolidation after chemotherapy or as palliation?
4. What were those eruptions? lymph glands? If those were lymph glands, were they biopsied or FNAC done to confirm relapse?
5. Was the fracture related to a bone deposit from lymphoma? Was any surgery done to fix it?

If it is a relapse, I would prefer to give him second-line chemotherapy according to the histology rather than only pain-killers (general condition of patient permitting).

I would like to give you specific suggestions after knowing the answers of the above questions.

Please write back with the above questions as this would help me in suggesting you better.

Awaiting your reply.

Regards.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Indranil Ghosh 2 days later
Hi Doctor,

He has B cell lymphoma. The relapse was seen soon after the chemotherapy. The Lumps are mostly seen in the areas where lymph nodes are there. The fracture has been due to a fall and he has not been operated upon as his platelet count is very low.

Regards,

K G XXXXXXX

doctor
Answered by Dr. Indranil Ghosh 58 minutes later
Hi,
Thanks for the query.

I believe that the first-line treatment was R-CHOP chemotherapy.

Probably the low platelets is because of bone marrow involvement.

In this scenario we can give him second line chemotherapy (DHAP or similar versus oral PEPC, depending upon condition of the patient).

He can consult his treating oncologist regarding the same.

Hope i have answered your query.
Wishing you good health.
Above answer was peer-reviewed by : Dr. Radhika
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