Lymphoma Relapse

[daughter01]

Hello, I am posting this question because  I absolutely feel helpless. My Dad was diagnosed with NHL in 2004. He went through chemotherapy and radiaiton therapy and he was in remission for almost 2 years. In December 2006 he had a relapse, his lymphoma was back and again he went through intensive chemotherapy and he went through autologous BMT in July 26 2007. In december 2007 he noticed swollen lymph nodes in his groin both sides. when we contacted his oncologists, she thought that it was a reaction to recent immunization he received. the lymph nodes in groin are continuing to grow and also his lymph nodes in neck area, under arms, and even his head is swollen now within a month. He has lost a lot of weight, and he coughs all the time. My whole family is going through a very hard time. We still dont know if his cancer is back since he will have a PET scan done next week. Does anyone know if lymphoma progresses so quickly? Could it be lymphoma?  does anyone have had any experiece like this? Can lymphoma be back within the five months of BMT? thank you for reading my post.

[bptr]

I had large B-cell NHL in july 2008 and finished R-CHOP in December 2008.  I have been in complete remission for almost 3 years now (although I don't have health insurance and last had a checkup in March 2010).   Since this past August (3 months ago) I have been bothered by what seems to be a slight swelling in my left waist area. This is painless and I have a bit of a gut despite riding my bike a lot.  But the left side definitely feels like a sock is in my waistband all the time - I can't really see a difference between my left and right slight stomach bulge..   I am very worried but can't afford to have a CT scan.  What could this be?  I am mortified of a relapse since I considered myself cured.  I am 50 years old in good general health although I seem to have chronic rash and itching all over and not as much energy as I used to have pre-NHL.

Thanks

[SebringGator]

My husban is two years out on his bone marrow transplant, he started with non hodgins lymphoma stage 4, the Dr said he is doing good, but he is really sick, some night sweats , tired all the time, his head hurts, back itches, weak and is loosing weight, we don't know what to think...Please help...

[Fernando Roque, MD]

Hi. The usual cause of coughing in lymphoma patients is respiratory tract infection.  The immune system of patients with lymphoma (or other cancers for that matter) is not functioning properly due to the disease itself, or as a side effect of treatment (chemotherapy).  This makes them prone to developing infection.  Once infection sets in, the lining of the respiratory passages become inflamed and more easily irritated, hence the repeated bouts of coughing.

Chemotherapy and radiation therapy can also induce cough by decreasing the production of mucus, which results in drying up of the respiratory passages, which makes them more easily irritated.

The cancer can also spread to the lymph nodes within the lungs or the lungs themselves.  This can also cause coughing.

[daughter01]

Hi, I am just wondering what causes coughing in cancer patients. My father has been taking some antibiotics and his cough went away. we are still waiting for the results for the PET scan and we are hoping that his swollen lymph nodes are due to infection. Can you please tell me more about chronic coughs in cancer and BMT patients. Thank You

[Fernando Roque, MD]

Hi.  The question of how long your dad is going to survive really depends on how strong his body is right now, and how aggressive the cancer is. There is an index which doctors use to estimate the prognosis of a patient with NHL.  It's called the International Prognostic Index or IPI. This system estimates prognosis based on the presence of 5 risk factors:

1. Age greater than 60
2. Higher stage (Stage 3 or 4)
3. Involvement of more than one site other than the lymph nodes
4. Poor functional status
5. Elevated serum LDH.

Patients who have none of these risk factors have a 73% chance of surviving for 5 years if untreated, while of those with 4-5 risk factors present, only 26% will be alive after 5 years.

[daughter01]

Hello. Thanks for responding to my post. My dad has decided that he will not go for any type of treatments anymore if the lymphoma is back. This breaks everyone's heart in our family. I was wondering how long do a patient with progressive lymphoma uusally live if they don't treat it? Thank You

[Fernando Roque, MD]

Hi.  I'm really sorry to hear about your dad's condition. From the symptoms you have described (enlarging lymph nodes in multiple areas, weight loss, cough), there is a real possibility that your dad has a recurrence of lymphoma, but this has to be confirmed by a re-biopsy of one of the enlarged nodes.  The PET scan will also help with the diagnosis.  Lymphoma is one type of cancer which can grow fast and progress quickly, and it is quite possible for it to come back within five months of bone marrow transplantation.