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Suggest Treatment For Lymphoma

Posted on Mon, 6 Jun 2016

Question: my brother has got diagnosed with lymphona.. he had a gastro bleed in the duedenal vessel and had 16 transfusions.. the cause is lymphoma, he is waiting to see a haemtologist.blood tests are done..pet scan done.his consultant is away for a another week.he has not reviewed any of the results yet.. tests took place in the last week..lymphoma was detected via a biosopsy. Is delaying all his treatment serious.. he is quite bloated and i am concerned..he is a private patient...he already has crohns and had part of his bowel removed (reversal of bag). Can you explain lymphoma briefly.. could it be leucimia

Answered by Dr. Anil Parth Desai (2 hours later)

Brief Answer:
Hi can you please send his complete reports

Detailed Answer:
Dear mam,

I did review your concern and I am sorry for your brother's current health.
Can you please upload his complete reports including the biopsy and pet and bone marrow and blood report? So that I can comment better in detail.

Lymphomas are a heterogenoua group of malignancy generally occuring due to uncontrolled growth of lymphoid cells, generally of mature typd( as opposed to leukemia that has immature cells). There are many different types of lymphomas withdifferent prognosis.
I can explaoin in much better detail once i get to know his exact condition.

Awaiting your reply.
Let me know if you have any more questions or concerns.
Sincerely,
Dr Parth Desai

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Anil Parth Desai (19 minutes later)

thanks
i will get the reports..we have only started the process..blood tests done and pet scan done.. biocepsy done already of the lymth nodes, could one of the consultants of picked up lymphoma earlier.. it is strange as he was very sick and they haad t o embolize the duoden, blood vessel and give him sixteen blood transfusions..when he was in hospital they mentioned something about a rare blood condition..i am concerned as i feel he should be treated quickly and his haemotologist is away so has not reviewed current reports

find attached what has happened to date.. note they found lymphoma in this report..

basically i have updated a summary of my brother condition..they found lymphoma in the final report..now he is waiting to attend a haemotologist.blood tests have been done,, pep scans have been done.. results for blood tests may take longer to get. i wil ask.no bone marrow test done.. i guess i am nervous for my brother as he is workign away and i am afraid his cancer will get worse.he is very fit..he had sixteen transfusions during the bleed and a haemoglobin levelof 4.6 and now it is back up to 11

Answered by Dr. Anil Parth Desai (58 minutes later)

Brief Answer:
Hi I would recommend the following.

Detailed Answer:
Dear Mam,

Thank you for your reply. I can indeed understand the state of your mind and worry you must be having for your brother. But I would like to assure you here to be very positive and take every difficulty as a challenge and never loose hope.

I did review the file you uploaded. Apparantly, it indicates the procedure done for duodenal ulceration and bleeding and mentions a thickened part. Ofcourse the thickening as mentioned by the doctor needs to be studied as it can be due to fibrosis due to crohn's disease or it can be sometimes due to lymphomatous involvement. However, I did not find any report that has confirmed evidence of Lymphoma diagnosis.

Is there any Biopsy report that is available with us to review? There are certain types of lymphomas associated with crohn's disease and it is indeed difficult to catch them as they occur in an inflammatory background. However, accurate diagnosis needs biopsy confirmation under a microscope to see for the presence of the lymphoma and what type it is. The report that has been uploaded mentions only a possibility of lymphoma but not a confirmed diagnosis of the same.

Kindly let me know if there is a biopsy report that is available.
I hope this helps mam.
Let me know if you have any other questions or concerns.
Sincerely,
Dr Parth Desai

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Anil Parth Desai (20 hours later)

unfortunately i do not have the biopsy result. I will try and get them..it has definitely been confirmed by the Gastro guy that my brother has lymphoma that needs to be treated. He has undergone a serious of blood test two weeks ago and a Pet Scan.. his consultant is away until the 11th of April.. how long do these tests take to come back.. my brother is a private patient. how long does it take for these results to come back.surely there must be another haemotologist that can reveiw these results..i am astonished that he has been diagnosed and as yet not been treated..this is not making sence.. as i mentioned earlier he nearly bled to death with the internal bleed..i am wondering is his condition is terminal and they are afraid to say it.he is feeling alot of discomfort and his stomach appears to be extended..apparentlly the lymphoma is near the bowel area.. could i suggest that somebody else reviews these scans in the absence of the consultant been away

Answered by Dr. Anil Parth Desai (5 hours later)

Brief Answer:
Hi I would recommend the following.

Detailed Answer:
Dear Mam,

I did review your concern. If the gastroenterologist has confirmed that it is lymphoma it may be the case. However, a biopsy report would be needed to see what type of lymphoma it is so that proper treatment can be decided. Generally PET scan reports do take 1-2 weeks and so does biopsy reports if a lot of tests are done on them after initial review. I can understand he may be having lot of discomfort in his abdomen but that necessarily does not mean his condition is terminal. We have to wait for his complete results including PET scan, bone marrow, biopsy and blood report to see the extent and type of the lymphoma he has. You can definitely consult another Hematologist and it is your right to do so if the primary hematologist is not on service.

Please let me know once the results are on hand so I can give my best comments on the further course of action that can be taken.
At this moment my best advice would be to not feel let down and take every step as a challenge and try to face it with bravery and a big smile. Your brother needs your best support at this time and if you will be positive he will be positive to fight this disease of.

I hope this helps mam.
Let me know if you have any questions or concerns.
Sincerely,

Dr Parth Desai.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Anil Parth Desai (36 hours later)

meant to say he has been diagnosed with high grade lymphoma in the dueon area..we are awaiting the results

Answered by Dr. Anil Parth Desai (13 hours later)

Brief Answer:
Hi I would recommend the following.

Detailed Answer:
Dear Mam,

Please send me the report of the lymphoma as soon as you get it. Even if it is a high grade lymphoma treatment with right choice of chemotherapy can help him.But first accurate diagnosis is necessary and also the extent of spread it has made.
Lymphomas can be of B cell type or T cell type.High grade can be seen in either of them and they require more extensive chemotherapy that includes medications that can cause some hairloss and fatigue and problems. But overall the success is pretty good.

Please upload the reports as soon as you get it so I can give a detailed specific comment on it.

Sincerely,

Dr Parth Desai

Above answer was peer-reviewed by : Dr. Sonia Raina