Dr. Pawar Satyajit Jalinder
Medical oncology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
About two months ago, I had a physical illness, and my doctor found, a mass under my right armpit. I was sent for an ultrasound needle biopsy, and blood test, and a pet test. I was told that I had follicular lymphoma stage 3. I was upset and in tears. My doctor told me, that follicular lymphoma, was a prolonged progressing cancer, and responded very well to chemotherapy.After all of these test, and verification, of what I had. My oncologist said, he would send me home, for three months, then at the next appointment, he would decide, on further test and or treatment. As the doctor said is that this cancer, and what do you think, about being sent home, for three months for a watch and wait.
Hello,
Welcome to icliniq.com.
So I would start by saying that follicular lymphoma is most common low grade lymphoma diagnosed in this age group. Incidentally detected lump is most common way in which follicular lymphoma presents, which was in your case. After histological confirmation staging is usually done with PET scan. Which shows stage III disease as per your query. Ideally I would like to know few things like,
1. Confirmation of stage and grade. 2. Any symptoms like fever or weight loss. 3. CBC (complete blood count) and liver renal functions. 4. Also report of pet CT to look for any bulky disease. Because in case of stage III or IV follicular lymphoma there are certain indications for treatment such as,
●Local symptoms due to progressive or bulky nodal disease ●Compromise of normal organ function due to progressive or bulky disease ●Presence of systemic B symptoms (ie, fevers, weight loss, night sweats) ●Presence of symptomatic extranodal disease, such as effusions ●Cytopenias due to extensive bone marrow infiltration, autoimmune hemolytic anemia or thrombocytopenia, or hypersplenism ●An increase in disease tempo (these are collectively called GELF criteria or BNLI criteria) If these indication are not fulfilled standard guidelines advice observation with follow up. In case physician feels some indications are borderline then usually decision is taken to follow up to see pace of disease and then take decision for need of treatment. If all these things are negative and I would say that decision for your follow up is ideal. If you have any further questions I would be happy to help you.
Patient's Query
Thank you doctor,
Thank you for your input. Also, doctor, I looked over my pet scan report-liver, and gall-bladder is normal, no fever no weight loss, no night sweats-thyroid gland not enlarged-no evidence of fdg avoid mediastinal hilar, internal mammary cardio phrenic or retrocaval lymphadenopathy. Doctor, please elaborate, on what I have found out some in the report. the doctor would there be a way that I could fax, this report to you for your analysis
Hello,
Welcome back to icliniq.com.
I think you can attach your reports on this app through PDF. That way, I can have a look at them. As far as your PET (positron emission tomography) report is concerned whatever you have mentioned is a normal part of the report, but I think it is not complete. It would be better if you can attach your reports here so I can have a look and would be able to help you in a better way.
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Medical oncology
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