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This question was answered on Thu 27, Mar 2008 09:28am by Dr Bobby V, MD

What next after radiotherapy? - Non hodgkins lymphoma: Radiation advises, any second opinion on this?


    
Asked by wamulume (Male ) on Wed 26, Mar 2008 05:47am

I am a Zambian male cancer patient. I was first treated for Casenoma for which I was given Vynchristin, Sacosalphemide, metthatroxic (PS: I am not exactly certain of the spellings for the medicine names). The tumour reduced in size drastically. However, before the casenoma was healed, I was referred to another Hospital, where a second biopsy revealed non hogkins lymphoma. I was put on chemotherapy and given Vynchristin, Sacosalphemide, and a third drug whose name I do not remember but the medicine was red in color, and administered by drip. After two sessions of chemotherapy,it seemed there was progress i.e the tumour was reducing in size,but it later started to grow again. After finishing the six sessions, It seems the chemo-treatment failed, as the tumour was bigger than before treatment. I was advised to take radiation and was told that it might reduce or completely remove the tumour. I do not know what it will be like if the radiation does not cure me. Is there a second option/opinion?
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Answer by Dr Bobby V, MD  on Thu 27, Mar 2008 09:28am:

Hi, There have been two pathological diagnoses in your case: carcinoma and lymphoma. The most important thing to do first is to confirm the diagnosis. I suggest that you submit the slides and blocks of your biopsy to a large referral hospital, preferably a cancer centre, for pathological review and immuno-histo-chemical (IHC) testing (including CD 20). This will confirm the diagnosis and guide further therapy. You have been given 6 cycles of Cyclophosphamide, Vincristine, doxorubicin (the red colored injection you mentioned) and prednisolone. This is the classic CHOP regimen for non-Hodgkin's lymphoma. You have got only a partial response, and your treating doctors have recommended an Involved Field Radiation Therapy (IFRT). This is indeed the correct sequence, provided we are very confident of the underlying diagnosis. There are many other second-line options available. These can be discussed after confirmation of diagnosis.

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