Hi,
I’m sorry to hear about your dad. He must have undergone a lot of tests that you may confused of where all of
this would be going. I hope this helps more than it confuses.
Lymphomas have a varied prognosis. On the one hand, we can expect 5 year survival of 80% for early disease –
these cases have a great chance for cure. On the other hand it may be as low as 30% for those with more
advanced disease.
Among the factors we look at to say if it is good or bad are the following:
The stage – this refers to extent of lymph nodes involved. This is usually evaluated with a CT or PET scan. If
there are involved lymph nodes on both sides of the diaphragm (this is a muscle under the lungs, you can
imagine it as a demarcation between the chest and the abdomen), this is more extensive disease, and prognosis
may be closer to 40% than to 60% chances.
LDH (lactate dehydrogenase)– this is a blood test, it approximates tumor burden (this would take into account
all the disease, even disease that is too small to show on the scans). Values above normal make chances of
cure less.
Performance status – this measures how the disease is affecting daily activities (an indirect measure of
disease extent as well). If he is unable to do light work and can only do self-care such as bathing, dressing,
and feeding, this indicates greater disease burden and confers a poor prognosis.
His age – patients older than 60 years old are less likely to be cured
There are some other factors to consider such as whether or not there is concomitant HIV, or extranodal
(disease outside lymph nodes) involvement which would also adversely affect prognosis. There are also gene
signature profiles that can be done – but unless there is a trial to improve on outcome, this may not be
affect treatment decisions.
If you have the above information, I could provide a better estimate instead of the ballpark figures I’ve
given.
If he happens to fall in the highest risk category for disease recurrence – you could consider enrolling him
in a clinical trial if there was an available one ongoing. Of course, what is important to bear in mind is
that even those who have lower chances of cure – still merit a shot at curative therapy, so there is enough
reason to keep positive.
