rod & bj

My 78 year old Mom was just diagnosed (Sept 13) with Lymphoma, it is stage 4
with sites on the left hip(soass muscle), spine and kidney with apparently 6
enlarged nodes).....I took her to the hospital(ER) on Sept 11. because of
recurring pain not connected to her right hip replacement surgery on Aug 8
and the cancer diagnoses has hit us out of the blue. We've yet to see a
Oncology specialist(appointment is for Sept 26) but have already began
radiation on the spine (15 treatments scheduled with 3 completed). We don't
know the specific type of lymphoma as we're awaiting further biopsy results
but I could use some wisdom when dealing with siblings and my 87 yr. old
Dad. A home health nurse sent out from the hospital mentioned hospice to Mom
today (I wasn't there) but the various medical people, GP , radiologist etc.
have just said it is "treatable" and have suggested Chemo immediately
following the radiation treatment. While I'd rather be upbeat and positive
when dealing with Mom, Dad and the 4 siblings I don't want to create a false
impression about her chances either.....Especially when it comes to Dad as
he always thought he'd go first so he is floundering and rightfully
confused. Anyway with such limited information any educated opinions about
the situation as hopeful or helpless? If helpless how much time is likely
with stage 4? Thanks much Rod

j

Hello Rod,
I'm sorry to hear about your mother. The pain description reminds me of Robert
and Cathy (below).

I've been reading this newsgroup for 4 or 5 years.
You /they are in the US, yes?
It's very rare for us to see a diagnosis and suggestion of hospice at the outset
especially in the US.
(where more aggressive treatments are often suggested vs UK or Canada or
Australia).

The above (along with the radiation therapy) says to me no more than 3 months,
possibly much less and that the focus is and should be on palliative
care/hospice. Although, I could be wrong on that and "hospice" is being
suggested for "at home' as adjunct for if/when she leaves hospital and/or
possibly because of her hip situation.

I would suggest that you call and arrange to meet (with your Dad and (at least)
one of your other siblings), with whoever will be giving the pathology results
and ask your same questions. Ask for honesty.

If/when discussions come up about chemo, use the following..(print it up and
take it along with you or use when discussing decisions with all).
http://groups.google.com/groups?hl=en&lr=&ie=UTF-8&selm=KyW97.994%243x.3689%40news.bc.tac.net

Please don't wait until Sept 26 about hospice.
Home hospice (vs institution) is available and can be cancelled or delayed, if
not required later or possibly switched to institution later. Look into these
matters now. Best make the initial inquiries about hospice now and ask the
(chemo) questions later. However, it's my understanding that once in
institutions for palliation, chemo and radiation therapy is not available. And
perhaps why they're rushing right to the radiotherapy?

So there's lots of decisions to be made based on how those closeby can cope in
helping both your Mom and your Dad at home.

Robert's Cathy passed away, in his arms, at home from lymphoma in July.
He made the offer that if he could be of help to contact him.
His e-mail is here, but I don't want to post it on the newsgroup again.
<http://groups.google.com/groups?q=Robert+Cathy+OR+Cathi+group:alt.support.c ancer&hl=en&lr=&ie=UTF-8&scoring=d&selm=vh07lrsogar89%40corp.supernews.co m&rnum=1>

If I'm wrong, I'd rather be wrong on the side of your mother getting good
pallation of symptoms and sort out the rest later.

Post anytime regardless of whether you seek assist from Robert,
We'll be here and help (where possible) and care.
J - not an expert nor a doctor

steph

If she's started radiation, she has already seen an oncology specialist. Why
not ask the radiation oncologist these questions? We don't

puppykatt

My father was recently diagnosed with stage 4 Lymphoma, too. Each case
is as different as the person who has it. I see an oncologist for a
Breast Cancer Prevention study here in Winnipeg, and I spoke with her
about my Dad's cancer. Apparently, Lymphoma is one of the easiest
cancers to fight off. The best advice I can give at this time is to not
cry in front of her; dad insists that we do this privately. Be very
supportive to each other, and be strong for both of your parents. Dad
is getting Chemo treatments about every three weeks, for now, until the
clinic determines if this is working. They removed a node from his left
armpit, and ran a series of tests. It is not the Hodgkins type, and it
is not the genetic type, so his chances of a full recovery have improved
dramatically. Dad just turned 69 in March. Good luck to your entire
family, and please, keep us posted and updated.

: My 78 year old Mom was just diagnosed (Sept 13) with Lymphoma, it is
stage 4
: with sites on the left hip(soass muscle), spine and kidney with
apparently 6
: enlarged nodes).....I took her to the hospital(ER) on Sept 11. because
of
: recurring pain not connected to her right hip replacement surgery on
Aug 8
: and the cancer diagnoses has hit us out of the blue. We've yet to see
a
: Oncology specialist(appointment is for Sept 26) but have already began
: radiation on the spine (15 treatments scheduled with 3 completed). We
don't
: know the specific type of lymphoma as we're awaiting further biopsy
results
: but I could use some wisdom when dealing with siblings and my 87 yr.
old
: Dad. A home health nurse sent out from the hospital mentioned hospice
to Mom
: today (I wasn't there) but the various medical people, GP ,
radiologist etc.
: have just said it is "treatable" and have suggested Chemo immediately
: following the radiation treatment. While I'd rather be upbeat and
positive
: when dealing with Mom, Dad and the 4 siblings I don't want to create a
false
: impression about her chances either.....Especially when it comes to
Dad as
: he always thought he'd go first so he is floundering and rightfully
: confused. Anyway with such limited information any educated opinions
about
: the situation as hopeful or helpless? If helpless how much time is
likely
: with stage 4? Thanks much Rod
:
:

j

Steph,
I should have said that !

However, he referred to a radiologist.

I've been trying to find info and sites which explain the role of each in
regards to
interpreting pathology reports
discussing treatment options
type and staging
prognosis

well, if I use this as an example, it seems like there's a split (between
radiologists and oncologists)
http://www.oncologychannel.com/oncologist.shtml
Medical oncology: The American Board of Internal Medicine (ABIM) examines and
certifies internists who choose to acquire additional education and training to
subspecialize in medical oncology, the use of medical and chemothe****utic
treatments of cancer.

Radiation oncology: The American Board of Radiology (ABR) examines and certifies
radiation oncologists, who specialize in radiation treatment of cancers. []

So if a person here is from the US and mention radiologist, I'm unsure if
they've seen a specialist in radiotherapy (but not chemo) or the reverse (if the
poster refers to oncologist), depending on the country or centre where they're
being treated.

Even here, they seem to split the roles http://cis.nci.nih.gov/fact/7_47.htm
Medical Oncology is a subspecialty of internal medicine. Subspecialists in
medical oncology treat all types of benign (noncancerous) and malignant
(cancerous) tumors.
Radiation Oncology is a subspecialty of radiology. Radiology is the use of
x-rays and other forms of radiation to diagnose and treat disease. Radiation
oncologists are subspecialists in the use of radiation to treat cancer. []

I spent hours, months ago trying to find same for Canadian and couldn't. (and/or
it was vague)

Can you unravel or make a general statement about this (for all countries
/centres)? Please.
Or I'll keep seaching to fnd a better broad statement I guess.
TIA
J

steph

In Canada, radiation oncology was originally associated with radiology, but
now it has its own specialty organisation under the general auspices of the
Royal College of Physicians and Surgeons of Canada. You can get more
information at the CARO website. Canadian radiation oncology expects that a
rad onc is an oncologist first, and a radiotherapist second. Rad oncs need
to understand the management of cancer, not just radiation. In many parts of
Canada, rad oncs give a lot of the chemotherapy as well.
In the UK, there is no such specialty as radiation oncology. The specialty
is "Clinical Oncology and Radiotherapy". Nobody is allowed to start training
in Clinical Oncology unless they are first accredited in internal medicine.
Clinical Oncology is administered as a Faculty of the Royal College of
Radiologists (the other faculty being Clinical Radiology). About 70% of all
the chemotherapy given in the UK is prescribed by Clinical Oncologists. The
other 30% is prescribed by medical oncologists and haematologists.

I am aware that is some parts of the US, radiation oncologists restrict
themselves to giving radiation, often under the "direction" of medical or
surgical specialists, but it's the US which is out of step with most of the
rest of the western world....

j

Okay thanks, I found CARO and lots of information there, but I got a little
offtrack and/or didn't find what we're discussing here.
Noted that response times in our area seem to have improved since my last rant.
Read the "ROLE IN INTERNATIONAL MEDICAL GRADUATE CERTIFICATION" and lots of other stuff.


okay so far but who would be telling a new patient their diagnosis, prognosis
and treatment options?
Whichever specialist they've been referred to?

So in the US, a new patient would have to be sure that:
a) they're being seen by a centre that has specialists in both, not just the
radiation oncologist who gives only radiation? OR see two different specialists
OR
b) see a radiation oncologist who gives both chemo and radiation
then get their diagnosis, prognosis and treatment options?
J

martin howard

I feel so sorry for all concerned that only chemo and radiotherapy has been
suggested.
That is probably all that is available from the orthodox side, but there are
alternatives.
My path for prostate and bone cancer, has included urine therapy,
homoeopathy, acupuncture, herbs (east and west), fasting, diet changes,
meditation, exercise and many different alternative therapists.

One interesting even was massive swelling of my left leg and genitals, which
has all gone down to normal using herbs and acupuncture. It is odd that
eodema, or lymphodema is recognised by some authorities to be a healing
effect. The lymph glands go to work to clean up places that have been hurt.
I may be wrong, because I am still experimenting and trying to get really
fit for a Christening on the 28th September.

One of the most important things is the relationship between the sick person
and the children of the extended family. They have been subject to all the
big C talk and now fear Cancer and pass that fear onto the person suffering
and other close relatives.
The alternative way of understanding what cancer actually is and how it can
be dealt with is a long way from the understanding of the oncologists and
orthodox "experts".

The result is that most people who are diagnosed with cancer are screened
from the really helpful research and only get that which comes from the
medical teams in the hospital and the drugs and systems paid for by
pharmaceutical sales.

My children will know of my cancer when they get to the Christening on
Sunday, BUT I and one of my sons will be putting it to them as "no big
deal". I certainly don't want to use Cancer as tool to get the family in
order!! But it might be a useful to start them talking. 3 of my children
have not spoken to me for years.

So, as difficult as it may be, I think there is the opportunity for
discussion at a deep level.

An understanding of life after death may well be helpful for all ages. Click
on http://www.webbscottage.co.uk/continuing_life.htm and other pages around there f
or some Quaker views of life after death and the anthology at /anthology.htm
for lists of all the evidence to date.

But the biggest problem, IMHO, is the fear that the current diagnoses and
orthodox treatments have on the whole psyche of the family and that is the
fault of the current system passing wrong messages.

Fear and lack of knowledge are the big killers. We can work around them. It
is up to us.
--
Martin Howard
Webbs Cottage Pottery
Woolpits Road, Great Saling
BRAINTREE, Es*** CM7 5DZ
01371 850 423
martin@webbscottage.co.uk
http://www.webbscottage.co.uk
Updated 12th July 2003

j

I wonder why...

steph

Yes, I do it all the time


the

specialists


Most cancer centres in Canada, Europe or the US will have both medical and
radiation oncs who work closely together. Patients often see both of us, and
whoever gets there first answers the general questions.