The Leukemia & Lymphoma Society - Fighting Blood Cancers
8 Replies Latest reply: Jun 13, 2012 12:02 AM by Katiedid RSS

follicular lymphoma stage 1, grade 3, treatment: rchop, radiation or watch and wait?

bella1966 Registered Users
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hello all

i am fortunate that this site exists. my 41 year old brother has been diagnosed with follicular lymphoma. he had 2 masses in his neck that were removed. all other tests (ct, pet, bone marrow) are clean. his oncologist has recommended 4-6 rounds of RCHOP. aside from the growths removed, he is asymptomatic. we are trying to get a second opinion from another oncologist (any recommendations in the Los Angeles area appreciated). anyone out there with similar profile doing rchop, or just radiation, or just waiting? would love to know more. having had cancer and chemo myself, i dont want him to have to go through rchop unless there is a true benefit for him at this point in his disease.

thank you

  • Re: follicular lymphoma stage 1, grade 3, treatment: rchop, radiation or watch and wait?
    abramsmm Registered Users
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    There's a lot of middle ground between watch & wait, radiation only, and R-CHOP.  There's R (Rituxan) by itself either with or without maintenance, R with Bendamustine, R-CVP (chop less antitumor antibiotic), any of the above with or without R-maintenance, etc.  If the fnhl is local, I would wonder why to start with R-CHOP, and he might want R-CHOP fresh and ready for when this ever becomes more aggressive.  Another might argue that R-CHOP might give the longest remission in a young otherwise healthy person.  I can't advise, but speaking personally (different circumstances but not that different), I am in no rush for R-CHOP. 

  • Re: follicular lymphoma stage 1, grade 3, treatment: rchop, radiation or watch and wait?
    CookieMonster Registered Users
    Currently Being Moderated

    Hi Bella,

     

    I've not been on the boards for quite some time, but reading that your brother is grade 3 is probably why they want to go ahead with the R-CHOP.  I was diagnosed with follicular lymphoma in August of 2006 and it was stage 3, grade 3 and the pathologist called it intermediate grade.  The follicular (slow growing) had turned aggressive and last I knew and read, which has been a while, grade 3 follicular is a sketchy/gray area for treatment, thus going the route of aggressive treatment. I was told that the follicular had transformed to something more aggressive in my case.

     

    I know it depends on what the cells look like under the microscope and since you've been down this road I believe you know this fact.

     

    I hope some of that made sense. 

     

    Blessings,

    Jane

    • Re: follicular lymphoma stage 1, grade 3, treatment: rchop, radiation or watch and wait?
      bella1966 Registered Users
      Currently Being Moderated

      thanks cookie monster....did you have rchop or some other treatment? thank you

      • Re: follicular lymphoma stage 1, grade 3, treatment: rchop, radiation or watch and wait?
        CookieMonster Registered Users
        Currently Being Moderated

        Hi Bella,

         

        I had 6 rounds of R-CHOP and was fortunate to be in remission after round 4.  However, my oncologist always does two more rounds after remission for good measure, so it could have been 8 rounds but thankfully wasn't. 

         

        I did have one relapse of the follicular variety in April of 2008 and that node was removed and found to be stage 1.  Since there weren't any other areas affected by the lymphoma my onc. decided on no further treatment since there wouldn't be any way to gauge if the treatment was being affected.  I've been clean and clear since.

         

        Also, I have been pronounced cured of the intermediate grade lymphoma as of last January.  It was 5 years from my last treatment and it has not returned.  Whew!

         

        My e-mail is attached to my profile, I think it still is, I've not been here much and I see some changes to this board.  If it is, feel free to send an e-mail if you'd like.

         

        Blessings and determination,

        Jane

  • Re: follicular lymphoma stage 1, grade 3, treatment: rchop, radiation or watch and wait?
    Katiedid Registered Users
    Currently Being Moderated

    I have Follicular Lymphoma, Grade 3 Stage 4. Diagnosed in March. I had several lymph nodes finally surface otherwise I thought I was fine...Just turning 42, working mother of 4, I just thought I was tired and maybe I was perimenopausal but nope its Cancer... Looking back I still would have decided to go with the RCHOP.. Rituxan- monoclonal antibody which belongs to the general class of man made substances called biological response modifiers especially positive for the CD 20 receptor. The monoclonal antibody finds the certain receptor attaches itself and then kills it no other cells affected, Doxorubicin (adriamycin) belongs to the general group of drugs as anthracycline anibotics which disrupts growth of cancer cells,vincristine (oncovin) belongs to a general group of drugs known as plant alkaloids which disrupt cell division, cyclophosphamide (cytoxan) group of drugs known as alkylating agents which disrupts the growth of cancer cells,and most popular prednisone which is a glucocorticoid steroid it decreases inflammation by preventing white blood cells from completing a inflammatory reaction. Every 3 weeks I sit for about 5 hours and receive all these drugs through my port... And yes I am very tired and yes I take all my medicine for nausea but honestly I am super lucky... My doctor says some people even look better and feel better after starting chemo. I know crazy huh. " IF " i had all my hair back you probably couldn't even tell. Now I have had 4 treatments and lots of time off from work because I did get pnemonia but I try to have a very upbeat attitude and just play the cards I'm dealt. My family and all my wonderful work friends are always with me in my heart and I know I can get better and hopefully in a few days the PET scan will give me good results for a change : )  I believe the more information you have the better so I hope through some online homework you can make a better decision. Also, the library has heaps of cancer books. After lots of homework and questions answered throughly by my doctor I think my husband and I made the right decision for sure ...xoxo

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