Cancer spread to lymph nodes... prognosis?

richardm

Philosopher
richardm
Joined
Aug 6, 2001
Messages
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Hi -

My brother-in-law to be has recently undergone surgery to remove a malign tumour. At the same time, they removed an assortment of other bits and bobs in the vicinity to test for the spread of the cancer.

He got the results yesterday, and the word is that the cancer has indeed spread into his lymph nodes.

This had a rather tolling sound to me, although he seemed quite upbeat, apparently.

So, does anyone know what the likely upshot of this is going to be? Is it possible to successfully treat cancer once it makes its way into the lymphatic system? Or is it simply impossible to tell with such a small amount of information (it's all I have!)
 
I'm not sure how helpful I will be, but having cancer myself I've got at least some experience with it.

Has he had Chemo already? If he hasn't then I would expect that to be the next course of action. Perhaps radiation as well (though it just helps the symptoms).

If he has had chemo already then I would suppose it would depend on what type he got. In my case the doctor said that I already had gotten the strongest drugs they've have so I won't be getting any more chemo. I hope your brother-in-law is not in the same situation.


Maybe someone else will have more information on lymph cancer (I'm sure it has a name, but I don't know it) specifically.
 
The Cats Venm said:
I'm not sure how helpful I will be, but having cancer myself I've got at least some experience with it.

Has he had Chemo already? If he hasn't then I would expect that to be the next course of action. Perhaps radiation as well (though it just helps the symptoms).

If he has had chemo already then I would suppose it would depend on what type he got. In my case the doctor said that I already had gotten the strongest drugs they've have so I won't be getting any more chemo. I hope your brother-in-law is not in the same situation.


Maybe someone else will have more information on lymph cancer (I'm sure it has a name, but I don't know it) specifically.
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Hi Cats (or do you prefer Venm?) -

Sorry to hear you're stuck on the Chemo front. He hasn't started the treatment yet, I believe they're waiting for him to heal up completely from the surgery first.

Does radiation only help with symptoms? I thought the idea was to kill the cancerous cells by irradiating them (cooking them, effectively)
 
Radiation is not a cure. I don't know how it works but it does help the symptoms.

As for chemo, I would expect that they will want to start as soon as it is safe to do so.

One thing I learned is that they are very careful about making sure that the chemo isn't doing, or going to do, more harm than good. If it's causing problems or they think it will cause problems, they will wait until the person is better able to handle it.
 
Non-hodgkins' lymphoma survivor of 14 years here.
Short answer: yes, it's possible to survive even with cancer cells in the lymphatic system.

Be supportive and start educating yourself on what the plan of action will be, how you and everyone will cope, what to expect and when. Plan for the worst and hope for the best.

Some things that might be helpful for your brother:
1.) pack an overnight bag that you can grab at any time (jammies, socks, toothbrush, deoderant, teddy bear, etc etc)

2.) Ensure is a good healthy drink to stock. There will likely be times when he is too tired or not hungry to eat. But you can't skip meals if you can possibly avoid it. Also canned soups, eggs, saltine crackers, ginger ale, applesauce, pudding packs, etc.

3.) a list of phone numbers that you can contact someone ASAP if required

now these are not written in stone, but just suggestions that I've found helps some people.
 
I had Hodgkins' disease back in the mid 1980's, so I come here with some experience, but not expertise. Your brother-in-law should be writing down questions as he thinks of them and asking his doctors when he sees them.

Some questions to ask:
  • What kind of cancer do I have (believe it or not, some people don't know)?
  • What stage is it at?
  • Statistically, what's the prognosis for people at my stage? This is the scariest question to ask, but even if the answer is "100% mortality", he needs to know, if for no other reason than to have time to get his affairs in order.
  • What can I do to help the treatments along? Activites to avoid, activities to do, diet, exercise, etc.?
  • What can I expect from the treatments? When I was getting the treatments, I was given a book, about 40-50 pages, called "Chemotherapy and You", put out by the U.S. Department of Health and Human Services. Among other things, it had a comprehensive list of all the possible chemo drugs you could get (I was getting eight of them, in two separate regimens), explaining what they did, how they worked, what the normal side effects were, what the dangerous side effects were, etc. (one drug turned your urine red for several hours, which could scare you to death if you didn't know it was supposed to do that).
Other stuff:
  • I let the doctors know I wanted every inch, that I wanted to hear bad news and good news, that I wanted them to treat the disease as aggressively as they considered prudent. My first chemo session, a nurse called the doctor over to the phone; "It's Mrs. So-and-So; sounds like she's in denial again, she wants to talk with another doctor..." I vowed that would never be me; nothing wrong with second opinions, but when you have a growth on your neck that keeps you awake day and night...
  • Well-meaning ignoramuses will tell him, "Oh, I hear the cure is worse than the disease"; this from people who have had neither the disease nor the cure. Ignore them.
  • Just because you're getting sick after treatments doesn't mean you're getting better; conversely, lack of nausea doesn't mean you're not getting better. Ask your doctor how you're doing. It's his job to know. My nausea wasn't bad at all - not remotely what the well-meaning ignoramuses had told me - but my cure was almost routine.
  • Believe me, doctors like patients who ask intelligent questions. At least mine did, and he didn't have the best bedside manner.
  • My understanding is that radiation is generally for zapping "spots" of cancer; chemo for more systemic treatment. Your brother-in-law may get one or the other or both, and he should certainly discuss the treatment options with his doctor. I asked mine why we weren't going to do radiation. He tried to brush it off with, "It really isn't warranted", and I pressed him as to why. "Because it wouldn't give you a significantly better chance today, and it would significantly increase your chances of getting thyroid cancer 20 years down the road." That was a satisfactory answer, as far as i was concerned.
  • There will be times when he feels lousy, even if everything is going well. For months, I felt like I had the flu - tired, achy, run-down. That's perfectly normal; the idea of chemo is that you're poisoning your body with drugs that attack the fastest-growing cells. Cancer cells grow faster than anything, which is why chemo works (and why hair often - not always - falls out), but it's going to run down the rest of you, too. Your doctor will be monitoring that, too; I had to postpone a couple of sessions near the end of my treatments because they found my white blood cell count was too low. And I got pneumonia twice in the last three months of treatment. It can be tough to get through, but it's not impossible. When you feel lousy, think to yourself how lousy the cancer cells must be feeling.

Hope this helps. Feel free to PM me about this.
 
One other thing, having re-read your OP: There's a difference between having cancer of the lymph system (Hodgkins' or non-Hodgkins' lymphoma) and having end-organ cancer that has spread to or via the lymph system. The first may or may not have spread to the end organs (liver, kidneys, etc.), but is a disease primarily of the lymph system.

The latter is a disease of an end organ (lung, for example) that can metastasize (spread) by way of the lymph system. That's how people who have lung cancer end up with it having spread to other organs.

Again, it's important for your brother-in-law to know, and he should be getting answers from his doctors.
 
Many, many thanks for that. I must admit that in my limited knowledge of the subject "The cancer has spread" sounded terminal, so it's good to know that it isn't necessarily so. Actually, I think I have a tendency to assume that a diagnosis of cancer is a death sentence, even though I know several people who have won out against it.

I think the plan was that they were going to put him on an aggressive course of chemotherapy in any case, just to make sure, so the treatment plan hasn't changed.

Anyway, thanks again.
 
Well, my sister's breast cancer had spread to the lymph nodes not only in her armpit, but into her neck. They removed all they could, she had a year of hellish chemo and radiation, and is now cancer free. Her prognosis, which initially was only 2-3 years, is now 15 years plus.

I'd echo what others said--it depends on the kind of cancer, the stage, and how it's treated. You might find re-reading the hitchhikers guide helpful. ("don't panic!")

Best wishes and kind thoughts :rub:
 
richardm said:
Actually, I think I have a tendency to assume that a diagnosis of cancer is a death sentence, even though I know several people who have won out against it.
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Natural reaction. Kinda like someone yelling, "Shark!!!". Everyone makes a mad scramble out of the water.

Then they stop and think for a second: "Hey, wait a minute; this is a swimming pool..."

You hear the word "biopsy" for the first time and all the air leaves your body, you discover that it's somehow possible for your heart to stop beating and start racing, simultaneously, and reason, at least momentarily, flees. Everyone resumes breathing again, and the heart goes back to normal again; the tricky part is recapturing your reasoning ability. But you have to do that; apart from the drugs, reason is your most powerful weapon.
 
Non-Hodgkin lymphoma 10 year survivor here.Lymphomas are very treatable.If this is a different type of cancer that has spread to the lymph glads then his prognois is probably worse than than if it originated there.
 
waitew said:
Non-Hodgkin lymphoma 10 year survivor here.Lymphomas are very treatable.If this is a different type of cancer that has spread to the lymph glads then his prognois is probably worse than than if it originated there.
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Yes, it spread there from the oesophagus, which is already a rather virulent type of cancer, apparently.

Thanks, Bug Girl and BPSCG. I do feel better for having spoken to people with first-hand experience like this, and so does Mary, whose brother it is. I'm sure he's in possession of the full details, but he's not letting on, which is fair enough. It's all especially trying because he's on the other side of the Earth, literally, so the whole thing seems even more remote. Not that we could do much if he was on the doorstep, exactly, but, you know...

Anyway, chemotherapy starts in a few weeks, and then I guess we have to wait and hope it works as well for him as it has for some of you guys.

Cat's Venm, if you don't mind my asking, what's the next step for your treatment? Reply by PM if you don't want to publicise, or tell me to mind my own business if you prefer ;)
 
I guess most is already covered, still...
Cancer starts somewhere, then when the tumor reaches a critical state (dependent on type of cancer), it sort of spills over (imagine a bucket filling up), and cancer cells start migrating through lymph channels and blood-stream. Some of them settle down in other parts of the body and start new colonies, metastases. The character of a metastase depends on the origin, not on its position, and thus the prognosis.

Both chemo and radiation aims at destroying the fast-growing cancer cells, but since both treatments destroy all fast-growing cells, there are some serious side-effects. The trick in effective treatment is to give enough to barely not kill the patient, as this will give the best chance of eradicating the cancer. Also makes the treatment pure heII.

The choice between chemo and radiation depends on type and postion of the cancer. Some types respond better to one of the treatments. Radiotherapy has the advantage of being selectively directed at certain body-parts (which, if the cancer is much spread, becomes a disadvantage).

Without knowing much about this particular type, I would think the prognosis is serious but not hopeless. The old saying: "Prepare for the worst and hope for the best" seems appropriate. What you can do is be supportive, help with ironing out practical problems, and ... listen. In my experience with cancer cases, I will say that one of the worst thing you can do to a seriously ill person is being insistently cheerful. If he wishes to talk about death, how family should cope if he dies, etc. take that converstion, and take it seriously. The worst thing you can do is brush such talk off with "Nonsense! You are gonna be just fine!". Instead it should be: "Let us hope it is not necessary, but of course we can discuss this."

Best of hopes, and good luck.

Hans
 
I second what Hans said. (you might also want to PM truthseeker--she works in this field.)

One of the most important things i was able to do for my sister was to listen, and to let her not have to put a happy spin on things.

The second most important thing was to supply her with MST3K/Monty Python tapes, and keep her entertained while she was to sick with chemo to move.

If he does end up with chemo, i strongly recommend that he investigate a port. the injections and the constant hunt for a vein were the most painful part of the process. All the survivors i know have said if they had to do it over again, they would have a port implanted.
 
Good call Bug Girl: movies, books on tape, art supplies, etc. Nice stuff to help cope when things are rough.
 
bug_girl said:
If he does end up with chemo, i strongly recommend that he investigate a port. the injections and the constant hunt for a vein were the most painful part of the process. All the survivors i know have said if they had to do it over again, they would have a port implanted.
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Emphasis on the word "investigate". I did fine without a port. Problem is that somehow all the drugs had a long-term side effect of narrowing my arteries, so whenever I have to have blood drawn today (almost 20 years later), the technicians have to search hard for something big enough to get a needle into. And they often use needles that are micro-sized for infants and small children. If I was going through the whole thing again today, I'd probably need a port.

Regarding what Hans says about the treatment being "pure hell"; yes, it can be, but is not necessarily so. I lost some hair, but not so much that people stared at me. Nausea was fairly mild - lasted an hour or so after each treatment (I learned to eat light on those days). I often felt achy and run-down, but not to the point of being unable to function. Other assorted aches and pains, but nothing I couldn't manage. I certainly wouldn't want to go through it again, but it was far from being "pure hell".

As always, your mileage may vary.
 
Well, but that's how bad heII gets, didn't you know ;)? This is like so many other things, some find it horrible, some not. There are also different levels and types of treatment. Some are worse than others.

Hans
 
MRC_Hans said:
Well, but that's how bad heII gets, didn't you know ;)? This is like so many other things, some find it horrible, some not. There are also different levels and types of treatment. Some are worse than others.
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Agreed. Some treatments are worse than others. Some people can have very different reactions to the same treatments. And people will vary wildly in what they find tolerable.

But unfortunately, the popular perception of chemo is nonstop vomiting for days or even weeks at a time, and tests that would qualify as medieval torture in any setting other than a medical one. That's what I'd been led to believe, and what I was girding my loins for. I was surprised - and not at all displeased - to find it wasn't nearly as bad as what the well-meaning, sympathetic, but ultimately ignorant (having had neither the disease nor the cure) had assured me I was in for.
 
Mmm? Your description of your own experience was more or less on par with my impression. Perhaps add severe loss of energy. Haven't tried it myself (yet), though.

Hans
 
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