My dad was diagnosed with Stage 4 Lymphoma on Tuesday, December 14th, 2010. This was his 12th day in the hospital and now we are on day 14. Radiologist wants to start radiation today and chemo after radiation. We need to know if he should go forward w.

Dad diagnosed with Stage 4 Lymphoma. Oncologist directs most questions to the radiologist. So the radiologist wants to start radiation today. Given Stage 4 with bone marrow involved and no host found, should he start the radiation. The plan is to get a second opinion on Chemo but radiologist seems to think that the radiation will get him mobile. Any information (personal experiences) on the disease or anything will help.
My dad is 70 and was in very good health walking 2 miles a day. Very mobile and very healthy before about 8 weeks ago and then this diagnosis happened. Since he walked into the hospital on the December 3rd, his helath has gone down and he is unable to walk at all. Anything helps.
Thanks to all!!!
Lindsay

It sounds like the radiologist wants to start radiation in an effort to shrink the tumor or tumors, and depending on where they are they could be the reason he's not mobile or finds himself extremely fatigued when he was (i.e. a chest tumor could severely compromise his lung capacity).

That said, second opinions in lymphoma are an absolute MUST because the disease is so often misdiagnosed. From your post I can't tell what subtype of lymphoma he has-- this could make a difference. Either way, it's very common for people to get pushed into treatment well before they've had a chance to consider it. If your dad's health is failing, that's another matter, and he may have an aggressive subtype.

Radiation can be an effective palliative treatment in the short term- i.e. reducing tumors, or it can be more aggressive. Either way, at his age I would think he could tolerate it- and the docs must think so too or they wouldn't recommend it- and also at his age the treatment poses no real threat to cause a secondary cancer later in life. My point is, there may not be much harm in going forward with the radiation.

Still, I think you need to find out the specific diagnosis he was given, and where the radiation field will be-- meaning if it's at his chest, does he have a history of heart problems etc?

The specific diagnosis is Diffuse Large B-Cell Lymphoma. They have done a bone marrow biopsy and they came up with Diffuse Large B-Cell Lymphoma. So what we do know is its in the bones and the doctor's words are "everywhere". They have checked every organ possible and all are clean. No cancer in the organs. They cannot find one or more than one lymphnode that has it either. Finally the doctor said this morning that he does believe that the lymphoma in the bones is the reason for him not being able to walk. To me its just weird that he walked in on the 3rd and couldn't walk at all by the 5th. Thats only two days. The radiologist said that its stage 4 but mid grade (meaning the spread is mild).
We are hoping to move him to another oncologist but having problems finding one that is covered by his health insurance.
They did the first radiation today and will continue to for 10 days at 30 seconds a day. I hope that gives more info. The specific diagnosis is Diffuse Large B-Cell Lymphoma.
Thanks for you reply and any others that may be out there.
lins

Lins-
He's been been staged at IV by convention, because when there's bone marrow involvement in lymphoma, it's an automatic stage IV. The grade doesn't indicate spread, it indicates aggressiveness (i.e. malignancy), so mid-grade is better than say high grade. So no other organs are involved, and no lymph nodes- an extranodal disease then with bone lesions and BM involvement, sounds more like primary lymphoma of bone (PBL) than DLBCL perse, although treatments are pretty similar- radiation and chemo. When done together, they can be extremely effective, with very high cure rates.

I agree it seems weird that in two days he goes from mobile to immobile. I hope others can offer you some practical and helpful advice on what to do- best of luck.

Ross