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Hello everyone. Hope all are doing well today. Yesterday we met with my sons doctor to see what he had to say. His primary doctor seem to think that he was in the early stages but yesterday the doctor told us he would have 4 months of treatment. When asked why that time frame? He said he thought that the HL was not stage one but higher. scheduled him for a bone marrow which we had done this morning. I asked him how he came to the conclusion and he said the lump was to large to be stage one. After talking to his office partner this morning, he seem to think that my son was not that far. Becuase he has no symptoms (night sewats, fever, weight loss , etc.,) I asked him how long before we would know if it was in his bone marrow? He said he would know a little in a few day but the complete information would take 10 days. Because they have not staged him yet and have already scheduled him for the chemo for Friday the 15th (He is haveing a pet scan Monday, Mug on tuesday, Port and another Biopsy on Wednesday, I almost feel that this is going to fast. Not sure if this is the corrrect corse of action. Should I ask for a second opinion or would we just be waisting our time? I see that some people are still waiting to see there doctors for the first time. I am really confused at the moment.

* I am not a doctor and my post is strictly advice and therefore up to your discretion.

If it is confirmed HL then chemo will be introduced eventually anyway. The bone marrow biopsy is to discover whether the cancer has penetrated into the marrow of the bone, often becoming leukemia.
With cancer, "fast" can be really tricky and hard to come to terms with, but technically a good thing. Prolonging the beginning of treatment is never a good thing unless they are truly unsure of the diagnosis.

The following technique on staging of HL is taken from the 'medic8' health guide and will be similar method that your doctor will use to stage your son-

Stages of Adult Hodgkin's Lymphoma

Key Points for This Section

•After adult Hodgkin's lymphoma has been diagnosed, tests are done to find out if cancer cells have spread within the lymph system or to other parts of the body.
•Stages of adult Hodgkin's lymphoma may include A, B, E, and S.
•The following stages are used for adult Hodgkin's lymphoma:
o Stage I
o Stage II
o Stage III
o Stage IV

After adult Hodgkin's lymphoma has been diagnosed, tests are done to find out if cancer cells have spread within the lymph system or to other parts of the body.

The process used to find out if cancer has spread within the lymph system or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

•CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerised tomography, or computerised axial tomography. For adult Hodgkin's lymphoma, CT scans of the chest, abdomen, and pelvis are taken.
•PET scan (positron emission tomography scan): A procedure to find malignant tumour cells in the body. A small amount of radionuclide glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumour cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
•Bone marrow biopsy: The removal of a small piece of bone and bone marrow by inserting a needle into the hipbone or breastbone. A pathologist views both the bone and bone marrow samples under a microscope to look for signs of cancer.
•Laparotomy: A surgical procedure in which an incision (cut) is made in the wall of the abdomen to check the inside of the abdomen for signs of disease. The size of the incision depends on the reason the laparotomy is being done. Sometimes organs are removed or tissue samples are taken for biopsy. This procedure is done only if it is needed to make decisions about treatment.
•Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
•Needle or surgical biopsy: The removal of tissue using a thin needle or scalpel. A pathologist views the tissue under a microscope to look for cancer cells.
•Thoracentesis: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.
Stages of adult Hodgkin's lymphoma may include A, B, E, and S.

Adult Hodgkin's lymphoma may be described as follows:

•A: The patient has no symptoms.
•B: The patient has symptoms such as fever, weight loss, or night sweats.
•E: "E" stands for extranodal and means the cancer is found in an area or organ other than the lymph nodes or has spread to tissues beyond, but near, the major lymphatic areas.
•S: "S" stands for spleen and means the cancer is found in the spleen.
The following stages are used for adult Hodgkin's lymphoma:

Stage I

Stage I is divided into stage I and stage IE.

•Stage I: Cancer is found in one lymph node group.
•Stage IE: Cancer is found in an area or organ other than the lymph nodes.
Stage II

Stage II is divided into stage II and stage IIE.

•Stage II: Cancer is found in two or more lymph node groups on the same side of the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
•Stage IIE: Cancer is found in an area or organ other than the lymph nodes and in lymph nodes near that area or organ, and may have spread to other lymph node groups on the same side of the diaphragm.
Stage III

Stage III is divided into stage III, stage IIIE, Stage IIIS, and stage IIIS+E.

•Stage III: Cancer is found in lymph node groups on both sides of the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
•Stage IIIE: Cancer is found in lymph node groups on both sides of the diaphragm and in an area or organ other than the lymph nodes.
•Stage IIIS: Cancer is found in lymph node groups on both sides of the diaphragm and in the spleen.
•Stage IIIS+E: Cancer is found in lymph node groups on both sides of the diaphragm, in an area or organ other than the lymph nodes, and in the spleen.
Stage III is also divided into stage III(1) and stage III(2) as follows:

•Stage III(1): Cancer is found only in the upper abdomen above the renal vein.
•Stage III(2): Cancer is found in lymph nodes in the pelvis and/or near the aorta.
Stage IV

In stage IV, the cancer either:

•is found throughout one or more organs other than the lymph nodes and may be in lymph nodes near those organs; or
•is found in one organ other than the lymph nodes and has spread to lymph nodes far away from that organ.

You can see that the number is based on how far the HL has spread and the letters on how badly your son suffers from his symptoms.

Regards Annie

My husband had already started chemo before he found out the results of his bone marrow biopsy. The doctor told us that no matter what he was going to need chemo so it was a good idea to go ahead and get started. Things moved very quickly with us as well. However, I found comfort in that rather than second-guessing it. I guess we're all a little different on how we process this situation. It will be fine if he goes ahead and starts his chemo. Then, they'll let him know the other test information when they get it.

My husband had none of the symptoms either. He just had a lump pop up on his neck one day, and I made him go and get it checked out. They originally thought he was stage I or II, but he ended up being IIIA. (He had one node below the diaphram). Now, he's half way through his treatments... he's done 7 out of 12, and his PET scan last week came back clean! So, even if he is at a later stage, it still has awesome cure rates.

Hang in there!

Hi Raylabo,
All these tests must be done before they can determine the stage of the cancer. I am not a Dr. either but can share with you what I went through. I discovered a swollen lymph node right above my left colar bone. Before any diagnoses was made, I first had an ultrasound, then chest x-Ray to make sure it wasn't lung cancer. It shows clear on the chest x-rays, so the dr. ordered blood wook before the Ct Scans ( they like to verify that the kidneys are healthy because of the dye that is injected in you). Ct scans showed other lymph nodes in my chest that were swollen, one was 7 cmm. I had others that were swollen down my esophagus area and left pectoral area. I went right away the next day and had a fine needle aspiration in the swollen node by the collarbone. This removes lymph node cells that the dr. can look at a microscope there in the office. These cells are sent to lab to see if there is presents of lymphoma. Three days later I was having the node above my collar bone surgically removed. Once they remove it, they dissect it over end over again. They found I was "classic Hodgkins". Went I met with my new oncologist, he ordered a PET then another CT and finally a bone marrow biopsy, which he did right in the office. Two days later, he diagnosed me with Hodgkins Lyphoma Stage IIA.
Right now it sounds like your son is Stage IIA but until you run the other tests, you won't know the final outcome. With my IIA, I have 4 cycles of ABVD. This is 2 treatments every month. Then off to radiation. Make sure you receive copies of all the tests and ask questions until you have a clear understanding of what will happen and what treatments have side effects.
I will keep you in my prayers. Please let us know what stage when you find out. Good luck to your son.
- Deana

It seems like everything is moving fast but fast is better he will need the cemo anyways why wait. Cancer is very visual thru scans when I was diagnoised in 1993 it moved fast i thought they were crazy but threw out it all I am glad i didnt wait I was a stage 3b and only had 6 months if I didnt start the cemo, iam here today to talk about it. Good luck to you and your son I will be praying for you and your family.

I am soooo thankful that I found this forum. It is good to hear the information from people who have or is going through this too. My son is very positive. Thank you to everyone for answering my questions. Every little bit helps.

So am i!

its better than waiting they have me waiting for stage b4 startin and im goin nuts atleast i go mon finally for bone marrow bio and then a wk later i will get the results and start chop at that time, but the wait is just wearin me down so much very hard on the family and myself. good luck on your journey stay possitive its the best med u can get for free.

hey raylabo,
I found this site about a week ago, I am a 30 year survivor of hodgkins, stage 3. Took radiation and MOPP chemo back in 1980, been just fine ever since, I run, ski, bike, have tons of energy, and in fact the healthiest days of my life were AFTER I had the disease. Really don't even think about it much anymore, but I happen to have been 'officially' diagnosed on my 25th birthday, recently turned 55 and realized it has been 30 years, did a little googling and found this site.

This stuff is very beatable, you and you son need to just hang in there and stay positive.

This is a very beatable disease and the doctors have a good handle on it, I am proof of that!!

Doug

I agree with Dougj this diease is very beatable Iam a 15 yr stem cell transplant