Father diagnosed with stage 4 NHL - low grade in nine narriw

Lymphoma in the bone marrow is always classified as stage 4.  It's not an indication of how advanced it is.

Lymphoma is also different to solid tumours.  While staging informs treatment, it's usefulness as a prognostic indicator is limited. 

There are over 60 different types of NHL.  It sounds like your dad might have a type which is classified as "indolent".  This means it is slow growing.  They will monitor it for signs of progression, but while it remains indolent and is causing him no problems - which it could do for the remainder of his life - there is no need to treat it.  This is why, despite it being classified as stage 4, there is no need to treat it unless something changes dramatically.

You should be asking about what would indicate your dad needs urgent re-evaluation.  You will probably be told to watch out for the "B" symptoms of fever, night sweats and weight loss, which can indicate an indolent lymphoma tuning aggressive.

Hi and welcome.

I was 4a2 for many years before I needed full on treatment so when watch and wait is suggested it means it is in his best interests to keep an eye on his lymphoma and to save other treatments for when they are needed.

There is lots of evidence that people do just as well in the long term if they are actively monitored and have other treatments kept until they are really needed.

Questions to ask

https://lymphoma-action.org.uk/about-lymphoma-tests-diagnosis-and-staging-your-medical-team/questions-ask-your-medical-team

When you feel up to it try putting some information in your profile. This really helps others when answering. It also means that you don't have to keep repeating yourself. Just click on YOUR username, select 'Edit Profile'. Put as much or as little in your profile and you can amend it at any time - you can see members profiles by hitting our forum names.

Just to add to what Mike said, one of the most common forms of chemotherapy used to treat lymphoma is R-CHOP.  One of the drugs in the regimen - doxorubicin - has a lifetime limit on administration.  Using it when it's not necessary can result in future treatment options being compromised. 

In fact, research has been conducted into whether 4 cycles of R-CHOP are as effective as the conventional 6, with a view to both reducing unnecessary exposure to cytotoxic agents and also keeping a buffer in reserve for the future.

Thanks Lolie. That makes me feel much better.its been a hard year. Dad was diagnosed with bowel cancer in September last year and had tumour removed and they confirmed it hadn't spread. He suffered from a bad foot so he had further tests and they found shadows on his spine. Biopsy showed NHL. The doctor said it wasn't secondary  with this it was unconnected. He's having stoma reversal later this year and they said it can still go ahead. 

I am very grateful for the reply. 

Thanks Mike. The questions were exactly what I was after. It really helped and thank you for the advice on my profile. 

Thank you again.

Good morning , I do hope things are ok.

Have you been able to find out what the exact type of NHL your dad has?........ as this can tell a lot about why W&W is being recommended.

We are always around to listen.

Thank you for asking I am trying to be very positive for dad but inside I'm not! Spoke to my dad last night and he was very positive and had got friends round for a meal.  He was told it was low-grade NHL but no other name given. Will ask at next appointment. 

I hope you are doing ok too. 

The more information you can get the more the noise between your ears will turn down.

As has been said, the stage numbers used in blood cancers indicate what type and how long treatment needs to be......... in solid tumour cancers stage 4 is bad but not in blood cancers.

Low grade is slow growing and as si said I was 24 years before some strong treatments were required.

((hugs)) 

Thanks Mike that made me smile - trying to imagine my dad not needing treatment until he was  104

you are right I need facts and  I will certainly be asking some more questions at the next appointment.

((hugs))