RCHOP 3 or 4 cycles with no tumor

Posted by fwpoole @fwpoole, Sat, Aug 31 3:02pm

In June, I had a tumor removed from my large intestine which was NOT colon cancer, but DLBCL stage 2. Prior PET and CT showed no sign of metastasis. The NCCN "Guidlines" suggests RCHOP X3 followed by radiation. Since the tumor has been removed, my oncologist tells me radiation is not necessary. Glad for that. I have finished 3 cycles of RCHOP-21 this past week and am scheduled for follow up PET/CT scan next week. If the scans come back negative, per the guidelines, I consider the treatment done since I have no tumor and radiation is not necessary. But, my oncologist is urging me to have one more cycle of RCHOP. Isnt the removal of the tumor equal to, or better than radiation of the tumor? So, therefore, RCHOP x 3 + ISRT – ISRT = RCHOP x 3 cycles.

Hi @fwpoole, I'd like to tag fellow Connect members @ginpene05 and @ckeys as they have experience with diffuse large b-cell lymphoma and may be able to offer you support.

Did you have the opportunity to ask this to your physician? What did they say?

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My Oncologist claims there are no clinical trials that 3 cycles is enough for stage 2. But there are trials for 3 cycles with radiation of tumor/nodes. My tumor was removed along with about a foot of intestine. Isn’t removal better than radiation?
@ckeys @ginpene05

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@fwpoole

My Oncologist claims there are no clinical trials that 3 cycles is enough for stage 2. But there are trials for 3 cycles with radiation of tumor/nodes. My tumor was removed along with about a foot of intestine. Isn’t removal better than radiation?
@ckeys @ginpene05

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@fwpoole Removal is not necessarily relevant, especially in stage 2. Lymphoma is a circulatory cancer and because of that it can spread, which is why treatment almost always involves chemo. Removal of a node is usually just for biopsy, although there is some research on removal being treatment in very early stage, or less aggressive forms. Removal cal also contribute to spread as you open up possibility of cells leaking. Radiation can help when the tumors are localized, but less so when they are multiple or all over. Being stage 2 sounds like your cancer was already circulating in the area, so radiation can provide some additional benefit even if you had everything removed. I’m sure your doctor can explain why he’s recommended a specific plan.

FYI, I had my initial lymphoma in one node and the base of my tongue (stage 2e). The node was removed for biopsy and I was given chemo plus radiation. My cancer returned in same area. I hope you have success with what your doc recommends!

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