Dear Dr. Roach: I was recently diagnosed with low-grade lymphoma. I have been trying to听research this online and am having no luck finding much information. I have a CT scan every six months to check for any changes in my lymph nodes. Can you offer any additional information on low-grade lymphoma?
Anon.
Low-grade lymphoma isn鈥檛 a diagnosis, which is why you aren鈥檛 finding anything on the web. A lymphoma is a type of blood cancer, very similar to a leukemia, and the abnormal cells live within the blood or blood structures such as the bone marrow, spleen and lymph nodes. There are many types of lymphomas, including very aggressive types, such as Burkitt鈥檚 lymphoma, and diffuse large B cell lymphoma, but also more indolent types, such as follicular lymphoma and small lymphocytic lymphoma. These slower-growing lymphomas are referred to, in aggregate, as low-grade lymphomas.
Aggressive lymphomas without treatment usually are rapidly fatal; however, the current treatments for aggressive lymphomas are remarkably good 鈥� such that there is a high cure rate of the cancer. Low-grade lymphomas, by contrast, are usually not rapidly fatal. For follicular lymphoma, the most common indolent lymphoma, more than 90听per cent of people will survive for more than five years from diagnosis if they have limited disease at diagnosis, and they have a听median survival of almost 20听years. 鈥淢edian survival鈥� means that half the group lived longer than that time 鈥� in this case, 19听years. On the other hand, it is very hard to cure indolent lymphomas, and very often, as in your case, oncologists don鈥檛 even start treatment right away, but wait to see if the cancer grows more rapidly. Every cancer, like every person, behaves a little differently, so they have to be watched, and it requires experience to know when to start treatment.
听
Dear Dr. Roach: I am 80 years old, and have been bothered by frequent urination for many years. My urologist recommended a surgical procedure, and performed diagnostic tests to determine what I already knew 鈥� that I do not void fully. I often must urinate three to four times at night. I have not seen this urologist for more than two years.
My question is: What are the risks of doing nothing? I was on Flomax and found it to be of no benefit.
W.B.
Difficulty urinating is a common problem for older men, and for many men, the symptoms themselves make them want to be treated. It sounds like you are asking if there might be additional downsides besides the symptoms.
The major risk is that there might be a cancer, especially of the prostate, so seeing the urologist to look for cancer is important. Prolonged blockage of urine occasionally leads to kidney damage, if the blockage is severe enough for long enough. Finally, having 鈥渟tale鈥� urine in the bladder predisposes you to infection. If your doctor finds that you have good kidney function, no cancer and no infection, you don鈥檛 need to get treated. That being said, there are other treatments besides Flomax that might help your symptoms.
听
Dear Dr. Roach: I read your recent column on grilled meat, and have a question about roasting vegetables. My daughter is a very healthy eater but loves roasted vegetables, to the point that they are quite charred, particularly brussels sprouts. Can this also be carcinogenic?
G.H.
It鈥檚 probably best not to char anything, even vegetables, but the risk is very low, and because cruciferous vegetables are so healthy, there still is probably an overall benefit.
