Internation Prognostic Index

I saw my oncologist yesterday for a check-up. I had low, but not dangerously low, white blood cell counts. So he decided to give me a boost in my next IV during chemo that will probably stop my wbc's from dropping next cycle. I picked up some Emend for next round too for anti-nausea. They are also going to give me some stuff that will help bone regrowth for my hip. Then I mentioned that I was having trouble getting to sleep the last couple nights, so he prescribed me some sleeping pills. I am becoming a walking pharmacy. I took the sleeping pill last night and went into a coma.

The Ann Arbor staging system is the common system used to define the stage of Non-Hodkin's Lymphoma (NHL):
I. Lymphoma is in lymph nodes in one region
II. Lymphoma is in two groups of nodes on the same side of the diaphragm
III. Lymphoma is in groups on both sides of diaphragm
IV. Lymphoma is widespread in an organ or organs, skin, or bone marrow.

Then they use letters after the stages. They put a 'B' after the stage if the patient is experiencing 'B' symptoms, which are soaking sweats, high fevers, and unexplained weight loss (I don't have these). If you don't get a 'B', then you get an 'A'. You can also get an 'E' if the lymphoma has spread into an organ or bone from a lymph node.

Notice that none of these stages include having lymphoma in BONE. I don't have any swollen lymph nodes in my body. So, they are going to give me Stage Ie if it is just in my hip. My situation is extremely rare, however, they have had a lot of success in those rare cases of lymphoma in bone. If I have lymphoma in my back bone too, then it counts as widespread and I am jumped to Stage IV...the treatment would be the same though, just a little longer. If I have lymphoma in my spinal fluid, I am also stage IV, but then they add chemotherapy that they inject into my back.

The Internation Prognostic Index is used to help a patient know their odds of successfully overcoming their lymphoma. You get one point if you have any of the following:
- age over 60
- stage III or IV
- presence of lymphoma outside of lymph nodes
- poor performance status...needing lots of help with daily activities
- elevated serum LDH

Right now, I can kind of get a point for presence of lymphoma outside of lymph nodes, but they are really talking about it being in other organs and stuff, since it just doesn't occur in bone. I do need a little help with daily activities, but that is just because I am in a wheelchair, they don't give me a point for that. My LDH was normal and I am well below 60 years old. So, my IPI is kind of 1 (or less) right now, it will kind of go up to 2 if I am in stage IV. IPI of 0 or 1 is "low" and 4 or 5 is "high". Therefore, my IPI is low, and it is basically going to stay low even if I am in stage IV. A low IPI means the best prognosis. 75% of people with low IPI for their Lymphoma live longer than 5 years. That stat is for all lymphomas, and since my lymphoma is a "good" lymphoma, I probably have even better odds. And odds are just odds, and are pretty much pointless, because really you either get over it or you don't. When you get bad news, it is all about your perspective, if you need odds to get your brain around your situation, then you get the odds. I don't need ignorance to make myself feel better, so I figured my odds. The important thing to remember is that you can always deal with any situation as it comes, and you always have a choice of how you are going to deal with adversity. Choose to be miserable or choose the way that makes yourself and others better off and be thankful for what you have.