Where I get some of my reading off my chest

Lately I've been doing Google searches on diffuse large B-cell lymphoma. Apparently, this is an active field of study with a number of large trials currently being conducted. It's interesting to read about how, just in the past ten or fifteen years, it was discovered there are at least three sub-types, with my sub-type (primary mediastinal) typically appearing in young women.

When I first started this reading, I thought one of the sub-types was called "bulky". Bulky disease has a poorer prognosis, and I was glad that wasn't the kind I had. Later, I realized that bulky disease is a tumor larger than 10cm. Mine was 13cm: not heartening. Having a pericardial effusion (fluid around the heart) is also associated with a poorer outcome. Shucks.

Still, the primary mediastinal sub-type has a better prognosis than the other sub-types, with most studies 5-10 years ago finding 5-year survival rates of 70-80%. This despite about 75% of patients presenting, like me, with bulky tumors and either pericardial or pleural effusions (fluid around the lungs). And the drug Rituxam has greatly improved the treatment of B-cell cancers: survival rates up 10-20% since it became part of standard treatment. (Unlike normal chemotherapy drugs, which kill rapidly dividing cells, Rituxam kills B-cells.)

With my good response so far, I'm confident I'll have a complete remission with my chemotherapy treatment. Still, it's sobering to know there's a not-insignificant chance of a relapse: if that happened, my chances of surviving 5 years would be less than 50%.

Exactly what my prognosis is I'm not sure. The clinical trials for diffuse large B-cell lymphoma that include Rituxam have not been completed. Even without the precise numbers, though, the general idea is that I have a very good chance of being cured. And a "very good" prognosis sounds good to me.