Tuesday, November 27, 2007

Burkitt's Lymphoma

Several people have asked me about Burkitt's Lymphoma and the symptoms. This is a summery of my two week cram course on this very rare and aggressive cancer. Hopefully my doctor friends are not to critical of my simplified explanation. This is a 101 lesson.

Lymphoma and Leukemia are very similar. They both attack the immune system. The primary difference is just how they process through the body.

Lymphomas fall into two categories, Hodgkin's, and the more serious non-Hodgkin's. Burkitt's is one of several non-Hodgkin's Lymphomas.

There are only around 200 cases of Burkitt's Lymphoma reported in the U.S. each year. There are two general types of Burkitt's. The more common is endemic Burkitt's, which begins in the neck. It effects primarily children of African decent (it is the most common childhood cancer in Africa), as well as occasionally adults with weakened immune systems.

The much less common version is sporadic Burkitt's, which is what Tyler has. It exclusively attacks caucasian children ages 10-20 (most commonly boys, ages 12-15, in the U.S and U.K.). In most cases the children are healthy and active with no prior symptoms or conditions. Researchers have been unable to find any connection to genetics, lifestyle, viruses, etc. It is the fastest growing cancer known, capable of doubling in size every 72 hours. It is commonly misdiagnosed for several months, ussually as a stomach flu, irritable bowel syndrome, colitis, or Chrome's decease. Over a four week period, Tyler received two rounds of x-rays and blood tests for stomach pains, and nothing was found. We were at children's two weeks ago meeting a G.I. specialist about colitis when the first tumor was found.

Sporadic Burkitt's begins in the abdomen and is immediately graded as stage III cancer. It very quickly expands into the bone marrow and central nervous system, upgrading it to stage IV (the highest staging). Once it gets into the central nervous system and spinal fluid, the treatment options become very problematic. Experimental trials become the primary option.

Tyler's cancer has expanded into his bone marrow, making him stage IV, but was caught before moving to his central nervous system. Because of the serious complications in treating the central nervous system, Tyler is receiving three Chemo injections per week directly into his spinal fluid. They are also testing his spinal fluid each time for any signs of cancer in his central nervous system. Every spinal fluid test has come back completely clear. These test and Chemo treatments will continue, three time a week, for a long time.

Because this cancer expands through the entire lymph node system, surgery is not really a treatment option. Radiation has not shown to be an effective treatment either. The good news about this form of Burkitt's is that, with aggressive Chemotherapy treatments, this cancer dies as fast as it grows. It recent years they have developed an aggressive Chemo "cocktail" of seven Chemo drugs at very high doses. This has been successful is about 70% of those with stage IV Burkett's, as long as it is not expanded into the central nervous system. It appears Tyler is in that 70%. After his first round of Chemo, which is the "mildest" of the Chemo treatments we will receive, the cancer is reduced by about 30%. He is now on day two of his second round, which is the beginning of the most intensive Chemo treatments. Typically, it takes about 6-10 rounds to be cancer free.

After treatment the news is also good. Once in remission, Burkitt's rarely returns, and almost never after two years of remission. Further, since Burkitt's is not connected to any other deceases, there is no greater likelihood of other deceases or complications. Once Burkitt's is beaten, there is every expectation of living a normal and healthy life without adjustments or complications.

The greatest blessing we have received are:

---Our G.I. specialist felt the primary tumor. Two days earlier Tyler's pediatrician could not feel it. The x-rays and blood tests from two days earlier did not pick up anything.

---A wonderful friend who is a radiologist at children's that quickly saw what it was and was tremendous help getting us quickly through the process.

---An extensive list of family and friends (and their family and friends) that have been praying for Tyler.

---A quality team of Oncologist that are willing to discuss and explain all the treatments and options.

---All of this serving to identify and attack the cancer before reaching the central nervous system.

---And above all, a God that has used all these people to begin the process for healing Tyler of this terrible disease.

Please pray for:
---Continued wisdom by the doctors in treating Tyler.
---Our other three sons. Cancer does effect the entire family.
---The continued strength as he fight the pain of the treatments.
---Continued shrinking of the cancer and clear spinal fluid.
---All the many other families here on the Oncology floor. There are a few other teenage boys here, but we have not been able to meet them. Each one has been in isolation.

1 comment:

jd said...


Excellent news and update! Al Michaels said it best after the USA hockey team wiped the Russian Commies..."Do you believe in miracles??!!" On a much grander scale, we've got a miracle in the making with Tyler's progress (as tears well up in my eyes).

BTW, the answer to yesterday's trivia question: Super Bowl III, the Jets vs. the Colts. Matt Snell was the Jets FB and Tom Matte was the Colts RB. Both wore #41.


JD, Val, Kari & Tara