Diagnosis X

Pathology interests me. From miniscule HIV pathogens to the rotting green flesh of gangrene, deviations from normal human physiology capture my attention. I already want to be a medical doctor, and I have been pursuing this path now for nearly two years. I deal with health issues ona daily basis, as I confront children with obesity, diabetes, respiratory infections, non-accidental trauma, or adults with psychiatric disorders and IV lines running left and right. I hold crying babies to soothe, and assist 80 year old women to the commode, helping them retain their dignity.

However, nothing reminds you, so starkly, that these patients are living creatures than when your own family is diagnosed.

My mother, yesterday afternoon, was typed and staged: Stage IV Mantle-Cell Lymphoma, aggressively growing, with a typical presentation. She has splenic involvement and pleural effusion (meaning it is in the lungs).

1. Lymphoma: Cancer of the lymph nodes; in this, the spleen is considered a lymph node, and not organ involvement
2. Cancer: Uncontrolled growth and spread of abnormal cells, which have typically lost normal growth cycle regulation
3. Stage IV: Abnormal cells have been found in several lymph nodes as well as either (A) organ involvement, or (B) specific symptoms unique to the specific diagnosis
4. Aggressive: Fast-growing; slow-growing lymphomas are called "indolent"
5. Mantle-Cell: MCL, a subtype of lymphoma

Mantle-cell lymphoma (MCL) is a form of Non-Hodgkin's lymphoma, stemming from abnormal B-lymphocytes. It is a fairly rare subtype of lymphoma, accounting for roughly 6% of NHL, and generally attacks men at a 3:1 ratio to women, usually aged in the late 50s and 60s.

Unfortunately, the prognosis isn't exactly heartwarming:

Mantle cell lymphoma is an aggressive Non-Hodgkin's lymphoma that historically been resistant to current standard chemotherapeutic approaches. Despite response rates to many regimens of 50% to 70%, the disease would progress after chemotherapy with a median survival time of approximately 2.5 to 4 years.

Time will tell. Until then, it's a constant reminder that my patients are sons and mothers and lovers, not just pathology incubators. I've always known this, especially when I bemoan a lonely, fussy baby whose parents would rather go outside and smoke, but even I forget the impact of losing that.

Resources:
http://www.lymphomainfo.net/nhl/types/mantle.html
http://www.leukemia-lymphoma.org/attachments/National/br_1172589724.pdf