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Oncology (General Cancer)/Diffuse large B cell lymphoma

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Question
My mother in law 83 year old female was diagnosed with diffuse large B cell lymphoma in Nov. 2011, In her neck area.  She had radiation only, and now Feb. 2017 has progressive adenopathy in the upper left pelvis felt to account for the lefthydronephrosis.  The mass measures 4.3 cm.  there are numerous sigmoid diverticula.  Large massin posterior left mid pelvis measuring 5.1 x 5.1 cm .  There has been hysterectomy.  I take care of her and need to know what to expect and look for?  Prognosis?

Answer
I suspect given her age that aggressive chemotherapy is out; however, some elderly people with large B cell lymphoma can tolerate chemotherapy and profit from it.  Radiation to the abdomen could be administered but would be more toxic since the bowel is sensitive.  And it wouldn't cure her anyway. If no further treatment is offered to shrink the lymphoma, she will gradually get increased mass symptoms in the abdomen, eventually possibly obstructing both kidneys and possibly causing a bowel obstruction.  There are some things interventional radiologists can do to relieve obstruction temporarily.  
If she can receive chemotherapy, I'd do that; if she can't then I would suggest a good hospice program.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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