How to find a specialist

Hello all

I have a rare form of lymphoma called lymphocyte predominant hodgkins disease. It is slow-growing, responds well to treatment, but often relapses. I am just diagnosed with replase number two, after remission periods of 10 years and a further 8 years following treatment with conventional chemo. The promises of cure faded out some years ago, and it looks like I am in the rare group of patients who continue to relapse no matter what. The rarity of this illness means that few oncologists/haematologists have experience of treating it. To complicate matters, I have moved to a different part of the country and have a new consultant who has only met me once. He rather shocked me by suggesting I need to have high dose chemotherapy and a stem-cell transplant, which is something I do not think previous consultants were considering. In fact, he seems unwilling to discuss any other options and is not too keen on discussing this one in detail. However, I know people who have undergone this technique, and are still relapse free 20 years later: albeit people who were 25 years younger than I am now. They all warn it takes a extreme toll on your overall long-term health, and that it should only be considered 1) as a last resort and 2) if there really is a chance of cure. I have long-term health problems from the regular chemo, so the idea of having even more serious ones fills me with dread. if the prospect is living a few more years in a state of permanent illness, frankly I do not want it. 

I'm going to see my GP later today to ask him to refer me for a second opinion. However, that might be someone who has equally little experience of treating this condition. Can anyone advise on how I might find someone who knows this illness well, and has experience of managing patients who continually relapse?

  • Hello LPHD,

    Thank you for your posting.  You say you were planning on seeing your GP on the 13th so it is likely that you have already discussed a second opinion.  So I hope the following information will be relevant and helpful.

    In some cases of relapsed nodular lymphocyte predominant Hodgkin’s disease a stem cell transplant is considered.  This is in line with what the current clinical guidance about this type of cancer say. There are different types of stem cell transplant so it would be good idea if your specialist doctor could discuss this in more details with you and tell you what the expected outcome for you would be.  We have some information about stem cell transplants here  

    You want to see a doctor who has experience with this specific type of Hodgkin’s lymphoma so I looked at this guidance to see who wrote it as this may be a good indicator of who specialises in it. Several UK specialist heamatological oncology teams contributed to it. However without knowing what part of the country you’re from I cannot tell you where the nearest centre would be for you, the teams are:

    Beatson Cancer Centre in Glasgow

    Velindre Hospital in Wales

    John Radcliffe Hospital in Oxford

    London hospital’s - University College, The Royal Free and St Bartholomew’s

    I think it would also be safe to say that Southampton General hospital has a reputable heamatology oncology unit.  Also The Christie in Manchester and the Royal Marsden in Sutton and Surrey have distinguished units and will have doctors who know how to treat this.

    You might find that the information from the Lymphoma Association about how to treat nodular lymphocyte predominant Hodgkin’s lymphoma is useful and you can see it by clicking here

    You may also want to speak with them by telephoning on freephone 0808 808 5555

    I hope this reply has been useful.  We are evaluating the nurse service at the moment so it would be really helpful if you could complete the short survey that you can see here

    If you have any other questions do contact us again. If you would like to telephone our Freephone number is 0808 800 4040. We are here from Monday to Friday between the hours of 9am to 5pm.

    Take care

    Caroline