I learned something new yesterday while reading the difference between SLL (small lymphocytic lymphoma). and CLL (Chronic lymphocytic lymphoma). When I was first told (Dec 27, 2011) what I had, my Oncologist told me I had non-Hodgkins lymphoma. It was revised in April 2011, after a lympnode biopsy, to SLL  which is also a lymphoma cancer, but was told, now it is the same as CLL.  I must say here, that when I was diagnosed with this cancer, it was already in stage 4 (Enlarged spleen, low RBC, and Platelet count under 100). I did not know that then, but that is because I didn’t ask, now of course, after much study and reading my blood results, I know. All of the remedies for helping curb SLL stage 3 and 4 growth, is now the same as CLL and SLL is actually the same as CLL.  As I read this particular article last night, I had several different reactions. I did not become angry, but I did say to myself, oh well, to late now, for a moment I felt sadness, and finally, hey, it is what it is. Plus, I really can’t get angry, at the beginning of this walk, God took a prayer that I had prayed for, more than any other, and that night in the hospital, He answered it. Finally I got a real glimpse of what the love of Christ is.

I offer this today, for those who are getting their yearly blood tests done religiously. Look at the results yourself, ask questions like, why have my platelets dropped so much in one year? Do I need other tests to see why? Ask any question or questions you may have about anything in those tests that have changed over the year. After reviewing my blood tests results from 2008 until now, it becomes apparent  that in 2008, I had a severe drop in my platelet count, going from 165,000 down to 119,000. Did SLL begin then, only God knows, but before 2008, all of my blood tests were normal.

Here are excerpts from the article: Therapy Options for CLL – vs – SLL:  It is when it comes to treatment, that differences occur. As SLL is a lymphoma, the Ann Arbor system of staging is used for SLL.

Ann Arbor staging is the staging system for lymphomas. It was initially developed for Hodgkin’s disease, but is used for non-Hodgkin’s disease as well. Stages are determined by location of the tumor:

  • Stage I : the cancer is located in a single region, usually one lymph node and the surrounding area. Stage I often will not have outward symptoms.
  • Stage II : the cancer is located in two separate regions, two different lymph nodes or organs, and both affected areas are confined to one side of the diaphragm – that is, both are above the diaphragm, or both are below the diaphragm.
  • Stage III: the cancer has spread to both sides of the diaphragm.
  • Stage IV: indicates diffuse or disseminated involvement of more than just lymph nodes, including any involvement of the liver, bone marrow, or lungs.

While this staging is entirely inappropriate for CLL, in SLL it provides for a potentially curative treatment. In stage 1 or stage 2 disease – where the lymphoma is localized to single group of lymph nodes or at least lymph nodes on one side of the diaphragm, the disease is potentially curable by involved field or extended field radiotherapy with 80% freedom from relapse in stage 1 and 62% freedom from relapse in stage 2.

Early stage SLL is defined as having enlarged lymph nodes; red blood cell, platelet and neutrophil counts all in the normal ranges, and peripheral blood ALC less than 5.0K. Bone marrow infiltration should be low, less than 30% according to some experts (but this is still a controversial cut-off point). In other words, except for a couple of pesky swollen lymph nodes everything else should look perfectly normal. This was me after looking back at my yearly blood tests in 2008.

When SLL progresses to later stages it gradually involves more and more of the lymph nodes, starts spilling over into the blood (you will see increased WBC, ALC) and infiltrates the bone marrow.  At this point, distinctions between SLL and CLL disappear for all practical purposes.  Late stage SLL and CLL are treated exactly the same way, same decision points of when to start therapy and what to use for frontline therapy etc.  Late stage SLL and CLL are the same beast, no difference.

Here is the most important take-home message as I understood it.  Early stage SLL, while it is still restricted to just a few swollen lymph nodes, before it has spread to the rest of the lymph nodes, blood and bone marrow, presents patients with a chance of possible CURE – by judicious use of targeted radiation therapy.

  • Think of it this way.  Early stage SLL is localized to a few lymph nodes only, we can hit it hard with radiation just as we can any localized lymphoma or solid cancer.  Radiation therapy has its own risks and toxicity but which of us would sneeze at the risks of radiation when weighed against the rewards of a possibly full CURE?

CONCLUSION:Radiotherapy remains the treatment of choice for early-stage low-grade follicular lymphomas (SLL). Patients who have remained free of disease for 10 years are unlikely to relapse. If you wait too long and your SLL has gradually spilled over into more and more lymph nodes, the blood and bone marrow, at that point you are no different than any other late stage CLL patient. It is no longer possible to do targeted radiation with an intention to cure.    Credit for this article:  by Chaya Venkat, 2010.

Enough crying over spilt milk, you live with what you have. The only thing that one can do, is to inform others of mistakes one makes,  and hope that it helps change someones life from just remission for several years, to a complete cure. Also I want to thank my Oncologists, who really knows what he is doing. He called it correctly that night in December, it was a lymphoma, unfortunately it was too late then for a total cure.

Now to continue our discussion: Personal Needs

In order to clarify our personal needs, we must expand our definition of the term “worth.” The sense of personal worth that we need daily may be divided into two categories: security and significance. We need to know that we are secure and significant as persons.

First, security comes from knowing we are loved unconditionally, without having to earn it or pay it back.

Second, we need to know we are accepted, just as we are, without turning over a new leaf, or promising to do better.

Third, we need know that we are forgiven for the past mistakes that continue to haunt our memories.

Only when we know that we are loved, accepted, and forgiven, can we begin to experience true security as a person.

Lets look at Spiritual Need to Love, tomorrow.

SLL/CLL not the same at first, but let it go, and it always becomes the same cancer.