Leukemia questions

I’ve just come back after a three week trip to Viet Nam. We go almost every year to visit my wife’s family, in particular her niece, the sweetest, prettiest girl in the whole world. She’s just 20 years old now. Here’s a picture of her from last year. She the one on the left. She was perfectly healthy when we got there, but a week ago started feeling feverish and had swollen glands in her throat. The day before I left she was diagnosed with leukemia and given three months to live. This is causing me more pain than I can even begin to describe, and this is the wrong forum anyway, so let me stick to questions.

  1. Would her prognosis be the same in a western country?

  2. Is there anything I can do? Any suggestions will be appreciated as I am fairly desparate at this point. If I could spend my life savings to give her a 5% chance to be cured, I would do it.

  3. Failing a cure, what can I do to make the end of her life more bearable?
    Thank you all very much. The Teeming Millions have been an incredible source of useful information for me for years. I know you’ll be able to give me some guidance in my darkest hour.

Greg

It depends on what kind of leukemia she has. If you go to the National Cancer Institutes page on leukemia at
http://cancernet.nci.nih.gov/location.html#leukemias you will find the following list, each with its own link:

• Acute Lymphoblastic Leukemia (ALL), Childhood
• Acute Lymphocytic Leukemia (ALL), Adult
• Acute Myeloid Leukemia (AML), Adult
• Acute Myeloid Leukemia (AML), Childhood
• Chronic Lymphocytic Leukemia (CLL)
• Chronic Myelogenous Leukemia (CML)
• Hairy Cell Leukemia

Another good source for information about cancer is the American Cancer Society. They, too, have a website.

It would be wrong of me, indeed a disservice, to advise on the basis of what you’ve shared. As, Yeah said, though, it really does depend on the type of leukemia. And, although I know this sounds like an arrogant Western doctor talking, it also depends on whether she does, in fact, have leukemia. In a twenty year old woman with fevers and swollen lymph glands there are certainly other diagnostic possibilities.

So, IMHO, one important thing you could do is to get the actual microscopic slides of her bone marrow sample or lymph gland biopsy (this would surely have been done to make any diagnosis of leukemia or lymphoma respectively) and send them to a reputable hematopathologist for a second opinion. Once the specific diagnosis has been confirmed, your options will be clearer.

I have no personal experience with health care in Viet Nam but I gather that it is spotty. I have some experience with health care in neighboring Thailand however and I think that there are excellent physicians and facilities in that country although they will be more expensive that what is available in VietNam.

As the above posts have said, there are many different types of leukemia. And some are more lethal than others. A good friend of mine learned she had leukemia shortly after missing a few days of class with what she thought was the flu. It’s amazing how quickly things like this can proceed.

She had some blood tests done, and was referred to another hospital. There, they told her she had leukemia. Horrible, obviously, and quite the surprise. After a few months, my friend got word from a prominent Minnesota polititian that he would fund her medical bills, and provide funds for whatever schooling she desired. After her first round of chemotherapy, her cancer subsided, and she came back to school–which was exactly what she wanted. She wasn’t able to stay for very long, but she got what she was hoping for–time with those she was closest to.

Much depends upon the diagnosis…some types of leukemia are more treatable than others, but it’s worth it to keep in mind the possible happiness she’ll feel while she’s undergoing the treatment for her disease.

My sympathies with you and your family. The advice given has been excellent and I hope you have the ability to follow through with it. Being a cockeyed optomist (and survivor) I’d go through with the lab tests and in the meantime contact any agencies that may be of help to you in the event her cancer is not as dire as the predictions. The Vietnamese Catholic Church is of great help in my area (central California) and is able to get the word out as far as fund raising goes; perhaps there is somthing similar in your area. Pictures such as the one you’ve shared are priceless in moving people to donate their time and money.

Am unsure of the medical training available during the last decades in Vietnam or where their wealthier students go abroad to study, but Southeast Asian countries often fool you - in Malaysia nearly all of the good M.D.s are trained in Austrailia, Britain or Hong Kong, and as such are excellent. Their cleanliness standards left much to be desired and their equipment wasn’t necessarily the best, but the doctors were aware of this and did have some access to the (few) best hospitals in the country. There are some US groups (Flying Doctor types) that periodically go to those countries as volunteers - I’d do all the research and run with it. You’ve got a big job ahead of you!

My best to you and your family.

Thank you all for your replies, especially Kubla Khan, who seems to have gone to effort of registering just to answer my question. I really appreciate it. You’ve given me some hope, which is something I didn’t have three days ago.

In the USA ALL is treatable about 60% of the time, IIRC. Since shes 20 years old I would bet that she has ALL. It’s very expensive and would be difficult to get her here for treatment. If I had to try I would go through the Catholic church and Catholic hospital. Maybe the Veitnamise community in the USA would pay for her transporation and treatments.

• Acute Lymphoblastic Leukemia (ALL), Childhood

I think KarlGauss is on the money. Lymphadenopathy has several causes. In someone this age, there is a good chance it is ALL (if it is leukemia) which certainly has a better than 3 months prognosis. But the most important thing is to get an accurate diagnosis, and a good hematopathologist is what you need.

FWIW, I have a friend from the United States who is doing a rotation in a clinic in Viet Nam. She says that the facilities are excellent and the staff made up of Vietnamese and US doctors. This is only one example but it’s encouraging that completely modern facilities are in the country.