Dr. Freddy Aviv

Honestly, it’s almost impossible to answer that from a single blood test alone.

Sometimes a patient arrives with very low hemoglobin levels, and the explanation turns out to be relatively simple. In other situations, the abnormalities may look mild at first, but further evaluation reveals an underlying blood disorder that needs closer attention.

That’s why I usually look beyond the numbers themselves. Symptoms, weight loss, shortness of breath, fatigue, and how quickly things have changed over time — all of that matters just as much.

Sometimes the picture becomes clear very quickly. Sometimes it doesn’t.

No, not at all.

Lymph nodes often remain enlarged for some time after infections or inflammatory conditions, and in many people that resolves on its own.

What concerns me more is when lymph nodes continue growing, or when they appear together with symptoms like persistent sweating during sleep together with noticeable weight changes, persistent fatigue, or fever.

That still does not automatically mean lymphoma. But in those situations, I usually recommend not postponing further evaluation for too long.

Definitely not.

Myeloma can behave very differently from one person to another. Some patients remain relatively stable for years with fairly moderate treatment, while others develop a more aggressive disease course that requires faster intervention.

There really isn’t one universal scenario here.

Age, kidney function, bone involvement, lab results, and overall health all influence the decision-making process. Treatment plans are always individualized rather than based on a fixed template.

In real life, it rarely works as “one disease — one treatment.”

There are situations where therapy should begin quickly, but there are also cases where repeating tests, monitoring changes over time, or slowing things down for a more careful assessment is actually the better option.

I usually try to understand the broader clinical picture first — how active the disease appears to be, how the patient feels overall, and how quickly things are changing.

Only after that do we seriously discuss treatment options.

Most often, patients are referred after an event such as thrombosis or unexplained clotting.

Sometimes the trigger is a family history, or situations that simply do not fit the usual pattern — for example, clotting problems in younger patients without obvious risk factors.

Not everyone needs extensive clotting evaluation. But there are cases where these tests help clarify whether long-term monitoring or preventive treatment may be necessary.

Yes, absolutely. Especially for patients living outside Israel or those who first want to better understand their situation before traveling.

Usually patients send blood work, pathology reports, PET-CT scans, biopsy results, and previous medical summaries in advance. I review everything beforehand so the consultation itself can focus on the actual medical questions rather than starting from scratch.

In some cases, a remote consultation is enough to understand the next step. In others, an in-person evaluation may still be needed later.

The reasons vary quite a bit.

Some patients simply want reassurance that the current treatment plan is appropriate. Others are searching for additional options because their disease has stopped responding as expected.

Very often, consultations involve lymphoma, myeloma, complicated bone marrow disorders, or situations where more intensive treatment approaches are being considered.

And honestly, in many cases people are not only looking for another medical opinion — they also want someone to calmly go through the situation with them, without pressure or rushed decisions.