If you are diagnosed with Non-Hodgkins Lymphoma, you have several options regarding treatment of your disease. You can combine treatment options to ensure the most effective and aggressive treatment or depending on the type or stage of cancer that you are in, you may pursue options different from other patients with Non-Hodgkins Lymphoma. The treatment that will work for you depends on the type of Non-Hodgkins Lymphoma that you have, the stage you are in, your risk score, age, overall health and your preferences. If you have indolent, or slow growing lymphoma, your doctor most likely will opt to wait to treat you, while active lymphoma should be treated immediately. You may also want to try taking part in a clinical trial, which could be beneficial to patients not responding well to their current treatments. To give you a better understanding, the most common treatment options are described below.
Chemotherapy
Chemotherapy may be used alone or in combination with other treatments to offer patients the best survival rate and long-term remission. The goal of chemotherapy treatment is to either eradicate all signs of the disease or slow down progression of the cancer. Chemotherapy is the use of medications to destroy or slow down the growth of cancer cells. Patients have several options of which chemotherapy medications to take to treat their particular type of cancer and many times, more than one chemotherapy drug is taken at one time.
It is also common to combine chemotherapy with a type of immunotherapy called monoclonal antibody therapy. Cancer that has spread to the central nervous system may be treated with chemotherapy medication injected directly into spinal cord fluid with a process called intrathecal chemotherapy.
Radiation Therapy
When Non-Hodgkins Lymphomais discovered in an early stage and the cancer is limited to a small area of the body, radiation therapy may be used for treatment. If the lymphoma is slow growing and in an early stage, radiation may be the only form of treatment needed for the patient, but more often, radiation therapy is used in combination with other treatments. Depending on the specific diagnosis of the patient, different doses may be given and different areas of the body will be treated with radiation therapy. With Non-Hodgkins Lymphoma, radiation is directed at the neck, chest and lymph nodes under the arm, also called the mantle field. Radiation may also be directed at other areas of the body or only to the area of the body where the cancer is located and nearby lymph nodes.
Immunotherapy
Immunotherapy, or biological therapy, is a form of treatment that uses the immune system in disease fighting. Since immunotherapy is considered a new approach to treatment, many times it may be offered through clinical trials so there may be some research involved in finding immunotherapy that works for you and your particular situation. Immunotherapy can be very effective treatment for Non-Hodgkins Lymphoma and there are several different types for patients to choose from.
Some immunotherapy treatments Non-Hodgkins Lymphoma patients are taking part in:
Monoclonal Antibody Therapy
Monoclonal Antibody Therapy is the most common immunotherapy and is used for almost all Non-Hodgkins Lymphoma patients, usually in combination with chemotherapy. Rituximab is a monoclonal antibody therapy that is used and it works by marking specific types of cells in the body as foreign cells, such as B lymphocytes. The foreign-marked cells are then attacked by the body's immune system.
Radioimmunotherapy (Monoclonal Antibodies with Radiation)
Radioimmunotherapy is the use of monoclonal antibodies to carry direct radiation to cancer cells. Using the same general idea as monoclonal antibody therapy, radioimmunotherapy takes the process a step further by attacking B lymphocytes with direct radiation into the diseased cells.
Often, this treatment is sought when certain types of B-cell lymphomas do not respond well to current treatment or when cancer has recently relapsed. It is also being studied to be used as one of the first options for treatment when diagnosed with Non-Hodgkins Lymphoma, possibly in combination with chemotherapy. This type of therapy could also prove useful as a form of preparation for the body before having an autologous transplant, which is a transplant using the patient's own blood-forming cells.
Interferon Therapy
Interferon Therapy is being studied in clinical trials to figure out the most effective way of using it and whether it should be used in combination with chemotherapy or with other forms of therapy. This type of therapy works by using proteins that are produced by the body to fight infection or cancer, which are called interferons. The specific type of interferon used to treat Non-Hodgkins Lymphoma is called interferon-alpha (INFa). This type of treatment has shown in some studies to be effective in shrinking lymphomas and lengthening remission time for some patients with follicular lymphoma, indolent T-cell or hairy cell lymphoma.
Bone Marrow or Cord Blood Transplant
When other treatments are not working properly for patients or to aggressively treat fast-spreading lymphomas, bone marrow or cord blood transplants offer patients a higher chance of long-term remission from cancer. With the use of the patients own blood-forming cells or those collected from a donor in combination with radiation or high-dose chemotherapy, patients are given a renewed chance at long-term survival. There are risks involved with this type of treatment and not every patient is eligible. Generally, patients considered for this type of treatment:
- Are younger (however, with new medical advances older patients have successfully completed this treatment)
- Are healthy
- Have a suitable donor or cord blood unit
There are two general methods for performing this treatment. Autologous transplants use blood-forming cells taken directly from the patient. Allogeneic transplants use blood-forming cells from a family member who donates blood, cord blood or from an unrelated donor. You may be considered for a transplant if:
- You have Follicular Lymphoma AND
- You are not responding well to your first treatment
- You haven't been in remission for 12 months or more before relapsing
- You relapsed more than once
- Your lymphoma has developed into scattered large B-cell lymphoma
- You have Diffuse Large B-cell Lymphoma AND
- You have relapsed one or more times
- You are in your first complete remission and your IPI risk score is high or high-intermediate
- You do not reach complete remission after your first treatment
OR
- You have Mantle cell lymphoma and have already had your first treatment
What Happens During a Transplant
During an Autologous Transplant, the patient's own blood-forming cells are collected from the blood stream or bone marrow. This process usually occurs after the cancer is already in remission. The patient is then treated with high-dose chemotherapy, radiation therapy or immunotherapy to kill the cancer cells in the body. After blood-forming cells are also destroyed with whichever therapy used, the patient's own blood-forming cells are returned to the body. Performing this type of transplant makes it possible for doctors to use high-dose treatment that may not have been an option otherwise.
An Allogeneic Transplant is performed the same way as an Autologous Transplant, only Allogeneic Transplants use a donor's blood-forming cells. An Allogeneic Transplant also presents a higher risk of side effects for patients. These types of transplants are beneficial though because the rate of relapse is lower afterward. The reason for the lower relapse rate could be that the donated immune cells attack the cancer cells. However, many studies have shown that patients undergoing autologous transplants have slightly higher survival rates than those who have had an allogeneic transplant.
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You may be awarded money if you were exposed to Benzene & now have Non-Hodgkins Lymphoma
