Lymphoma is a kind of blood cancer that affects the lymph nodes and the lymphatic system. This type of cancer develops when the lymphocytes present in the body begin to grow in an uncontrolled manner. The diagnosis is done through various blood tests and a bone marrow biopsy. Treatment options include chemotherapy, radiation therapy and stem cell transplant.
Chemotherapy uses medicines to kill cancer cells and shrink tumors. You may receive chemotherapy as an outpatient or you may need to stay in the hospital for a few days at a time. You’ll have breaks between treatments so that your body can build healthy cells. Cancer is the result of uncontrolled cell growth and failure to die when it should. It can be caused by inherited genetic mutations or exposure to certain chemicals, such as formaldehyde, benzene, pesticides and weedicides.
Treatment options depend on tumor stage, phenotype (whether B- or T-cell or NK/null), histology, patient performance status and comorbidities. Currently, 6-8 cycles of CHOP chemotherapy plus rituximab is the standard therapy for most lymphoma treatment in India. This regimen is safe and effective for most patients with non-Hodgkin’s lymphoma. Patients with low-grade lymphoma may be able to avoid treatment and watch their symptoms. Some patients with advanced disease may need more aggressive therapies. These may include chemotherapy and stem cell transplant.
When cancerous cells are limited to a particular area in Stage 1 and Stage 2 lymphomas, radiation therapy can be very useful. Radiation therapy uses high-powered energy beams to shrink the tumor and destroy the cancerous cells. It can be delivered externally using radiation treatment machines such as 3D conformal radiation therapy, intensity-modulated radiation therapy (IMRT), TomoTherapy(r), and image-guided radiation therapy. It can also be delivered internally through radioactive iodine therapy and high-dose rate brachytherapy.
After the chemotherapy and radiation are done, patients should follow supportive care to prevent symptoms from coming back. Supportive care includes a balanced diet, regular check-ups, and physical activity. Patients should also take supplements and avoid smoking. It is also important to get enough sleep. This is because if patients don’t get enough rest, they may develop fatigue or other side effects. If these symptoms persist, consult a doctor for further evaluation. Patients who have undergone radiation should not receive a stem cell transplant as it could interfere with the recovery process.
Stem Cell Transplant
Chemotherapy uses powerful anticancer drugs to destroy cancerous cells and prevent them from re-growing. It may be combined with radiation therapy or stem cell transplant. Stem cell transplants are used to replace blood-forming cells that have been destroyed by radiation or chemotherapy. These cells are infused into the body through an IV. They usually come from a donor who is a family member, with HLA (Human Leukocyte Antigen) matching or mismatched to the patient.
A preparative regimen is used before the stem cell infusion to eliminate any remaining malignant cells and induce immune tolerance for the engrafted cells. The engraftment process can be allogeneic or syngeneic. After the treatment patients should follow a regimen of care that includes checking for post-treatment side effects and watching for any sign that the lymphoma is returning. The doctor will also recommend vaccinations for hepatitis B, influenza and pneumococcus. In addition, patients should wash their hands frequently, stay away from sick people and brush their teeth with clinically tested toothpaste.
A variety of other therapies may be used to treat lymphoma, particularly if the cancer has spread or when it is in an advanced stage. Usually, they are combined with chemotherapy and radiation therapy. Among the most important diagnostic tools are a biopsy and blood tests to check for abnormal levels of white cells and red cells. The doctor can also do a radioisotope scan that uses a dye injected into the blood to help see more clearly. A gallium scan is often useful, as well.
Another key test is sampling of the bone marrow, the spongy material inside bones where blood cells are produced. A sample of this tissue can help determine whether lymphoma has spread. In addition, it can be a helpful tool for diagnosis when the lymph nodes are very enlarged, as with Hodgkin’s lymphoma. It can also be useful in determining the subtype of the lymphoma. This information can help in choosing the most effective treatment.
Lymphoma treatment in India depends upon many factors and primarily the stage of lymphoma too. The majorly recommended treatments include chemotherapy, radiation therapy, bone marrow transplantation and immunotherapy. Generally, a hematologist or a medical oncologist handles the lymphoma treatments. He or she also handles the radiation therapy process.