Non-Hodgkin Lymphoma treatment

The treatment team will discuss the treatment options with the patient after they have been diagnosed with non-Hodgkin lymphoma.  There, the treatment options will be discussed.  There are several different types of treatment for non-Hodgkin lymphoma.  The choice of treatments depends on the stage of the cancer and the type of lymphoma the patient has.  Each case is unique and requires a different treatment plan.  Treatment is designed to help the patient recover from their disease.

There are several different treatment plans available for non-Hodgkin lymphoma. These include immunotherapy, chemotherapy, stem cell transplant, radiotherapy, and targeted therapy.  There is no surgery that can treat this type of disease.

There are many types of healthcare providers who work on patient’s with non-Hodgkin lymphoma. These include a radiation oncologist (who uses radiotherapy to treat the patient), a medical oncologist (who uses chemotherapy to treat the cancer), and a hematologist (who is a doctor who treats blood disorders like non-Hodgkin lymphoma. There are many other healthcare providers when a patient is being treated for lymphoma, including social workers, nutritionists, nurses, and nurse practitioners.

It is essential to discuss all of the treatment choices with the specialists, including how they work and what to expect in the way of side effects.  The doctors will help the patient decide what treatment is best for them.  In selecting a treatment plan, the doctor will consider the stage of the lymphoma, the type of lymphoma, and the overall health of the patient.  The patient needs to make sure that they understand all of the benefits, risks, and side effects from each treatment option.  It is not unusual to get a second opinion when dealing with this type of cancer. 

Before starting the treatment , the patient needs to make an appointment with their family doctor for a pre-treatment evaluation.  This includes a history, physical examination, blood tests, and possibly an EKG or chest x-ray.  These things will be forwarded to the hematologist prior to being treated for lymphoma. 

Because visits to the specialist can be short and there is often a lot to say, the patient should prepare by having a list of medications ready to ask the doctor.  It is a good idea to bring along a friend or loved one to the doctor’s visit.  This person may be able to ask questions the patient forgot to ask and may remember the doctor’s answers if the patient can’t remember them after the visit. 

It is a good idea to stop smoking once you have the diagnosis of non-Hodgkin lymphoma.  Smoking can interfere with healing and should be stopped even after the treatment is over with.  Smoking is unhealthy and the patient needs to be healthy if they are going to recover from the disease. 

After treatment for non-Hodgkin lymphoma, the patient may be cured of the disease.  Completing treatment can be both exciting and stressful.  The patient may be relieved that treatment has finished but will continue to worry that it might come back again.  When the cancer returns, this is called a “recurrence”.  It may take time before the patient actually knows and believes that they have been cured of the disease. 

For some patients, the non-Hodgkin lymphoma will not resolve after an initial round of chemotherapy.  Should this occur, the patient may need to have another round of chemotherapy or may be a candidate for immunotherapy or targeted cell therapy.  If these don’t work, the patient may ultimately die of the disease.  The goal is to keep the patient alive for as long as possible using whatever means necessary to keep the patient alive. 

When the patient has completed the treatment for lymphoma, the doctors will want to watch them very carefully.  It is essential that the patient follow up at all of their appointments to make sure the cancer doesn’t come back.  During follow up visits, the doctor will examine the patient and will ask questions to see if the patient is recovering.  Blood tests and possibly imaging tests may be done to see if the cancer has stayed in remission.  Follow up care is necessary to make sure the cancer has not metastasized.

If the disease does return after a period of time, different chemotherapy medications will be attempted or the patient will go on immunotherapy or targeted cell therapy.  The treatment given after recurrence of the disease depends on the doctor’s and patient’s preferences and on the stage of the disease at the time of the recurrence. 

It is possible that the patient could have long term side effects from the lymphoma or from the treatment for the disease. Side effects can last for many months after surgery or longer, depending on what treatment as given.  Some side effects, such as the ability to conceive a child, are permanent.  Others are temporary and will go away after a period of time.  The type of side effects the patient has depends on the treatment that was given.

Some patients will develop a second cancer after being treated for non-Hodgkin lymphoma.  This is because the radiation treatments given for the disease can interact with normal cells, turning them into cancer that can show up years after being treated for the original cancer.

After therapy for lymphoma, the patient may be unable to conceive a child.  If the patient is a male, he may want to bank some sperm cells to be used in the future should he eventually want to have a child.  Women with lymphoma may stop having menstrual cycles after having the disease and may have reduced fertility.  The banking of eggs is also a possibility for women with lymphoma but it must be done prior to treating the disease. 

Treatment for non-Hodgkin lymphoma is done whenever there is documented evidence that the patient has the disease.  There is no surgery for this disease and the patient needs to rely on chemotherapy, radiation therapy, targeted cell therapy, and immunotherapy to treat the lymphoma. 

It may be difficult to completely clear up even a low grade lymphoma.  Fortunately, the patient can be kept alive for many years while being treated for the disease on a long-term basis. About ninety percent of patients will still be alive after five years following the diagnosis of stage 1 disease.  After stage 2 disease, about 90 out of every 100 individuals will be alive after five years. Those with stage 3 and stage 4 disease have an 80 percent chance of survival after five years.