Lymphoma Treatments

Written by Dale Kiefer | Published on November 14, 2014
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP on November 14, 2014

Lymphoma Treatment

Lymphoma treatment depends on its type. It also depends on how advanced the cancer is. Some slow-growing lymphomas may not need treatment for many years. These cancers are followed with a watch-and-wait approach. Treatment isn’t started until they become symptomatic.

Other, more aggressive cancers may require intense treatment. This usually involves a combination of:

  • chemotherapy
  • radiation
  • medications

Radiation

Radiation is one of the main treatments for lymphoma. It uses high-energy beams to destroy tumors. The energy is carefully focused on target areas to kill cancer cells. The goal is to minimize damage to healthy tissues. Whole-body radiation can also be used to destroy tumor, normal, and stem cells before a transplant.

Individual radiation treatments are fairly rapid. However, it usually has to be done five days a week for several weeks.

Side Effects

The procedure itself is painless. However, it can cause side effects including:

  • skin changes, like sunburn
  • dry mouth
  • fatigue
  • nausea
  • diarrhea

Radiation may also increase the side effects of chemotherapy. The treatments are often used together for more aggressive cancers.

In the long-term, radiation may increase the risk of developing other cancers. It can also cause damage to nearby organs.

Chemotherapy

Chemotherapy is an important part of lymphoma treatment. It involves the use of anti-cancer drugs. They are usually infused directly into the bloodstream. This is especially helpful when tumors may have spread throughout the body. Radiation is impractical under such circumstances.

Chemo drugs may also be injected directly into the cerebrospinal fluid. This is done to treat brain and spinal cord tumors. Such therapy is called intrathecal chemo.

Chemotherapy is usually given in cycles. Each treatment usually takes an hour or more. Usually, treatment will be given for several days in a row. That is followed by a rest period. Most people receive multiple cycles of treatment. 

Generally, two or more drugs are used in each cycle. This maximizes overall effectiveness. Using multiple drugs means cancer cells are attacked in a number of different ways. In addition, some drugs work better together than on their own. This effect is called synergism. Using several drugs in lower doses also has another benefit. It helps reduce potential side effects, without sacrificing effectiveness. In addition, it reduces the risk of drug resistance. 

Side Effects

Chemo targets and destroys cells that are dividing quickly. This is a defining characteristic of all cancers. However, certain healthy cells also divide rapidly. These include:

  • hair follicle cells
  • bone marrow cells
  • cells lining the mouth and digestive tract

As a result, these tissues are affected by chemo drugs. This accounts for the side effects of chemo that include:

  • hair loss
  • nausea and vomiting
  • mouth sores
  • loss of appetite
  • fatigue
  • increased susceptibility to infections

Fatigue and infection risk are increased because new blood cells are made in the bone marrow. Red blood cells deliver oxygen to help keep you energetic. White blood cells help to fight infection.

Immunotherapy

Immunotherapy includes several new technologies. These harness the body’s own immune system to identify and destroy cancerous cells.

Antibodies are the targeting proteins of the immune system. Drug companies have developed man-made antibodies that bind to lymphoma cells. These antibodies can be used to target radiation or chemotherapy to the cells. They can also be used to attack the cells directly. Examples include:

  • rituximab
  • ibritumomab
  • alemtuzumab

Interferon

Interferons (IFNs) are proteins used to slow the growth of cancer cells. The three major types of interferons are alpha, beta, and gamma. These proteins are normally produced by white blood cells to help fight infection. Man-made interferon can shrink or halt the growth of some lymphomas.  It may be given in addition to chemo.

Interferon is rarely used because of its side effects. These include:

  • vomiting
  • weight loss
  • flu-like symptoms
  • fever
  • general weakness
  • depression
  • dizziness
  • dry mouth

Immunomodulating Agents

These drugs weaken or “modulate” certain aspects of the immune system. How they treat lymphoma is not yet understood. The two drugs in this class are thalidomide and lenalidomide.

Immunomodulating drugs are usually only used after other treatments have failed. Their side effects can be severe. They include:

  • serious blood clots
  • painful nerve damage
  • severe constipation
  • fatigue

These drugs also cause birth defects. They must never be given to pregnant women.

Stem Cell Transplants

Stem cell transplants are infrequently used to treat lymphoma. However, the use of this technique is gradually increasing. Transplants may be appropriate when a patient is in remission and the disease is no longer active. They may also be used if there is a relapse during treatment.

There are two main types of stem cell transplants.

Allogenic Transplants

These transplants use a donor’s stem cells. These can be collected from the:

  • bone marrow
  • circulating blood
  • umbilical cord blood

This type of stem cell transplant is of limited value. It can be hard to find a good donor. There is also the potential for serious side effects.

Autologous Transplants

These stem cell transplants make use of a patient’s own cells. Stem cells are harvested from the bone marrow or peripheral blood. This avoids side effects related to compatibility. Unfortunately, it is only feasible if the patient’s disease has not spread to the bone marrow or blood.

Harvested blood can be treated to remove lymphoma cells. However, there is always a risk of reintroducing cancerous cells.

Novel Lymphoma Treatments

In recent years, several promising new treatments have emerged. Participating in a clinical trial can be a good option for people with treatment-resistant lymphoma. 

It’s important to remember these trials are research studies. They are not necessarily safe for all patients. Clinical trials may provide enormous benefits. However, they can also pose harmful side effects. The risks should be carefully considered beforehand.

Several new treatments for lymphoma are currently being investigated.

Vaccine Therapy

Vaccine therapy is a type of immunotherapy. It teaches your immune system to fight cancer cells. It is similar to a vaccine for a disease. However, the vaccine uses proteins found on your cancer cells. In addition, this type of vaccine is aimed at reducing existing cancer. It’s not a form of prevention.  

Cancer vaccines are investigational treatments. They are not yet widely available.

High-Dose Chemotherapy With Stem Cell Transplant

This treatment is usually used when less invasive treatments do not work. High-dose chemotherapy is used to aggressively attack cancer cells. However, treatment damages stem cells. Therefore, it’s followed with a stem cell transplant.

Some insurance companies consider this to be an experimental treatment. It can be very expensive.

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