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Medical Author:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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General health-care providers rarely undertake the sole care of a cancer patient. The vast majority of cancer patients receive ongoing care from oncologists but may in fact be referred to more than one oncologist should there be any question about the disease. Patients are always encouraged to gain second opinions if the situation so warrants this approach.

• Although medical treatments are fairly standardized, not all physicians behave similarly.
• One may choose to speak with more than one oncologist to find the one with whom he or she feels most comfortable.
• In addition to one's primary-care physician, family members or friends may offer information. Also, many communities, medical societies, and cancer centers offer telephone or Internet referral services.

Once one settles in with an oncologist, there is ample time to ask questions and discuss treatment regimens.

• The doctor will present each type of treatment, discuss the pros and cons, and make recommendations based on published treatment guidelines and his or her own experience.
• Treatment for lymphoma depends on the type and stage. Factors such as age, overall health, and whether one has already been treated for lymphoma before are included in the treatment decision-making process.
• The decision of which treatment to pursue is made with the doctor (with input from other members of the care team) and family members, but the decision is ultimately the patient's.
• Be certain to understand exactly what will be done and why and what can be expected from these choices.

As in many cancers, lymphoma is most likely to be cured if it is diagnosed early and treated promptly.

• The most widely used therapies are combinations of chemotherapy and radiation therapy.
• Biological therapy, which takes advantage of the body's innate cancer-fighting ability, is used in some cases.

The goal of medical therapy in lymphoma is complete remission. This means that all signs of the disease have disappeared after treatment. Remission is not the same as cure. In remission, one may still have lymphoma cells in the body, but they are undetectable and cause no symptoms.

• When in remission, the lymphoma may come back. This is called recurrence.
• The duration of remission depends on the type, stage, and grade of the lymphoma. A remission may last a few months, a few years, or may continue throughout one's life.
• Remission that lasts a long time is called durable remission, and this is the goal of therapy.
• The duration of remission is a good indicator of the aggressiveness of the lymphoma and of the prognosis. A longer remission generally indicates a better prognosis.

Remission can also be partial. This means that the tumor shrinks after treatment to less than half its size before treatment.

The following terms are used to describe the lymphoma's response to treatment:

• Improvement: The lymphoma shrinks but is still greater than half its original size.
• Stable disease: The lymphoma stays the same.
• Progression: The lymphoma worsens during treatment.
• Refractory disease: The lymphoma is resistant to treatment.

The following terms to refer to therapy:

• Induction therapy is designed to induce a remission.
• If this treatment does not induce a complete remission, new or different therapy will be initiated. This is usually referred to as salvage therapy.
• Once in remission, one may be given yet another treatment to prevent recurrence. This is called maintenance therapy.

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