Lymphoma (cont.)
IN THIS ARTICLE
Other Therapy
Watchful waiting means choosing to observe and monitor the cancer rather than treat it right away. This is strategy is sometimes used for indolent recurrent tumors. Treatment is given only if the cancer starts to grow more rapidly or to cause symptoms or other problems.
Stem cell transplantation is usually not used as a primary therapy in lymphoma.
- Stem cell
transplantation is usually reserved for lymphoma that has been previously
treated into remission but has recurred.
- Stem cell therapy as primary therapy has been used for aggressive T-cell NHL in first remission, usually as part of a clinical trial. Stem
cell therapy is also considered when standard primary treatment is unable to
control the lymphoma and achieve remission.
- This procedure, which requires a lengthy hospital
stay, involves very high doses of chemotherapy to kill the aggressive cancer
cells.
- The chemotherapy doses are so high that the
chemotherapy also stops the patient's bone marrow from
producing healthy new blood cells.
- The patient then receives a transfusion of healthy bone marrow or blood stem cells, either from previously collected stem cells from the patient himself or herself (called autologous transplantation) or from a donor (called allogeneic
transplantation), to "kick start" the bone marrow into producing
healthy blood cells.
- This is a very intensive therapy with a lengthy recovery period.
An oncologist may belong to a network of investigators who offer novel treatments for various types of cancers. These novel therapies are newer agents that have been recently developed, and extensive data on treatment results are not yet known. Such new agents can be offered in the context of a clinical trial. Usually, a consent form that explains the drug, its known side effects, its potential side effects, and alternatives to the drug treatment are presented to the patient. If the treatment seems promising for the particular subtype of lymphoma, and the patient is fully appraised of the potential benefits and risks associated with such treatment and is interested in receiving such treatment, then the consent form is signed by the patient and the managing physician, and possibly other involved parties. The patient is then enrolled in a treatment protocol that specifies exactly how a patient is to be treated with the new therapy.
Alternatively, an oncologist may refer a patient to another institution to receive investigational treatment or intensive treatment, such as a stem cell transplant.
Complementary/alternative therapies
Several alternative therapies have undergone preliminary testing in lymphoma. None has been found to work better than or as well as standard medical therapies. A few therapies, still felt to be experimental, have been found to be potentially helpful as complements to medical therapy, however.
- Acupuncture has been
helpful in relieving musculoskeletal symptoms, as well as in
controlling nausea and vomiting associated with chemotherapy.
- The supplements coenzyme Q10 and
polysaccharide K (PSK) are undergoing further evaluation to determine their
effects on treatment outcome. Both drugs have immune enhancing properties. PSK
has been used more extensively in Japan as part of an anticancer therapy.
- Neither of these therapies has undergone extensive blind studies and cannot be considered a part of any planned therapeutic endeavor.
Next: Next Steps »
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Lymphoma, B-Cell »
Non-Hodgkin lymphoma (NHL) is a heterogenous group of lymphoproliferative malignancies with differing patterns of behavior and responses to treatment (Armitage, 1993).
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