Non-Hodgkin's lymphoma occurs when lymphocytes (a white blood cell) in the lymph nodes begin changing and multiplying out of control to form tumors.
Most types of cancer in the lymphatic system are grouped together under the name non-Hodgkin's lymphoma.
Marshfield Clinic has Cancer Specialists who are trained specifically in the diagnosis and treatment of this disease.
There are about 30 different kinds of non-Hodgkin's lymphoma and treatments may vary across the range of the disease. However, there are some standard treatment forms that apply to most cases.
Surgery is generally not an effective treatment for non-Hodgkin's lymphoma and is used only to obtain a biopsy to determine an accurate diagnosis.
Chemotherapy drugs interfere with the growth of cancer cells, eventually causing them to die.
Chemotherapy treatment is used to shrink the tumor, keep the tumor from spreading, kill cancer cells that have spread to other areas of the body or relieve symptoms related to cancer.
Chemotherapy, often combined with monoclonal antibody treatment, is the most common treatment for non-Hodgkin's lymphoma.
Biologic therapy: also called immunotherapy, is a form of cancer treatment that uses the body's immune system to fight cancer.
It is generally used together with other cancer treatments to improve treatment effectiveness or to decrease side effects.
Monoclonal antibodies: Monoclonal antibodies are laboratory-made drugs that find and attach to specific places (proteins) on the surface of cancer cells.
When they attach, they stop the protein from doing its job, such as making cancer cells grow. Monoclonal antibodies can be used alone or in combination with other therapies.
Radiation may be used for treatment of non-Hodgkin's lymphoma in certain circumstances. This treatment uses high-energy X-rays to kill cancer cells.
A team of trained personnel determines if this type of treatment is right for your cancer. Radiation therapy that may be used for non-hodgkin's lymphoma includes:
IMRT - Intensity Modulation Radiation Therapy (IMRT). This allows the radiation oncology team to:
- Customize a patient's treatment to the size, shape and location of the tumor.
- Minimize the amount of healthy tissue that is exposed to radiation.
- Treat tumors previously considered untreatable.
TomoTherapy® - a form of IRMT that delivers highly precise radiation therapy from all angels which can be used for many tumors, including those that are hard to reach. TomoTherapy targets tumors using built-in CT scanning to confirm the shape and position of the tumor before each treatment.
IGRT - Image Guided Radiation Therapy combines scanning technology with radiation therapy to provide the most targeted treatment in the shortest time span.
TBI - Total Body Irradiation is important in stem cell transplantation. TBI is radiation therapy that is given to the whole body. TBI is used to:
- Kill cancer cells that may be in places the chemotherapy cannot reach like bones, brain and ovaries.
- Suppresses the immune system and prepares the body to accept the new donor stem cells.
Stem Cell Transplantation
In certain circumstances, use of higher doses of chemotherapy or radiation therapy may be used to treat non-Hodgkin's lymphoma.
Because radiation therapy and chemotherapy destroy stem cells when they eradicate cancer cells, stem cell transplantation is used to rebuild a patient's supply of those cells.
In stem cell transplantation, before a patient begins radiation or chemotherapy doctors give the patient a medication to increase the number of stem cells in the blood, and then collect stem cells, a process called apheresis.
After the stem cells are removed, the blood is returned to the body. There are two forms of stem cell transplantation:
- Allogeneic stem cell transplants refer to stem cells that are taken from one person and given to another. With these transplants, the donor's cells must match the recipient's.
In many cases, the stem cell donor is related to the recipient, typically a brother or sister.
However, stem cells from unrelated donors can be used if the tissue types matches. It may also be possible to use cells from banked cord blood.
- Autologous stem cell transplants are performed when high doses of chemotherapy are used to treat cancer.
The chemo drugs can destroy the patient's bone marrow, so some stem cells are taken from the blood stream (apheresis) prior to treatment.
The stem cells are frozen and the patient is given high-dose chemotherapy (with or without radiation) to treat the cancer.
The stem cells are then thawed and given back through a catheter to replace what was destroyed. Autologous stem cell transplant is most commonly used for non-Hodgkin's lymphoma.