There are many differing treatments for patients with Non- Hodgkin's Lymphoma. The main types of treatment are:
Radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells and shrink tumors)
Chemotherapy (using drugs to kill cancer cells and shrink tumors).
Immunotherapy (using your body's immune system to fight cancer)
Bone marrow and peripheral blood transplants - transplants (actually high dose chemotherapy and/or radiotherapy with a "rescue" of the immune system) are being used for certain patients, especially with high grade or recurrent disease.
Need Help with Treatment Decisions? Click here to sign up for the FREE Profiler Treatment Option Tool. This tool will assist you in understanding your treatment options and possible side effects.
Radiation therapy is the use of high-energy x-rays to kill cancer cells and shrink tumors. Radiation for NHL usually comes from a machine outside the body (external-beam radiation therapy). Radiation therapy given to the neck, chest, and lymph nodes under the arms is called radiation therapy to a mantle field. Radiation therapy given to the mantle field and to the lymph nodes in the upper abdomen, the spleen, and the lymph nodes in the pelvis is called total nodal irradiation. Radiation therapy may be used alone or in addition to chemotherapy.
Chemotherapy is the use of drugs to kill cancer cells and shrink tumors. An in-depth discussion of chemotherapy can now be found on the Adult Non-Hodgkin's Lymphoma Chemotherapy Page.
Immunotherapy tries to help your body to fight cancer or infections.
It uses materials made by your body or made in a laboratory to boost, direct, or restore your body's natural defenses against disease. Immunotherapy is sometimes called biological response modifier (BRM) therapy. Recent advances have been made in the use of
Monoclonal Antibody therapy and vaccines. In Non-Hodgkin's, T-Cell Immunotherapy is now coming out of the labs into trials which uses a patient's own immune cells (modified to kill tumors).
Bone marrow transplantation (BMT) and peripheral blood stem cell transplantation (PBSCT) are the use of high doses of chemotherapy with a rescue of the immune system afterwards. More on the
Transplantation Information Page.
Watch and Wait is used in some low grade/
indolent (slow growing) NHL cases. Since it is difficult to treat low grade the doctor will wait until symptoms become troublesome or nodes flare up. It is difficult to see why the doctor refuses a more direct approach. Newer treatments for low grade NHL may allow this method of treatment to be used less often.
Monoclonal antibodies are a new form of
chemotherapy that may bring this about.
Clinical trials are often used for people who are not responsive to conventional treatment or who wish to help researchers test new therapies.
The treatment chosen will depend on the exact
type of lymphoma (there are many subtypes), how much it has spread through the body, the health & age of the patient, and other factors determined by your doctor.
Depending on the choice made by your doctor, some cutting edge / recent advance treatments may be chosen including
immunotherapy which includes
vaccines and
monoclonal antibody therapy. New drugs in this area are
rituxan,
bexxar, and
zevalin. These drugs are not for all types of NHL though.
Several types of therapy may be combined - for example immunotherapy is being studied in conjunction with traditional chemotherapy drugs to make them work better. Likewise, depending on disease presentation, radiotherapy may be added to chemotherapy.
A
list of questions you can use to discuss treatment options.
Need Help with Treatment Decisions?
Click here to sign up for the FREE Profiler Treatment Option Tool. This tool will assist you in understanding your treatment options and possible side effects.
For specific types of treatment see the pages for
individual types of NHL or the National Cancer Institute (NCI) data sheets listed under the
Non-Hodgkin's Lymphoma: Resources Page.
Resources
Multimedia Resources
Falling Short: Under-Treatment in Non-Hodgkin's Lymphoma
Pretreatment Testing
Pulmonary Function Test information from NLM
Interpretation of Pulmonary Function Tests from the Virtual Hospital (more technical)
MUGA heart scan information from NLM
Radiotherapy
Radiotherapy / Radiation Therapy information and resources section
Chemotherapy
Chemotherapy is now discussed on the Adult Non-Hodgkin's Lymphoma Chemotherapy Page
Watch and Wait / Watchful Waiting
A new page on Watch and Wait (watchful waiting) as a form of treatment
Blood Work
Comprehensive Information on Blood Counts
Supportive Care
Supportive Care Information from NCI
Nutrition
NCI information on Nutrition
Lymphoma patients taking procarbazine should avoid the supplement Melatonin - the Melatonin FAQ concurs with this.
Procarbazine Food Restrictions from Li's Pages
Bone Marrow and Peripheral Blood Cell Information
Bone Marrow / Peripheral Blood Stem Cell Transplant Information Page
Abstract - Benefit of Autologous Bone Marrow Transplantation Over Sequential Chemotherapy in Poor-Risk Aggressive Non-Hodgkin's Lymphoma: Updated Results of the Prospective Study LNH87-2, Haioun et al, 1997. (abstract not on Net anymore)
Immunotherapy / Biological Therapies
Immunotherapy Page
Monoclonal Antibody Therapy
Clinical Trials
See the page on Clinical Trials
Related Articles
For more information on Adult Non-Hodgkin's Lymphoma, please see the following pages:
Adult Non-Hodgkin's Lymphoma: Chemotherapy
Adult Non-Hodgkin's Lymphoma: Resources
Bone Marrow and Stem Cell Transplants
Adult Non-Hodgkin's Lymphoma: Diagnosis
Lymphoma Classification and Types
Adult Non-Hodgkin's Lymphoma: Aggressive NHLs
Adult Non-Hodgkin's Lymphoma: Indolent NHLs
Non-Hodgkin's Lymphoma: Introduction
Other pages you may want to visit:
Lymphoma Information Network
Childhood Non-Hodgkin's Information
Books
Non-Hodgkin's Lymphomas, Peter M. Mauch (Editor), James O. Armitage (Editor), et al., 2004.
Section III: Treatment Principles and Techniques
Chapter 11: Principles in Radiation Therapy
Chapter 12: Principles of Chemotherapy and Combined Modality Therapy
Chapter 13: Biologic Therapy of Lymphoma
For Patients & loved ones:
Living With Lymphoma, Elizabeth Adler, Oct. 2005
Part 2: Treating Lymphoma, pp 59-230
Other
Books on Lymphoma Treatment 
