Non-Hodgkin Lymphoma: Treatment Choices
There are different types of treatment for non-Hodgkin lymphoma. Which may work best for you? It depends on a number of factors, such as:
The type of lymphoma
The stage of the lymphoma
The results of certain blood or urine tests
Your age and overall health
Your personal concerns and preferences
Learning about your treatment options
You may have questions and concerns about your treatment options. You may also want to know how you’ll feel and function after treatment. You may wonder if you’ll have to change your normal activities.
Your doctor is the best person to answer your questions. He or she can tell you what your treatment choices are and how successful they’re expected to be. Your doctor can also tell you what the risks and side effects are. Your doctor may advise a specific treatment. Or he or she may offer more than one, and ask you to decide which one you’d like to use. It can be hard to make this decision. It is important to take the time you need to make the best decision.
Understanding the goals of treatment
Treatment may control or cure the lymphoma. It can also improve your quality of life by controlling symptoms of the disease. The goal of non-Hodgkin lymphoma treatment is to do one or more of the following:
Try to cure the lymphoma
Keep the lymphoma under control for as long as possible
Treat symptoms of the lymphoma, such as pain or pressure on organs
Types of treatment
In some cases, a doctor may recommend not starting treatment right away. This is called watchful waiting. It is most common with some types of slow-growing lymphomas.
You may have several options for treatment. These are the most common ones:
Chemotherapy. For this treatment, you take one or more drugs to kill lymphoma cells throughout your body. You may have this treatment along with other types of treatment.
Immunotherapy. For this treatment, you take man-made substances that are like the ones your immune system makes. They help your immune system fight the lymphoma.
Radiation therapy. This treatment kills lymphoma cells with high-energy X-rays. It is often combined with chemotherapy. If it’s combined with immunotherapy, it’s called radioimmunotherapy.
Targeted therapy. This treatment uses medicines that target parts of cancer cells that make them different from normal cells. Targeted medicines sometimes work when chemotherapy medicines don't. They often have different types of side effects.
Stem cell transplant. A stem cell transplant can be used after treatment with very high doses of chemotherapy or radiation. High doses of these kill the cells in the bone marrow, called stem cells, which help make new blood cells. With a stem cell transplant, healthy stem cells are put back in your body after treatment. The cells may come from another person, called a donor. This is called an allogeneic transplant. Or you can have stem cells in your own blood collected before the high-dose treatment. You get the stem cells back in a process like a blood transfusion. This is done a few days after the chemotherapy. It is called an autologous transplant.
Surgery. In rare cases, a surgeon may take out an organ, such as your spleen, if it has lymphoma.
Clinical trials for new treatments
Doctors are also finding new ways to treat non-Hodgkin lymphoma. These new methods are tested in research studies called clinical trials. Before starting treatment, ask your doctor if there are any clinical trials you should consider.
Working with your doctor on a treatment plan
Your oncologist will help you make a treatment plan. Talking about your treatment choices will be one of the most important meetings you'll have with your doctor.
It may take time to choose the best plan. Ask your doctor how much time you can take to look at all your options. You may want to get an opinion from another doctor before deciding on treatment. You may also want to talk with your family and friends.
March 16, 2019
NCCN Clinical Practice Guidelines in Oncology: Non-Hodgkin's Lymphomas Version 2.2015. National Comprehensive Cancer Network
Cunningham, Louise, RN,Gersten, Todd, MD