Doctors usually treat people with non-Hodgkin lymphoma (NHL) with chemotherapy, radiotherapy, immunotherapy, and stem cell transplants. However, the type of treatment varies depending on the stage of a person’s lymphoma and whether it is aggressive or indolent.
NHL refers to a group of cancers of white blood cells, called lymphocytes.
There are different types, and some are more aggressive than others. Aggressive lymphomas grow, and spread, more quickly than indolent ones. Doctors treat the two types differently.
This article explains some of the most common treatments, and looks into their risks, and side effects.
Treatment for NHL aims to remove all the cancerous lymphocytes, according to the Leukemia and Lymphoma Society (LLS).
Complete removal of these cells is called a complete remission. The person will have no signs of the disease. However, it can return, and the person may need further treatment.
Sometimes, treatments do not completely treat the cancer, but instead slow its progress. Doctors call this partial remission. People can be in partial remission for years before they need further treatments.
According to the
It is a systemic treatment, which means the medications are carried in the bloodstream throughout the body. This means that they can treat cancer cells wherever they find them.
Depending on the type of NHL, a doctor may administer chemotherapy alone, or alongside immunotherapy drugs or radiation therapy.
Chemotherapy side effects can include:
- hair loss
- mouth sores
People having chemotherapy also have a
Immunotherapy uses a person’s own immune system to destroy the cancer cells, or slow their growth. It uses substances from the body, or medications made in a laboratory, to boost the person’s natural defences.
The Cancer Research Institute (CRI) points out that the immune system learns to recognize cancer cells, and continues to attack them even after the person has finished treatment. They add that immunotherapy may lead to longer-lasting remission.
Side effects for immunotherapy can range from mild to severe.
Common side effects include:
- skin changes
- sores in the mouth
- blood pressure changes
There is also a risk that the treatment boosts the person’s immune system so much that it targets healthy cells.
Targeted drug therapies use medications that only attack certain cancer cells.
These medications alter proteins in the cancer cells and stop them from growing.
Targeted drug therapies are precision medicines that work on specific cells. They are less likely to damage healthy cells.
Side effects can include:
- mouth sores
- liver problems
Doctors use radiation therapy to interfere with the genetic material, or DNA, inside the cancer cells.
They usually recommend external beam radiation for people with NHL.
People are also at a higher risk of other infections and low blood counts.
However, the procedure itself is painless.
Chemotherapy effectively treats cancer cells, but high doses can damage a person’s bone marrow, reducing their ability to make new blood cells.
This treatment option can destroy more cancer cells and aid in the development of healthy new bone marrow growth.
- mouth and throat pain
- nausea and vomiting
- lung problems, such as pneumonia
There is also a risk that a person will reject the transplant. Long-term complications, such as infertility, can also occur.
Doctors may suggest that a person has surgery if the cancer starts in the spleen or other organs and has not spread.
The advantage of surgery is that it removes all the cancerous cells if they are contained within the one organ.
However, all surgery carries risks, such as:
- reactions to the anesthetics
- damage to other organs
- pain after the procedure
Two main types of NHL affect different lymphocytes, according to the
Doctors treat people with this type of lymphoma with a combination of chemotherapy medications, usually abbreviated as R-CHOP.
Doctors may also recommend this or different combinations of chemotherapy medications for people with other types of B-cell lymphomas.
Doctors combine different treatments to suit the individual, so some people may also have radiation therapy, immunotherapy, and targeted therapy in their treatment plan.
Learn more about the treatment for B-cell lymphoma.
Doctors tailor treatment plans depending on the type and stage of lymphoma.
Some T-cell lymphomas start in the skin, and doctors may recommend radiation therapy, or topical chemotherapy.
People with acute T-cell lymphoma may need
Learn more about the treatment for T-cell lymphoma.
According to the
Doctors usually recommend highly active antiretroviral therapy (HAART), which supports a person’s immune system, before prescribing higher doses.
Doctors can prescribe various medications to help people cope with any side effects of their treatments. Thesecan include antibiotics and antivirals to treat infections.
They may also recommend blood transfusions for people with low blood cell counts.
If treatments stop working and a person’s lymphoma progresses, doctors may still prescribe radiation therapy to relieve pain, as well as strong painkillers.
Palliative care professionals can help people with NHL cope with physical and mental symptoms.
The treatments described above can cause side effects, and people with NHL need to discuss these with their doctors.
If they wish to have children, they may want to talk about the impact of treatment on their fertility, before making their choice.
NHL describes a group of cancers that affect white blood cells. There are many different types, and they may grow quickly or slowly. People with fast-growing cancers may need higher doses of chemotherapy than people with slow-growing types.
Doctors take a person’s age, general health, symptoms, type of lymphoma, and the stage at which it is at, into account before deciding on treatments.
Regular treatments include chemotherapy, radiation therapy, immunotherapy, targeted therapies, and stem cell transplants.