Once the biopsy confirms lymphoma, and all of the imaging has been done, the oncologist can stage the cancer. Staging describes how advanced the lymphoma is, and helps the oncologist determine the best treatment.
Lymphoma staging is different from the staging for solid tumors such as lung cancer or breast cancer. The lymphoma staging system is determined based on the number of areas of lymph nodes that are affected, whether they are on the same or on both sides of the diaphragm (the muscle separating the chest from the abdomen), and if lymphoma is present in any solid organs.
Once the staging is determined, and the type of lymphoma has been diagnosed, the oncologist can develop the treatment plan. Chemotherapy is often used for both Hodgkin and non-Hodgkin lymphomas.
Chemotherapy is medication that is used to stop the division of cells, causing cell death. Because cancer cells are abnormal and usually grow out of control, they are killed by chemotherapy. Unfortunately, chemotherapy can cause side effects because healthy cells are affected as well. The exact chemotherapy regimen can change from person to person based on the type of lymphoma they have. Some examples of chemotherapy that may be used include:
Combinations of chemotherapy are most often used to treat lymphoma.
Immunotherapy is often used to treat lymphoma as well. Immunotherapy medications work by alerting the immune system to attack certain proteins on the outside of the lymphoma cells. These medications work differently than chemotherapy, but are often used along with chemo.
Examples of immunotherapy include:
Some types of both Hodgkin and non-Hodgkin lymphoma respond well to radiation. Radiation therapy uses high energy beams of radiation to treat and kill lymphoma cells. The radiation is most often given Monday through Friday for a period of a few weeks. Each treatment takes only a few minutes. This type of radiation is called external beam radiation.
Stem Cell Transplant
For people with certain types of lymphoma, or lymphoma that comes back quickly after treatment, a stem cell transplant may be suggested. During this treatment, high doses of chemotherapy, and sometimes radiation, are needed to completely kill the cancer cells. These high doses can cause the bone marrow to stop working properly, leaving someone at high risk for infection, severe anemia, or severe bleeding, because their blood cells are low.
A stem cell transplant can be done by removing the stem cells from a person’s own body in the weeks before the procedure, which are frozen until they are ready to be used. Once the high doses of chemo are given, the stem cells are then infused back in, to help the bone marrow start to make blood cells again.
Stem cells can also be used from a donor, either someone in the family or unrelated. They have to be a close match to the person who needs them though, or there is a high risk that the cells will be rejected, leading to many complications.