Cancer of the lymph glands (lymphoma) describes a group of cancers that affects a type of white blood cells called lymphocytes.
The good thing with lymphoma is the chemo-sensitivity of the disease allows it to be treated quite effectively. These cancers respond favorably to chemotherapy and many lymphomas are actually curable. We have the option of using targeted antibodies in most lymphomas and that has made a difference in the treatment outcome in the last two decades. Additionally, other oral drugs targeted against specific genetic pathways have improved the odds of survival.
FINDING THE CANCER
If lymphoma appears in the cervical region, under your arm or down in the groin, a physician can feel it during a medical exam. Lymphomas, however, can appear in any area of the body — inside the mouth, inside the chest or in the colon, in the GI tract, or in the bones or organs such as the liver or kidneys. The fact is lymphomas can be anywhere because lymphocytes traverse through the entire body.
TREATING LYMPHOMA
The usual treatment of lymphoma is a combination of chemotherapy with a targeted antibody. Surgery is rarely used as lymphoma therapy is usually systemic. Sometimes radiation is used as a primary modality of treatment when the lymphoma is confined to one group of nodes only or sometimes to consolidate the response of the chemotherapy and antibody therapy. As mentioned above, we are now in the era of targeted therapy and so several compounds are being discovered which offer blockage of genetic pathways which cause the lymphomas.
TYPES OF LYMPHOMAS
Today, a subset of lymphomas called Hodgkin lymphomas are cured with a high degree of success, usually more than 90 percent.
In addition, a fairly common lymphoma called diffuse large B-cell lymphoma is now cured with more than a 50 percent chance of survival at five years.
There are also low grade lymphomas, most classically follicular lymphoma, which tends to go into a quick remission with chemotherapy. This lymphoma has a tendency to recur several years later yet it can be controlled for a long time despite the relapse.
There are other aggressive lymphomas such as mantle cell lymphomas and angioblastic lymphomas which require a more advanced therapy such as stem cell transplantation. However, the cure for these lymphomas is still reasonable using targeted antibodies and high-dose chemotherapy.
FINAL THOUGHT
We are seeing great strides and progress in treating lymphomas with remarkable advancements due to the discovery of specific genetic pathways, which can be targeted with immunotherapy and oral agents in addition to standard chemotherapy and stem cell transplantation.
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