There is no simple answer to how to treat lymphoma, a cancer that develops in the lymphatic system. There is no one-size-fits-all approach. Because there are numerous forms of lymphoma, and treatment will vary depending on the particular stage of the disease.
There are three types of lymphoma listed in most of the information available online:
Non-Hodgkin lymphoma – The disease’s most prevalent form. Lymphatic system cells become abnormal, multiply and divide irregularly and start or spread to almost any body part.
Hodgkin lymphoma – The lymphatic system cells become abnormal. It spreads in an orderly fashion from one set of lymph nodes to the next. It may take root virtually anywhere.
Cutaneous T-cell lymphoma – Infection-fighting white blood cells called T-lymphocytes become cancerous, causing skin or other problems.
However, The World Health Organization classifies more than EIGHTY TYPES of mature lymphoid neoplasms (B-cell, T-cell, and Hodgkin lymphomas). Each is defined according to its morphology, immunophenotype, genetic lesions, molecular profiles, clinical features, and cellular derivation.
Treating lymphoma depends on the type but also is stage-dependent. ‘Staging’ refers to the process of determining which areas of the body are afflicted by lymphoma and its degree.
To assist in evaluating the patient’s health and the stage it may have reached, a doctor will do a physical examination and may request blood tests or a lymph node biopsy. There are procedures to check for enlarged lymph nodes throughout the body if lymphoma is identified and assess whether the lymphoma has spread. These include:
- Bone marrow aspiration and biopsy – A surgical procedure in which a small quantity of liquid bone marrow is extracted from the hip bone and examined under a microscope. This technique is generally conducted following a lymphoma diagnosis to establish whether the cancer has progressed to the bone marrow.
- Lumbar puncture (spinal tap) – A minimally invasive test that includes the removal of a tiny quantity of cerebrospinal fluid (CSF)—the fluid that surrounds the brain and spinal cord—to determine the presence of lymphoma cells. This test is generally reserved for specific lymphoma or when the patient exhibits symptoms consistent with lymphoma spreading to the brain.
- Chest x-ray – used to look for enlarged lymph nodes
- Body CT (CAT Scan) – A body CT is used to identify enlarging lymph nodes or organs, along with deformities in the belly, pelvis, chest, head, and neck. In rare instances, CT may be used to accurately guide a biopsy needle into a questionable region, allowing for the removal and examination of a tissue sample under a microscope.
- Positron Emission Tomography (PET) – a trace quantity of radioactive material is used to determine whether an enlarged lymph node is malignant and detect cancer cells in the body that are not visible on a CT scan. Following treatment for lymphoma in adults, some patients receive PET scanning to assess if the malignancy responds to the treatment. PET scans are also used in conjunction with CT, or MRI scans to get extremely detailed body images.
- Bone scan – A radioactive isotope known as technetium-99m is injected into a vein and travels to regions of bone that may be cancerous. This test is generally ordered when a patient complains of bone pain or when other tests indicate lymphoma has spread to the bone.
- Body MRI – A magnetic resonance imaging (MRI) scan is beneficial for identifying lymphoma that has progressed to the spinal cord or brain. It may also be useful in other regions of the body, such as the head and neck.
- Abdominal ultrasound – Examines swollen lymph nodes, especially those in the belly. The abdominal organs and kidneys, which swollen lymph nodes may harm, can also be seen using ultrasound.
The kind and stage are revealed to provide the most effective lymphoma treatment needed with these various tests. Treatment options are also based on the age and overall health of the patient.
Ann Arbor Classification for Staging Lymphoma
The Ann Arbor staging classification is frequently used to classify lymphomas and is specified in the American Joint Committee on Cancer’s Manual for Staging Cancer. This staging system was initially established for Hodgkin’s disease but was subsequently expanded to cover non-Hodgkin’s lymphoma.
Stage I – involves a single lymph node region or lymphoid structure (e.g., spleen, thymus, Waldeyer’s ring) or involvement of a single extra lymphatic site.
Stage II – Involvement of two or more lymph node regions or localized contiguous involvement of one extranodal organ and its regional lymph nodes with all disease confined to one side of the diaphragm.
Stage III – Involvement of lymph node regions on both sides of the diaphragm, which may also be accompanied by involvement of the spleen or by localized contiguous involvement of one extranodal organ or both.
Stage IV Disseminated (multifocal) involvement of one or more extranodal organs or tissues, with or without associated lymph node involvement or isolated extra lymphatic organ involvement with distant (non-regional) nodal involvement.
Stage 4 lymphoma is the most advanced stage. This is lymphoma that began in lymph nodes and has spread to at least one organ not connected to the lymphatic system, for example, the liver, lungs, bone marrow, or solid bones. Because the spleen and thymus are lymphatic organs, lymphoma in those organs alone does not qualify as stage 4.
Treatment Options for Lymphoma
Treatment options for lymphoma have traditionally included chemotherapy, which kills tumor cells directly, like radiation therapy and targeted therapy.
Unlike conventional medicine, immunotherapy uses medicines (man-made proteins that function like human antibodies) that imitate the patient’s immune system. There are several types of adverse effects with each of them. These adverse effects tend to be immune-based and less severe than chemotherapy’s side effects, however. A side effect is possible in cancer patients. The symptoms resemble flu symptoms, which is how someone feels as their immune system fights the flu.
Fever, muscular pains, tiredness, and shortness of breath are all possible side effects of manually administering antibodies to a patient. Once the infusion is stopped, symptoms usually improve within a few hours, if not seconds.
CAR T cells can cause neurotoxicity or toxicity, which affects the nervous system, and other immune-related adverse effects such as cytokine release syndrome. Finally, checkpoint blocking, another form of antibody treatment, is available as an option.
Aside from a little tiredness, immunotherapy is usually well tolerated. Rashes or inflammation in other organs can sometimes occur due to autoimmune-type consequences when the immune system is stimulated. Depending on the kind and stage of lymphoma, approved immunotherapies for the disease vary.
How to treat lymphoma naturally? Can lymphoma be cured naturally?
No natural treatments such as a certain diet, types of food, herbs, or supplements have been found to treat lymphoma. However, integrative medicine can help patients cope with the stress associated with a cancer diagnosis and the side effects of treating lymphoma. Reducing fatigue, pain, and anxiety can help lymphoma cancer patients manage their symptoms and improve their quality of life. Examples of integrative medicine include:
- Animal-assisted therapy
- Dietary supplements
- Massage therapy
- Music therapy
These techniques and activities are NOT intended to be replacements for alternative or traditional treatment for lymphoma.
What happens if lymphoma is not treated?
Most people with indolent (grows and spreads slowly) non-Hodgkin lymphoma can live 20 years after diagnosis. Faster-growing cancers (aggressive lymphomas) have a worse prognosis and must be treated quickly to be cured.