Non-Hodgkin Lymphoma Treatment Options in Central New York
Recommended treatment options primarily depend on the type and stage of lymphoma, its growth rate, and the patient's age and overall health. Treatment for non-Hodgkin lymphoma (NHL) may involve:
Watchful Waiting
Some patients with an indolent, or slow-growing, type of non-Hodgkin lymphoma may not require immediate treatment, particularly if they are not experiencing symptoms. This is often referred to as watchful waiting.
If this is the path recommended, you will be monitored every three months to look for signs of further growth. This may include regular laboratory tests, physical exams, and imaging tests such as CT scans or X-rays. Treatment will be recommended if symptoms occur or tests indicate the lymphoma is worsening.
Some people may feel uncomfortable with the watchful waiting approach because they are concerned about having an untreated cancer. If you initially choose watchful waiting but later feel anxious, discuss your feelings with your cancer care team.
Non-Hodgkin Lymphoma Chemotherapy
Chemotherapy is used to kill lymphoma cells, known as systemic therapy because the drugs circulate throughout the bloodstream. This is necessary because lymph fluid flows throughout the body.
There are several ways to receive chemotherapy: by mouth, through a vein, or in the area surrounding the spinal cord. Intravenous treatment is most likely for lymphoma patients. It’s given in our comfortable outpatient cancer center, easily accessible to patients in the Central New York region.
Chemotherapy is given in cycles. This means you will go through a treatment period followed by a rest period. The duration of the rest period and the total number of treatment cycles will depend on the stage of your disease and the specific anticancer drugs being used.
Targeted Therapy for Non-Hodgkin Lymphoma
Targeted therapy is a treatment approach that uses drugs or other substances to identify and attack specific cancer cells, resulting in less harm to normal cells compared to chemotherapy. Your oncologist will determine if a targeted therapy drug is effective for you.
There are three main types of targeted therapy for adult non-Hodgkin lymphoma:
- Monoclonal antibody therapy: Lab-made immune system proteins that can attach to specific targets on cancer cells or other cells that help cancer grow. These antibodies can kill cancer cells, block their growth, or prevent them from spreading. Monoclonal antibodies are administered by infusion and may be used alone or to deliver drugs, toxins, or radioactive material directly to cancer cells.
- Proteasome inhibitors: Thesedrugs work by stopping enzymes from breaking down proteins that are important for controlling cell division.
- BTK inhibitors for some types of B-cell non-Hodgkin lymphomas work by blocking the Bruton tyrosine kinase (BTK) protein from helping lymphoma cells multiply.
Non-Hodgkin Lymphoma Immunotherapy
Immunotherapy, also known as biologic therapy, is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to enhance, direct, or restore the body’s natural defenses against cancer. Several types of immunotherapies are used to treat non-Hodgkin lymphoma:
- Monoclonal antibodies: These lab-made proteins bind to cancer cells and assist the immune system in killing lymphoma cells. This treatment is administered intravenously at a doctor’s office, clinic, or hospital.
- Checkpoint inhibitors: These immunotherapy drugs work by blocking checkpoint proteins from interacting with their partner proteins. This prevents the “off” signal from being sent, allowing the T cells to kill cancer cells. The PD-1 pathway is a target for several checkpoint inhibitors. Pembrolizumab (Keytruda) may be used to treat primary mediastinal large B-cell lymphoma that has not responded after at least two other treatments.
- Immunomodulators: Lenalidomide (Revlimid) and thalidomide (Thalomid) are immunomodulators that treat adult non-Hodgkin lymphoma.
- CAR T-cell therapy: This therapy uses the patient's T cells (a type of immune system cell) to attack certain proteins on cancer cells. T cells are taken from the patient, and special receptors are added to their surface in the laboratory. These modified cells are called chimeric antigen receptor (CAR) T cells. The CAR T cells are grown in the laboratory and infused back into the patient. The CAR T cells multiply in the patient's blood and attack cancer cells. This therapy is used to treat large B-cell lymphoma that has not responded to treatment and is also being studied to treat mantle cell lymphoma that has relapsed or not responded to treatment.
Radiation Therapy for Non-Hodgkin Lymphoma
Radiation therapy (or radiotherapy) uses high-energy radiation to destroy lymphoma cells. It can reduce tumor size and alleviate pain and is typically administered after or alongside chemotherapy, depending on the type of non-Hodgkin lymphoma.
Two types of radiation therapy are used for people with lymphoma:
- External radiation: A large machine directs radiation at the specific area where lymphoma cells have collected. Since this method only affects cells in the treated area, it is often referred to as local therapy. Patients typically receive this treatment five days a week for several weeks at a hospital or clinic.
- Systemic radiation: Some lymphoma patients receive an injection containing radioactive materials that travel throughout the body. These materials are attached to monoclonal antibodies that locate lymphoma cells, allowing the radiation to destroy them.
Your cancer care team at HOA will include a radiation oncologist, who specializes in determining the right type and dosage of radiation therapy that may be needed based on the stage and location of the cancer.
Non-Hodgkin Bone Marrow Transplantation
If lymphoma returns after initial treatment, you may receive a bone marrow transplant. This procedure involves using your own blood-forming cells to enable treatment with high doses of chemotherapy, radiation therapy, or both, which can kill lymphoma cells in the bone marrow. However, this also kills the healthy cells.
After receiving high-dose treatment, healthy blood-forming cells are reintroduced through a flexible tube placed in a large vein in your neck or chest. These transplanted cells will develop into new blood cells.
There are different types of transplantation:
- Autologous transplantation: This type of transplant uses your own cells, which are extracted before high-dose treatment. The cells may be treated to eliminate any remaining lymphoma cells and then frozen for storage. After you receive high-dose treatment, the stored cells are thawed and returned to you.
- Allogeneic transplantation: his process uses healthy cells from a donor, who could be a sibling, parent, or an unrelated donor. Doctors use blood tests to be sure the donor’s cells match your cells.
- Syngeneic transplantation: This type of transplant uses cells from a patient’s healthy identical twin.
Lymphoma Clinical Research Trials Available in Central New York
Hematology-Oncology Associates of Central New York (HOA) is actively involved in cancer research and is currently offering clinical trials for lymphoma patients. If you are interested, please talk with your hematologist-oncologist to see if you qualify for participation.
Learn more about clinical trials available at Hematology-Oncology Associates of CNY.
Supportive Care for Lymphoma Patients
In addition to cancer treatments, HOA provides supportive care to alleviate cancer symptoms and side effects and enhance the patient's quality of life. This supportive care may include emotional counseling, pain management, nutritional assistance, and guidance on addressing practical challenges related to the disease and its treatment.
If you need support while managing life with cancer, please reach out to a member of your lymphoma care team.
Find a Lymphoma Specialist in the Syracuse Area
At Hematology-Oncology Associates of CNY, we are committed to providing expert, patient-centered care for blood cancer. Our multidisciplinary approach ensures that each patient receives a personalized treatment plan based on the latest advancements in lymphoma treatment. With a dedicated team, comprehensive diagnostic imaging, state-of-the-art treatment options, access to clinical research trials, an in-house pharmacy and laboratory, and a post-treatment survivorship program, HOA provides exceptional lymphoma care in Central New York.
Our cancer centers offer care for patients in Central New York, in the Syracuse area, including Camillus and all of Onondaga County; Auburn, and the rest of Cayuga County; Cortland County; Herkimer County, Jefferson County – including Watertown; Madison County – including Oneida; Oneida County – including Utica and Verona; and Oswego County – including Fulton and Oswego.
Sources: American Cancer Society, National Cancer Institute.
