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Non-Hodgkin’s lymphoma : 6 best treatments to fight back

In September 2016, Shikha was enjoying life to the fullest. She was 45 years old back then and working in the banking industry. Life was good until she woke up with severe chest pain in the morning. Severe chest pain along with high breathing and constant cough was beginning to change her life forever.

At first, she was diagnosed with bronchitis and later pneumonia. But conditions did not improve even after medication. After 6 months, she underwent a CT scan, which revealed she had a large mass on her upper left lung that was compressing the main artery to the left lung.

That was causing her cough and chest pain. Further medical tests confirmed that she has a 9 cm long mass in the chest and it was diagnosed as large B cell Non-Hodgkin’s lymphoma.

Everything about non-Hodgkin's lymphoma
non hodgkin lymphoma

There are many surprising facts about Non-Hodgkin’s lymphoma. It is one of the most common types of blood cancer, There are more than 60 types of Non-Hodgkin’s lymphoma.

It is the most common white blood cell cancer. It spreads too fast. It is caused by some potential changes in DNA. There is no way to completely treat it.

We have created this post to help you understand everything about  Non-Hodgkin’s lymphoma. What it is, What are symptoms of it and what are treatment options available for it in India.

After reading this post you will have complete awareness about how you can fight back with Non-Hodgkin’s lymphoma.

So, First of all we are starting with

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Non-Hodgkin's lymphoma

What is Non-Hodgkin's lymphoma ?

It is a type of cancer that starts in white blood cells called lymphocytes. Lymphocytes are an important part of the immune system of the body. Non-Hodgkin’s lymphoma is often referred to as NHL.

There is also Hodgkin’s lymphoma which is treated differently from NHL. Generally, it affects adults but it may happen to kids as well.

NHL starts in lymph nodes. It is also generally referred to as lymphoma as there are various types of lymphoma and NHL is one of them.

Now we will see different types of NHL.

Non hodgkin's lymphoma cells
Location of lymphoma in body

What are different types of Non-Hodgkin's lymphoma

It is very important for you to know what type of Non-Hodgkin’s lymphoma it is. Because treatment of NHL is highly dependent on what type of NHL it is.

The type of lymphoma depends on 

  • What type of lymphocyte is affected (B cell or T cell)
  • How mature cells are while becoming cancerous

First type of lymphoma is 

B cell and T cell lymphoma

Lymphocytes are white blood cells that help in preventing infections. There are 2 type of lymphocytes B cells and T cells

B lymphocytes

B cells produce proteins called antibodies. Antibodies attach to foreign germs like bacteria and viruses. This attachment works as a mark that helps the immune system to destroy it.

T lymphocytes

T cells destroy germs and abnormal cells in the body. T cells also help the immune system to boost or slow their activity.

 

There are 2 types of lymphomas

Indolent lymphoma

This type of lymphoma is slow in growing and spreading. It is generally not treated immediately but doctors keep watch on it.

Aggressive lymphoma

This type of lymphoma needs to be treated immediately because it spreads and grows very quickly.

Most common type of aggressive lymphoma is large B cell lymphoma.

It doesn’t matter if it grows slow or fast, If not treated on time , it can spread to other parts of the lymph system.

After knowing types of lymphoma it is important for you to know various stages of NHL.

symptoms

What are symptoms of Non Hodgkin's lymphoma?

These are the symptoms of Non-Hodgkin’s  lymphoma.

Symptoms may include

  • Pain in abdomen and swelling
  • Fever
  • Sweating at night
  • Weight loss without any reason
  • Chest pain, cough and trouble in breathing
  • Fatigue for long time
  • Swollen lymph nodes in groin , armpits and neck

If any of these symptoms remain for a long time, and if you are at any risk factors of NHL, it is time to visit the doctor.

Now we will see  different stages of Non Hodgkin’s lymphoma

Different signs and symptoms of non hodgkin's lymphoma

Stages of Non-Hodgkin's lymphoma

Physicians attribute the stage of the cancer by combining the T, N and M classifications. Staging also includes PSA level (see Pre-screening) and category group.

Stage I: The onset of cancer at this early stage is slow if it is not aggressive lymphoma. In stage 1, cancer is found in 1 lymph node.

In stage 2, cancer is spread to at least 2 lymph nodes on the same side of the body diaphragm.

At Least one organ and it’s nearby lymph nodes gets involved in stage 2.

In stage 3, cancer is found in lymph nodes of both sides of the diaphragm.

In stage 4, Cancer spread throughout the body outside lymph nodes. It spreads to lever, bone marrow and lungs.

Stage 3 and stage 4 NHL are very common and they are treatable and curable.

Often stage 3 and 4 are considered one category because the same treatment is applied to both.

Lymphoma_causes

Causes

What causes Non Hodgkin's lymphoma?

There are some reasons behind Non-Hodgkin’s lymphoma and some risk factors associated with it. If you are associated with any of these risk factors, then there are higher chances of developing NHL.

  • If you are taking any medication that suppress immune system, it increases risk of NHL
  • Infection with bacteria such as H.Pylori and virus HIV increase risk of NHL
  • Exposure to chemicals like pesticides and insecticides increase risk of NHL
  • Ageing also increases the risk of NHL. Even though it may happen at any age, increasing age also increases risk of NHL.

As you are aware of symptoms and risk factors, it is important for you to know about the diagnosis of NHL.

diagnosis

How Non Hodgkin's lymphoma is diagnosed?

Doctors will try to understand the medical history of the family to know chances of NHL. Apart from that, various tests will be used to diagnose NHL

Blood and urine tests are used to check if there is any other infection in the body. It doesn’t directly conclude the NHL.

Doctor would check the neck, underarm and groin to check if there are any swollen lymph nodes.

Doctors may recommend imaging tests like PET, CT scan and MRI to see if there is any effect of lymphoma on other body parts.

In lymph node test, biopsy is carried out. Small part of the lymph node is removed to check in the lab to see if  it is NHL.

A small needle is inserted in the hip bone to take a sample of bone marrow. Then a sample is analyzed to check the presence of any NHL cell in the bone marrow.

If a doctor feels that you are at risk of lymphoma affecting fluid around your spinal cord, he may recommend lumbar puncture. A small needle is inserted in the lower back to remove a sample of fluid for further analysis.

After all these diagnoses, if a doctor finds NHL, they start treatment of it.

Treatment

What are treatment options available for Non Hodgkin's lymphoma

Treatment of Non-Hodgkin’s lymphoma depends on what stage the cancer is.

Doctors see which type of lymphocytes are involved, what stage it is and whether it is aggressive or not. It helps them to decide which combination of treatment you require.

If lymphoma is indolent, the doctor may not suggest any immediate treatment and keep watch on it. If it is aggressive then various treatments are performed. 

Chemotherapy is a common treatment for NHL. In chemotherapy drugs are administered either orally or by injection.

For people having NHL , chemotherapy is used in bone marrow transplant, also called stem cells transplant.

In radiation therapy high energy beams of radiation are used to kill cancer cells.

In radiation therapy. high energy beams like protons and x-ray are targeted to specific parts of your body.

Radiation therapy is often combined with chemotherapy for better results.

In this treatment, T cells are engineered to make them able to fight with lymphoma.

In bone marrow transplant, high doses of chemotherapy and radiation are used to suppress the immune system.

Then healthy bone marrow cells are infused from your body or from the donor’s body to rebuild the bone marrow.

For NHL,  bone marrow transplant is a good option if other treatments don’t work.

In immunotherapy, the immune system is made stronger to fight cancer cells. Body’s immune system doesn’t kill cancerous cells because they produce similar proteins like normal cells. Immunotherapy interferes with this process and the immune system then kills cancerous cells.

Targeted drug therapy looks for specific weakness in the cancer cells and targets that weakness to kill that cancer cell.

It is often combined with chemotherapy, to avoid recurrence of  lymphoma.

Treatment cost in India

How much does Non-Hodgkin's Lymphoma treatment cost in India?

The cost for Non-Hodgkin’s Lymphoma treatment in India varies on the size of the tumor, stage of cancer, and also the treatment option is chosen according to the condition of the patient.

A cancer evaluation will reveal the extent of the spread and the best-suited treatment to restrict and cure it. The cost for cancer evaluation starts from 500 USD.

After the initial evaluation, the oncologist will be able to gauge what treatment should be recommended.  Thanks to advancements in technology and innovation, newer and safer surgical options are also possible.

Advanced cutting-edge treatment like Bone-marrow transplant is available in India. However, it is to be noted that not every patient is eligible for this treatment option. The onco-surgeon will suggest the best-suited treatment plan based on the patient’s case.

In certain cases, surgery is also to be combined with other treatments like chemotherapy and radiation therapy to ensure a complete cure.

The cost of chemotherapy starts from 400 USD / cycle.

Radiation therapy cost starts from 3300 USD in India.

Stem cell transplant costs can range between 25,000 to 47,000 USD in India.

Treatment cost
prostate cancer survival rate

Success Rate

What is the survival rate of Non-Hodgkin's lymphoma ?

Survival rate of Non-Hodgkin’s lymphoma

5 Survival rates of diffuse B cell lymphoma are 73% for localized cancer, 73% for regional cancer and 57% for distant cancer.

5 year survival rates of follicular lymphoma are 96% for regional cancer, 90% for regional and 85% for distant cancer.

Conclusion

A lot of people survive NHL, even those with advanced illness. It is treatable and curable. Connect with us, If you wish to know more about treatment of Non-Hodgkin’s lymphoma.

 

Frequently Asked Questions and patient concerns:

1. Who is eligible for treatment of Non Hodgkin's lymphoma?

Patients in the early stage of NHL are very much suitable for treatment of chemotherapy and radiation therapy. Stem cells transplant is performed if a patient experiences symptoms again.

2. Who is not eligible for treatment of Non Hodgkin's lymphoma?

Severely ill patients or patients in late stages of cancer are not eligible for the treatment. Also age is the big factor. Patients having age above 65 and having comorbidities may not become eligible for stem cells transplant.

3. What are side effects of treatment of Non hodgkin's lymphoma?

Every cancer treatment has its own side effects. Side effects of chemotherapy are fatigue, breathlessness and bleeding. Side effects of radiation therapy may be red skin, dry mouth, nausea, loss of appetite. Side effects of stem cell transplant may be hair and skin problems, anemia, and digestive system problems.

Are the results of treatment permanent?

Results of chemotherapy, radiation therapy and stem cell transplant are permanent. Still, in some cases recurrence may happen.

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