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Non-Hodgkin’s lymphoma

Non-Hodgkin’s Lymphoma is the eleventh most prevalent cancer around the world, with 544352 cases in 2020, according to WHO.

However, with the advancement of technology, experience, and new protocols, the survival rates of Non-Hodgkin’s Lymphoma patients are also increasing.

Though detecting Non-Hodgkin’s Lymphoma itself is a matter of concern, with the proper treatment with the right doctor at the right time, you can beat Non-Hodgkin’s Lymphoma. 

Let’s understand from the experience of Amanda, a 45-year-old woman from Addis Ababa, Ethiopia, working in the banking industry. 

Two years back, Amanda’s health was deteriorating. She was having fever again and again, with abdominal and chest pain. She met a physician nearby. The doctor prescribed some medication and she started following the prescription. Even after taking the medicines for a month, there was no relief in her condition. One night Amanda woke up with severe chest pain, high breathing, and constant cough. Amanda’s husband Brock booked an appointment in the hospital for consultation. 

Amanda and Brock went to the hospital for a checkup in the morning. The doctor did the physical examination and checked for the swollen lymph nodes. The doctor suggested Amanda do an Imaging test.

non hodgkin's lymphoma treatment in india
non hodgkin's lymphoma lymph nodes

Amanda did the test, revealing that she had a large mass on her upper left lung that compresses the main artery to the left lung. That was causing her cough and chest pain. 

The doctor suggested doing a biopsy test, Amanda did the test and the report confirmed that she was diagnosed with large B cell Non-Hodgkin’s lymphoma.

The cancer news was shocking and Amanda and Brock both got emotional. The doctor asked Amanda to consult an oncologist for the treatment. Brock supported Amanda and they both came back home. 

Brock researched the internet for the best treatment for Non-Hodgkin’s lymphoma and came across the MedicoExperts website. Brock left the inquiry on the MedicoExperts website and the MedicoExperts, patient care department got in touch with Brock. Brock shared the test reports of his wife with the MedicoExperts team. MedicoExperts explained to Brock about the revolutionary Tumor Board approach for the treatment. They arranged an online video consultation with the onco-hematologist and the head of the tumor board. During the consultation, the doctor explained the treatment plan and process in detail and cleared all the doubts of Amanda and Brock.

Amanda and Brock decided to come to India for the treatment.

After 15 days, Amanda landed in India for the treatment with Brock. Amanda got admitted to the hospital on the same day. An evaluation test was performed to check the current condition of cancer.

After checking Amanda’s condition designed a custom treatment plan that suited Amanda the best. 

The treatment started with the combination of chemotherapy and radiation therapy.

Amanda responded very well to the treatment. A re-evaluation test was performed to check the treatment outcome, and the PET scan showed no evidence of lymphoma.  

 Amanda had a further two rounds of chemotherapy to end the treatment.

Amanda and Brock were delighted with the results and thanked the doctor and MedicoExperts. 

This can be your story as well to win the battle against Non-Hodgkin’s Lymphoma even if you have complex cancer. What you need is the right guidance, right treatment at the right time from the right experts.

Before we move ahead with Non-Hodgkin’s Lymphoma symptoms, stages, treatment, and survival rates, let’s understand what Non-Hodgkin’s Lymphoma is.

non hodgkin's lymphoma, non hodgkin's lymphoma treatment in india

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Non-Hodgkin's lymphoma

What is Non-Hodgkin’s lymphoma (NHL)?

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.

Non-Hodgkin’s lymphoma 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

What are the different types of Non-Hodgkin's lymphoma?

It is very important for you to know what type of NHL it is. Because the 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

(I): 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.

(II): 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

(I): Indolent lymphoma

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

(II): Aggressive lymphoma

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

The 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 the types of lymphoma it is important for you to know the various stages of NHL.

stages

What are the different stages of Non-Hodgkin's lymphoma?

There are 4 stages of NHL. From stage 1 to stage 4.

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 its nearby lymph nodes get 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 the liver, bone marrow, and lungs.

Stage 3 and stage 4 NHL are very common and they are treatable and curable. Often stages 3 and 4 are considered one category because the same treatment is applied to both.

Now we will see symptoms of NHL.

symptoms

What are the signs and symptoms of Non-Hodgkin's lymphoma?

There are various symptoms of NHL. 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 a 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 what causes NHL and associated risk factors.

Different signs and symptoms of non hodgkin's lymphoma
Lymphoma_causes

Causes

What causes Non Hodgkin's lymphoma?

There are some reasons behind NHL and some risk factors associated with NHL. 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 suppresses the immune system, it increases the risk of NHL
  • Infection with bacteria such as H.Pylori and virus HIV increases the risk of NHL
  • Exposure to chemicals like pesticides and insecticides increase the risk of NHL
  • Aging also increases the risk of NHL. Even though it may happen at any age, increasing age also increases the 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 the 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.

The 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 the lymph node test, a biopsy is carried out. A small part of the lymph node is removed to check in the lab to see if it is NHL.

A small needle is inserted into 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 a 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 NHL 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 transplants 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.

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.

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

In bone marrow transplants, 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, a 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. The body’s immune system doesn’t kill cancer cells because they produce similar proteins like normal cells. Immunotherapy interferes with this process and the immune system then kills cancerous cells.

Now, we will see what is the treatment cost

Non-Hodgkin Lymphoma Treatment

The typical approach of doctors to treat Non-Hodgkin Lymphoma

The treatment protocol depends upon the type and stage of non-Hodgkin lymphoma, as well as the patient’s overall health, personal needs, and goals.

Chemotherapy, immunotherapy, targeted therapy, and/or radiation therapy are the most common treatments for these stages of NHL, according to doctors.

If your lymphoma has spread to the fluid surrounding your brain and spinal cord, you may need intrathecal chemotherapy. To receive this treatment, your doctor will insert a thin needle between your lower back bones and inject chemo drugs directly into your spinal fluid.

Bone marrow transplant is an curative option for some types of NHL after treatment, or if the disease returns after treatment, This procedure entails extracting and preserving immature blood cells known as stem cells. You can get stem cells from a donor or use your own. 

The lymphoma cells in your body are then killed with high doses of chemotherapy and radiation. The stem cells are then implanted into your body, where they will grow and rebuild healthy blood cells over time.

Chemotherapy, immunotherapy, targeted therapy, and/or radiation therapy are the most common treatments for these stages of NHL, according to doctors.

If your lymphoma has spread to the fluid surrounding your brain and spinal cord, you may need intrathecal chemotherapy. To receive this treatment, your doctor will insert a thin needle between your lower back bones and inject chemo drugs directly into your spinal fluid.

Bone marrow transplant is an curative option for some types of NHL after treatment, or if the disease returns after treatment, This procedure entails extracting and preserving immature blood cells known as stem cells. You can get stem cells from a donor or use your own. 

The lymphoma cells in your body are then killed with high doses of chemotherapy and radiation. The stem cells are then implanted into your body, where they will grow and rebuild healthy blood cells over time.

Which country is best for Non-Hodgkin Lymphoma treatment?

When choosing a country for non-Hodgkin’s treatment, one should consider the following factors:

  • Country must have good healthcare facilities with advanced technologies.
  • Highest success rates.
  • Better survival rates.
  • Costs of treatment and duration of stay during treatment.

In addition to the following factors, you must consider logistical factors such as connecting flights, transportation, and safety in the chosen country.

While many of us think of western countries (USA, UK) when it comes to non-hodgkin lymphoma treatment, India has risen to the top as one of the best countries in the world, with high success and survival rates.

Many people have travelled to India to have their non-hodgkin lymphoma treated at a cost that is nearly half of what it would cost in developed countries because of the availability of world-class treatment and a dedicated post-care facility.

Treatment cost
prostate cancer survival rate

How to choose the best hospital for Non-Hodgkin Lymphoma treatment in India?

Choosing a hospital for cancer treatment can be difficult. Make sure the hospital you choose for cancer treatment has the latest cancer treatment technologies and takes a multidisciplinary approach.

To handle the complexity, the hospital should have a highly skilled team of oncologists, including medical, surgical, and radio oncologists, as well as a well-trained paramedical staff.

In addition to selecting a hospital with world-class facilities, you must ensure that the hospital you choose has a dedicated cancer treatment unit and a well-trained post-care team.

Also, look into the hospital’s cancer treatment success and survival rates.

The above guidelines were used to form the MedicoExperts panel of hospitals.

How to choose the best oncologist for your Non-Hodgkin Lymphoma treatment in India?

To improve your chances of success and survival, you should consult with other oncologists. You should not rely on just one doctor for a successful outcome and higher success and survival rates. 

The tumor board approach is a new way to improve non-hodgkin lymphoma patient survival rates. To achieve the best possible treatment outcome, highly skilled medical, surgical, and radiation oncologists collaborate closely on the case.

MedicoExperts helps patients all over the world get the best possible treatment and survival rates by using this tumor board approach to treating them.

 

Treatment cost
Treatment cost

Treatment cost in India

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 (37210 INR).

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 (29768 INR).

Radiation therapy cost starts from 3300 USD (245587 INR) in India.

Stem cell transplant costs can range between 25,000 to 47,000 USD (1860511 – 3497761 INR) in India.

survival rate

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

5 Survival rates of diffuse B cell lymphoma are:

  • 73% for localized cancer
  • 73% for regional cancer
  • 57% for distant cancer

5 year survival rates of follicular lymphoma are

  • 96% for regional cancer
  • 90% for regional
  • 85% for distant cancer

Non-Hodgkin’s lymphoma has high 5 years survival rate. It is treatable and curable. Connect with us, If you wish to know more about the treatment of Non-Hodgkin’s lymphoma.

prostate cancer survival rate

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.

Is it possible to be cured of non-Hodgkins lymphoma?

Yes, NHL is a treatable and curable disease in many cases, especially in aggressive NHL. It’s important to know how far along the cancer has progressed before starting treatment. 

This is referred to as the disease stage. The stages go from I (least severe) to IV (most severe).

When is non-lymphoma Hodgkin's treated with chemotherapy?

 Chemotherapy (chemo) is the most common treatment, usually consisting of four drugs known as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), as well as the monoclonal antibody rituximab (Rituxan). The R-CHOP regimen is usually administered in three-week cycles.

What is the difference between lymphoma and leukaemia?

Both diseases are blood-related, but they begin in different places. 

Leukemia starts in the bone marrow and spreads through the bloodstream. 

Non-lymphoma Hodgkin’s is a cancer that develops in body tissue such as lymph nodes or other organs.

How can non-lymphoma Hodgkin's (NHL) in adults be avoided?

Many of the risk factors for NHL are beyond anyone’s control. However, the following factors can be managed:

  • Avoiding behaviours that weaken the immune system, such as those that increase the risk of AIDS and hepatitis C infections.
  • Avoiding unnecessary radiation exposure.
  • Maintaining a healthy weight and eating habits.
  • Lymphoma can develop in the scar tissue around breast implants in rare cases. Breast implant surgery should be carefully considered.

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