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Treatment

In general, the goal of treatment is to destroy as many lymphoma cells as possible and to induce a complete remission. Complete remission means that all evidence of disease is eliminated. Patients who go into remission are sometimes cured of their disease. Treatment can also keep non-Hodgkin lymphoma (NHL) in check for many years, even though imaging or other studies show remaining sites of disease. This situation may be referred to as a “partial remission.”

Diagnosis

Having the correct diagnosis is important for getting the right treatment. Hodgkin lymphoma (HL) may be difficult to diagnosis. You may want to get a second medical opinion by an experienced hematopathologist before you begin treatment. A hematopathologist is a specialist who studies blood and bone marrow cells and other tissues to help diagnose diseases of the blood, bone marrow and lymph system.

Diagnosis

An accurate diagnosis is one of the most important aspects of a person’s care. Obtaining a precise diagnosis will help the doctor

• Determine the MDS subtype 
• Estimate how the disease will progress
• Determine the most appropriate treatment

Since MDS can be a difficult disease to diagnose, you may want to get a second medical opinion by an experienced hematopathologist before you begin treatment.

Chemotherapy and Drug Therapy

There are many different types of drugs used in the treatment of MDS.

Immunosuppressive Therapy. Drugs that suppress certain parts of the immune system can help some patients with lower-risk MDS. In some types of MDS, lymphocytes, a type of white blood cell, may attack the bone marrow, causing it to stop making enough healthy blood cells. Immunosuppressive therapy lowers the body’s immune response to allow bone marrow stem cells to grow and make new blood cells. The main immunosuppressive therapy drugs used to treat MDS are:

Chemotherapy

Chemotherapy is the use of potent drugs or chemicals, often in combinations or intervals, to kill or damage cancer cells in the body. Chemotherapy drugs are often called anticancer agents. The drugs must be toxic enough to kill leukemic cells, which is why chemotherapy can be hard on your body; the drugs' toxicity can harm your healthy cells as well. However, successful chemotherapy depends on the fact that cancerous cells are more sensitive to the chemicals in the drug than normal cells are.

Allogeneic Stem Cell Transplantation

Allogeneic stem cell transplantation involves the use of stem cells from someone other than the patient. The donated stem cells can come from either a person related or not related to the patient. 

Mental Health

The term “mental health” includes your emotional and psychological well-being. Your mental health guides how you handle stress, manage relationships and make decisions. Mental health, like physical health, is important to your overall well-being.

Emotions like sadness, anger or stress are normal and healthy responses to difficult life events, such as a cancer diagnosis. However, sometimes persistent feelings of sadness, stress or anxiety can be caused by a mental health disorder. Don't ignore any of these feelings. Talk to your healthcare team about how you are feeling.  

Hodgkin Lymphoma Subtypes

The World Health Organization (WHO) divides Hodgkin lymphoma into two main subtypes. They are:

Treatment

Every patient’s situation should be evaluated individually by a hematologist-oncologist who specializes in treating MDS and who will discuss the disease subtype, prognostic factors and treatment options with the patient. It is also important to seek treatment at a center that has experience in treating MDS. 

Doctors use several types of approaches and treatment combinations for MDS:

Stem Cell Transplantation

An allogeneic stem cell transplantation is a treatment that uses stem cells from a healthy donor to restore a patient’s bone marrow that is damaged or diseased after receiving high doses of chemotherapy and/or radiation therapy. Allogeneic stem cell transplantation remains the only potential cure for MDS. 

Managing Side Effects

Work closely with your doctor and cancer care team to prepare yourself with information about what to expect and how to cope with side effects.  For some patients, side effects may last well after treatment is completed or may be permanent. For most patients, side effects are temporary and go away when the body adjusts to therapy or once treatment ends. On the other hand, some patients suffer symptoms that may require hospitalization until they subside.

Reactions to treatment vary from patient to patient. Reactions also vary depending on:

How to Find a Treatment Center

A number of resources are available to help you find a treatment center. Your primary care doctor may be able to provide a referral or you can use doctor and insurance referral services.

The National Cancer Institute (NCI) supports a national network of cancer centers. Each center must meet specific scientific, organizational and administrative criteria. See a list of NCI-approved cancer centers.

The following organizations can also help:

Survivorship

Use this Survivorship Workbook to collect all the important information you need throughout diagnosis, treatment, follow-up care and long-term management of a blood cancer.

Talking With Members of Your Oncology Team

Ask your oncology team about the fertility effects of your treatment. By having this information before treatment begins, you can consider the options most likely to preserve your fertility. You can also ask for a referral to a fertility specialist to help you understand and explore your options. Fertility specialists include:

Pregnancy and Breastfeeding

Most people of childbearing age who have been treated for cancer and are able to conceive can go on to have low-risk pregnancies and healthy babies. Patients should be able to become pregnant if treatment did not affect their ovaries or uterus, and there are no other medical issues that may impact fertility. Before you try to become pregnant, talk with your treatment team about your medical readiness for pregnancy. You may also want to have a fertility assessment by consulting with a doctor called a “reproductive endocrinologist.”

Bereavement

Losing a child is possibly the most difficult thing a parent can experience. Grief can affect each person emotionally, physically, cognitively and behaviorally. Many people express grief in an outward way; for example, crying, a lack of energy or trouble sleeping. Others, on the surface, may not seem to be grieving. Instead, these people process grief internally. Their grief may go unrecognized and unacknowledged. Be aware that grief is personal and specific to the person. Try not to make judgments about how you, your co-parent or others process the loss of your child.

Nausea and Vomiting

Many cancer treatments can cause nausea and vomiting. Nausea, also called feeling “queasy” or “sick to your stomach,” is that unpleasant feeling you have when you are going to throw up. Vomiting is throwing up what is inside your stomach through the mouth. Nausea and vomiting can happen together, or one can occur without the other. The severity of nausea and vomiting varies among patients. Sometimes these side effects improve as you adjust to treatment, and most side effects go away after treatment ends.

Diarrhea and Constipation

Diarrhea and constipation are common side effects of cancer treatment. The severity of diarrhea or constipation varies among patients and depends on the type of treatment you receive. Sometimes side effects improve as you adjust to treatment. Most side effects go away when treatment ends.

Tell your healthcare team if you are experiencing new or worsening diarrhea or constipation. Do not take over-the-counter medications without talking to your doctor.

Follow these tips to manage diarrhea:

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Jenna

Whitney

I am delighted to be a new member of the Clinical Trial Support Center team at The Leukemia & Lymphoma Society (LLS)! After eight years as a clinical nurse, charge nurse, and assistant nurse manager at various oncology hospitals across the country, I am honored to now work with blood cancer patients as a Spanish-speaking, CTSC nurse navigator.

Grace

On February 6, 2023, I was diagnosed with stage 3 Hodgkin lymphoma (HL). However, my story starts months before that. I was attending my sophomore year of college at my university when I started experiencing symptoms I did not understand or put together. I started experiencing extreme exhaustion, I was dropping weight very fast, and I was always lightheaded. I decided to come home only three weeks into my spring semester because I couldn’t keep up my course load with how bad I was feeling.

Keisha

In 2017, I was diagnosed with a rare and chronic form of non-Hodgkin lymphoma (NHL). I was beyond devastated as I knew there was no cure for my condition, and I also knew my life would be altered in many ways. I was also finishing my last semester in graduate school and almost gave up my dream of graduating. But with the support of my family, school, physicians, and The Leukemia & Lymphoma Society (LLS), I persisted and received my Master of Education in 2018.

Brooke

In September 2014, just shy of four months after college graduation, I was blindsided sitting in the emergency room at Duke Hospital.

Christine

My father, Alan Schwall, was diagnosed with acute myelogenous leukemia (AML) at the very start of my sophomore year in college -- in the fall of 2006 when he was only 51 years old. He always had knee issues, but the summer between my freshman and sophomore year at college, he developed a swollen leg/knee and other problems that made it hard for him to walk at times.