Lymphatic Cancer Therapy
NOTE : This is only information of a general nature! Each therapy should be discussed in detail with the responsible doctor and decided together!
The therapy for lymph gland cancer is strongly dependent on the type and the stage of spread in which the cancer is at the time of diagnosis and on the age of the patient and his condition. For this reason, a staging is carried out before each start of therapy, which shows the exact spread of the disease. Usually the chemotherapy, the Radiotherapy (Irradiation) and the surgery available as therapy options. These can also be combined.
If tumors have already settled in other tissues (metastases), attempts are usually no longer made to cure the cancer, but to create the best possible quality of life for the patient with therapy. This is called a palliative treatment.
General therapy options
Lymphatic cancer is divided into two subgroups:
1. Hodgkin's lymphoma and
2. Non-Hodgkin lymphoma
Hodgkin's lymphoma occurs at a rate of 3 new cases per 100,000 people. Non-Hodgkin lymphoma is more common with a frequency of 12 per 100,000 population. Today there is a whole range of treatment strategies, which are mainly composed of chemotherapy and radiation. In the very early stages, surgery to remove the cancerous lymph node may also be considered. An individual therapy adjustment is necessary for each patient. So play factors like:
- other comorbidities
- Stage of the disease and
- Formation of metastases
plays an important role in deciding how to treat.
Each therapy should be carried out as part of a clinical study and there are special therapy protocols, i.e. specific guidelines for each cancer stage, according to which the therapy is based.
A removal of the lymph gland cancer by means of an operation is only possible in early stages recommended for cancer and only for so-called non-Hodgkin lymphomas. The cancer must not be too big and must not have spread, it must be on one easily accessible place in the body and the operational risks must not be too great. For example, if only one lymph node on the neck is affected by the cancer and the lymph gland cancer is not in the immediate vicinity of large, important vessels and nerve tracts, surgical removal of the lymph gland cancer is in principle possible. Another point that is crucial when deciding for or against an operation is whether the operation causes damage to neighboring organs and structures so that they would no longer function properly.In this case, surgery would not be justified as the disadvantage would be greater than the benefit.
Since every operation carries risks, this should be a therapy option discussed in detail with the doctor.
Treatment for lymph gland cancer usually consists of chemotherapy and radiation treatment. Both are carried out in close succession. The treatment is usually divided into several cyclesthat by short Chemotherapy breaks are separated from each other. Treatment takes place in so-called treatment studies and is carried out on the basis of treatment protocols.
You come to the hospital for chemotherapy cycles, where the medication is usually given in the form of infusions.
Read more about this under: Performing chemotherapy
In most cases, chemotherapy is carried out according to the ABVD regimen, the CHOP regimen, or the BEACOPP regimen. The letters stand for the first letters of the corresponding chemotherapy drugs.
In stages 1 and 2, therapy is carried out using the ABVD therapy scheme over 29 days long and then repeated again. The ABVD scheme stands for four chemotherapy drugs Adriamycin, bleomycin, vinblastine and dacarbazine. After that, two radiotherapy sessions are usually carried out, and one comes to the hospital for the sessions.
If it is a more advanced stage, the so-called BEACOPP scheme is used. This consists of 6 chemotherapy drugs and from cortisone. A repetition takes place a little earlier, namely after day 22. The chemotherapeutic agents used here include: bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbacin and, as a non-chemotherapeutic drug, prednisolone.
This is usually the case with so-called non-Hodgkin lymphomas CHOP scheme used, which consists of the four drugs cyclophosphamide, hydroxydaunorubicin, vincristine and the cortisone-like agent Prednisolone consists.
More information can be found here: chemotherapy
Despite the constant further development of chemotherapeutic drugs, which increasingly have fewer side effects, it still happens Nausea and vomiting, often to gastrointestinal problems such as Diarrhea and loss of appetite unspecific malaise, weight loss, and insomnia.
Further information can be found here: Chemotherapy side effects
Radiation therapy is usually carried out after chemotherapy for lymph gland cancer. If chemotherapy alone is very successful and causes rapid and effective destruction of the cancer cells, radiation therapy can also be dispensed with in some cases. As with the other therapy options, it depends most on the stage of the lymph gland cancer and then the decision as to whether radiation therapy is carried out depends.
You can also find more information here: Treatment by radiation therapy and Radiation therapy planning
Not only chemotherapy has some side effects and intolerances, but also radiation. So it can after irradiation too local skin irritation and redness (similar to a sunburn) come. Continue to occur frequently Loss of appetite and nausea on. It can also be used for Irritation of the organs that are located near the irradiated area. For example, if a lymph gland cancer on the neck is irradiated, the radiation therapy can also irritate the esophagus.
Therapy options according to stages
As already emphasized several times, the therapy is basically based on the cancer stage. Here you will now find an overview of the therapy options in the individual stages. However, exact therapy schemes are provided with the competent doctor agreed that for each patient individually a risk-benefit analysis undertakes.
An early stage is characterized in that mostly only single, more superficial lymph nodes are affected. If the lymph gland cancer is in the chest or abdominal cavity, it no longer belongs to the early stages. In addition, the lymph gland cancer must not be too large, even if it is limited to only one lymph node.
In the early stages of lymph gland cancer shows the Chemotherapy combined with radiation therapy the best results. In these cases, brief chemotherapy and two exposures to the affected area are usually sufficient to kill all cancer cells.
Chemotherapy is usually carried out according to the above ABVD scheme, because this scheme is comparatively effective with very good effect few side effects Has. Chemotherapy is usually followed by one, even in the early stages Radiation therapy.
In the case of non-Hodgkin lymphatic cancers, which are a large part of the lymphatic cancers, the affected lymph nodes can also be removed in the early stages by a surgery respectively. If chemotherapy then follows, the chances of recovery are usually good outstanding.
Medium stages are found when several lymph node regions are affected on the same side of the diaphragm. Here, too, a combination of chemotherapy and radiation therapy is usually used.
Chemotherapy is mostly used in four cycles performed with a total of ten different chemotherapy drugs. This is also called Polychemotherapy ("poly" = a lot). This is followed by radiation therapy. Since the combination of chemotherapy and radiation therapy has more side effects, such as has a higher rate of secondary tumors, this therapeutic option must always be carefully weighed with regard to the risk-benefit ratio.
In the advanced stages chemotherapy is usually carried out with six cycles, which can be followed by radiation therapy after consultation with the doctor.
Additional information can be found here: Lymph gland cancer - what is the prognosis?
Therapy of a relapse
In addition to the primary treatment of lymph gland cancer, there is also a separate therapy that is used when lymph gland cancer recurs. This recurrence of an "already cured" cancer is called Relapse.
Since radiation treatment is usually no longer allowed after a certain lifetime dose, there will be a few more Chemotherapy drugs for this late therapy (or also second line therapy) used.
Patients with a relapse are divided into three different groups. The first group makes up about 15% of all patients. This get one Late recurrence and must be treated again. But you have good chances of long-term healing. The second group includes patients who Early recurrences got. They also make up 15% of all cases. Here, too, the prognoses are for a renewed containment of the disease pretty goodif a new treatment is started soon. The third group includes the complete Therapy failurethat first-line treatment did not help at all. Even after the start of the second-line treatment, the chances of success are unfortunately very low.