Month: June 2018


Stem Cell Treatment for Lymphoma: What You Should Know

If you or a loved one has been diagnosed with non-Hodgkin’s lymphoma and are embarking on treatment, it’s likely you’ve heard about stem cell transplants at some point. These transplants can be an important part of treatment for some patients, but they’re not appropriate for everyone who has lymphoma. Let’s take a look at the facts you should know.

These transplants work by improving function in the bone marrow

Stem cells are blood cells in their earliest stage of development, and they’re made in the body’s bone marrow. Think of bone marrow — the spongy substance inside our bones — as the immune system’s factory, churning out additional fighters every day.

The stem cells develop into mature blood cells within the bone marrow and then go into the bloodstream, where they serve a number of functions, including carrying oxygen to cells, helping blood to clot, and fighting infection. Normally, the bone marrow makes millions of new blood cells daily, to replenish the cells that are dying off naturally. For example, red blood cells live for only about four months.

In a stem cell transplant, bone marrow that’s been damaged — for those with non-Hodgkin’s lymphoma, that trauma comes from chemo — and unable to keep producing stem cells on its own gets a fresh infusion, so the factory can get back up and running.

Stem cell transplants are usually only used for recurring lymphoma

There are many forms of lymphoma, so when and how stem cell transplants are used will depend on what type of lymphoma is present, says Robert Dean, M.D., in the Department of Hematology and Medical Oncology at Cleveland Clinic. But, that said, these transplants are primarily used only when first-line treatments aren’t working, or if lymphoma has gone into remission and then recurred.

“When that happens, it tells us that some of the cancer cells were strong enough to resist the initial chemo, or that they managed to bypass the chemo in some way,” he says. “In that case, going back to using the same chemo as we did the first time wouldn’t be the best treatment, because it’s likely those cancer cells would be resistant. So, we need to consider adding a stem cell transplant into the mix for those patients.”

Stem cell transplants are not a treatment option on their own

Although they’re sometimes called “stem cell treatments,” this form of intervention is not a treatment by itself, the way that chemotherapy or radiation would be. Instead, it’s used as a way to help the immune system recover from stronger chemotherapy, says Jack F. Jacoub, M.D., medical oncologist and medical director of California-based MemorialCare Cancer Institute at Orange Coast Medical Center.

When lymphoma patients see their cancer come back, high-intensity chemo is the best option, Dr. Jacoub adds. But the major side effect of that is significantly reduced or even destroyed capability within the bone marrow.

“When you wipe out the bone marrow, essentially you no longer have immune system function,” he says. “You may have eliminated the cancer, but you can’t operate without an immune system.”

Stem cell treatments help the body start growing blood cells normally again, so that your immune system can get back to its normal functioning. “Think of a stem cell transplant as a parachute,” Dr. Dean says. “It’s a valuable safety mechanism, but chemo is the jump out of the airplane.”

Ideally, this combination provides a powerful way to treat recurrent lymphoma, because the stronger chemotherapy potentially clears the system of cancer cells, and the stem cell treatment helps the body get back to normal immune system function more quickly.

Dr. Dean adds that for many patients, higher dose chemo without a stem cell treatment isn’t recommended, because the body may not be able to get “back online” without one. After all, he adds, who would risk skydiving without a parachute?

You may get your own stem cells or donor cells

In some cancers, like leukemia, donor cells are preferred because they tend to be better at finding and attacking leftover cancer cells, Dr. Dean notes. But for lymphoma, using a patient’s own cells can often be just as effective. If that’s the approach an oncologist chooses, some of your stem cells will be harvested and stored before the stronger-chemo rounds, and then re-introduced to the body after the chemo has cleared from the system.

There are some cases where donor cells are more commonly used, mainly with certain forms of particularly aggressive lymphoma. For example, there’s a type of non-Hodgkin’s lymphoma called mantle cell lymphoma where the body makes abnormal B-cells (the white blood cells that fight infection). Dr. Dean notes that this type of cancer tends to be treated more effectively with high-dose chemo and donor stem cells.

But no matter where your stem cells might originate, the goal is the same. “Stem cell therapy is added on to treatment with the expectation of a longer remission,” he says.

Elizabeth Millard is a freelance journalist specializing in health, wellness, fitness, and nutrition. Her articles have appeared in SELF, Men’s Health, CNN, MyFitnessPal, and WebMD, and she has worked on patient education materials for Mayo Clinic and UnitedHealth Group. Find her on Instagram at @bossykind and on Twitter at @EMillard_Writer. Her online portfolio is at When not writing, she’s also a yoga teacher and organic farmer.

Article & Image Source: Stem Cell Treatment for Lymphoma: What You Should Know


How Your Lymph Nodes Protect You from Cancer — And What Happens When They Don’t

Unlike cancers related to an organ or a specific part of the body — such as lung cancer or breast cancer — lymphoma can develop at any point within the lymphatic system, and involve one of numerous types of cancers under the larger definitions of Hodgkin’s and non-Hodgkin’s lymphomas. To understand how this cancer can develop, let’s first take a look at the lymph system, how it works, and what happens when it can’t.

What is the lymph system?

Your lymphatic system is an important part of your immune system, and is represented by an extensive network of vessels passing through almost all of the body’s tissues, shuttling a clear liquid called lymph throughout the body.

On this network are around 500 to 700 “lymph nodes” that essentially act as manufacturing stations for lymph — a fluid that contains white blood cells used to defend the body against invaders like viruses and bacteria. One of the main types of these cells is called a lymphocyte, which include T cells and B cells, two of the strongest fighters in your immune system’s army of cells.

Lymph nodes also serve as filtering mechanisms; the lymph system regularly drains excess fluid from body tissues and then routes it though the lymph nodes for assessment by immune system cells.

“Think of it as a whole branching network that runs through your body and works to keep everything well regulated, and as part of that effort, to identify invaders,” says Catherine Diefenbach, M.D., clinical director of lymphoma at NYU Langone Perlumtter Cancer Center, New York.

Lymph nodes are small, bean-shaped structures that are grouped into clusters, particularly in the neck, armpits, groin, chest, and abdomen. Also considered part of the lymph system are bone marrow, the spleen, tonsils, and the thymus.

How does the lymph system work, and how does it fail?

When the lymph system shuttles fluid out of the tissues for examination and finds bacteria or viruses, it traps them and enlists immune cells to attack. This often creates an inflammatory response, causing the nodes in that area to swell, and if it’s in a part of the body where it can be felt externally, you might feel pain or tenderness there, Dr. Diefenbach says. The effect of “swollen glands” is actually enlarged lymph nodes.

You may also experience more aggressive symptoms like night sweats, fever, weight loss, adds Jack F. Jacoub, M.D., medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Memorial Medical Center, Fountain Valley, California.

When the system gets out of balance in some way, the process of keeping your body fluids in balance can get out of whack. That can lead to fluid building up in your tissues instead of being shuttled out by the lymph vessels. When that happens, you will likely have swelling — called lymphedema — that can cause issues like infections and blockages. Because your immune system won’t be operating efficiently, it can also leave you more susceptible to illness.

Cancer of the lymph system can arise either because of cells in the system that have turned malignant, or because a lowered immune system allowed cancer cells to go unchecked. In both cases, those cancer cells can spread throughout the body along the lymph system and then grow in lymph node clusters.

If you’re experiencing swelling that doesn’t go away, or having some of the more aggressive symptoms like fever, that should prompt a check with your doctor for possible lymphoma or other conditions that might be affecting the lymph system, advises Dr. Jacoub.

How is lymphoma diagnosed and treated?

Because the lymph system runs throughout the entire body, lymphoma is detected through whole-body imaging like a PET scan or a CAT scan, Dr. Jacoub says. It may also be diagnosed through a bone marrow biopsy. He adds that staging is still evolving, but in general, stage 1 involves a cancer that is in one lymph node region, such as contained in the neck or the groin. Stage 2 is in two or more lymph node regions and may involve one organ as well. Stages 3 and 4 represent a spread beyond the lymph node areas to organs like the liver or lungs.

Both Hodgkin’s and non-Hodgkin’s lymphoma involve the lymphocytes, but the former has the presence of a certain type of B cell — called a Reed-Sternberg type — that has become malignant. If you don’t have this abnormal cell, you have non-Hodgkin lymphoma.

Unlike some forms of cancer that benefit from tumor removal by surgery, it’s rare for lymphoma to be addressed that way, Dr. Jacoub notes. That’s because it’s considered a “total body illness” due to the way the lymphatic system operates. There are more than 30 types of non-Hodgkin’s lymphoma, so specific treatment will be based on what type is present. But in general, says Dr. Jacoub, chemotherapy and targeted radiation are considered the first-line treatments for most lymphomas.

Elizabeth Millard is a freelance journalist specializing in health, wellness, fitness, and nutrition. Her articles have appeared in SELF, Men’s Health, CNN, MyFitnessPal, and WebMD, and she has worked on patient education materials for Mayo Clinic and UnitedHealth Group. Find her on Instagram at @bossykind and on Twitter at @EMillard_Writer. Her online portfolio is at When not writing, she’s also a yoga teacher and organic farmer.


What You Should Know About Clinical Trials If You Have Lymphoma

With both Hodgkin’s and non-Hodgkin’s lymphoma, there are numerous clinical trials in progress designed to test new protocols, different medication regimens, or pre-market drugs.

For those who have been diagnosed and are curious about whether a trial is a good fit, it’s worth doing some research and talking with your physician about the possibility. Here are some basics as a solid starting point.

What the ‘phases’ of a clinical trial mean

There are four phases of clinical trials. Phase one assesses the safety of a drug, device, or other intervention. It usually includes a small number of participants — often fewer than 100.

“Phase one trials used to have a negative connotation, because patients sometimes believed you would be ramping up dosage of a drug until they saw bad side effects,” says Jack F. Jacoub, M.D., medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Memorial Medical Center, Fountain Valley, California. “That’s simply not the case. You’re not seen as a lab rat in these trials, you’re viewed as a vital participant in a very important process toward improving medicine. That’s true at every phase.”

In phase two, with safety in place, the drug or device is evaluated for efficacy. This involves more participants, and may use a “control” group that receives a placebo or standard treatment. Most often, though, there is no placebo — simply different levels of medication dosages or the same dose applied to multiple types of conditions.

“There’s a common misconception that some people in the trial will get a placebo and therefore not be treated for their condition,” says Dr. Jacoub. “But there will always be a standard of care in place.”

Phase three brings in several hundred to several thousand participants and uses randomized and blind testing to determine whether the treatment works for a larger number of people. Phase three also looks more closely at potential adverse reactions, such as significant side effects.

At that point, the drug, device, or intervention can then be approved for use among a wider patient population, and may enter phase four, which looks at long-term effectiveness.

For every phase, there is an initial process called “informed consent.” During that period, you’ll have the chance to ask the researchers questions — although you can certainly do that during the trial as well. Informed consent is required by federal law for research institutions, to ensure that patients understand the requirements, risks, and benefits of participating in a specific trial.

No matter what phase you join, keep in mind that you can drop out anytime. Joining a trial doesn’t mean you’re automatically “locked in” until the end. Participation is always voluntary.

What to consider before joining a trial

Even if you’ve qualified for a trial based on the specific research criteria of that trial, there are still several factors to keep in mind before joining. For example, a major aspect is what type of support you have from caregivers, says Marlon Saria, Ph.D., R.N., advanced practice nurse researcher at the John Wayne Cancer Institute, Santa Monica, California.

Dr. Saria has been involved with clinical trials for eight years, with usually around 20 trials open simultaneously. Those who seem to do the best with trials, he notes, are people who have engaged and organized caregivers.

“If you have a diagnosis like cancer, you already have a complex medical issue,” he says. “You’re dealing with pain management, treatment, possible medication schedules, testing, and appointments. Adding a clinical trial into that gives you more to track and remember. It’s best to have support for that.”

Also, an active caregiver can be observant about potential side effects. Dr. Saria has seen patients leave clinical trials because they haven’t noticed problems until their side effects were quite advanced. But if those effects are caught early, they can be addressed and allow you to stay in the trial.

For those with lymphoma who don’t have an involved caregiver, help is available through the Leukemia & Lymphoma Society (LLS), says Alissa Gentile, R.N., director of the organization’s Clinical Trial Support Center. The LLS service has nurses who follow patients through clinical trials and help them through the process. Also useful, LLS maintains an online database of lymphoma-related trials on its website.

Keep financial aspects in mind

Another consideration when thinking about whether to join a trial may be the financial impact. In some cases, participants receive payment, but more often, the pharmaceutical or device company involved in the treatment only pays for the treatment used in the clinical trial.

That doesn’t cover expenses like hospital stays, doctor and nurse time, and other costs, including some drugs costs, according to Gentile.

“There is a large misconception that clinical trials will cover all expenses, and unfortunately, that’s rarely true,” she says. “That’s why it’s important to look at potential costs and insurance coverage when evaluating whether to join a trial. Otherwise, you may have an unpleasant surprise when you find that you have to cover costs that you didn’t expect.”

Knowing the aspects of a trial — how long the trial will be conducted, how current treatment will be affected, which out-of-pocket expenses will be involved, and what factors would cause you to be dropped from the trial — is a crucial part of making the decision about whether a trial seems like a good fit for you.

Elizabeth Millard is a freelance journalist specializing in health, wellness, fitness, and nutrition. Her articles have appeared in SELF, Men’s Health, CNN, MyFitnessPal, and WebMD, and she has worked on patient education materials for Mayo Clinic and UnitedHealth Group. Find her on Instagram at @bossykind and on Twitter at @EMillard_Writer. Her online portfolio is at When not writing, she’s also a yoga teacher and organic farmer.


Abby Lee Miller Continues To Fight Rare Cancer

The Dance Moms star is starting her third round of chemo.

  • ‘Dance Moms’ star Abby Lee Miller has begun her third round of chemotherapy for her Burkitt lymphoma.
  • Abby Lee was first diagnosed with the rare form of cancer following a hospitalization in April for what doctors thought was a spinal infection.
  • Burkitt lymphoma is an aggressive type of non-Hodgkin’s lymphoma, a type of cancer that starts in the white blood cells, and can be lethal within weeks without treatment.

Dance Moms star Abby Lee Miller has had an intense past few months in the health department. First, she was hospitalized with severe neck pain and had to have emergency spinal surgery. Then, she learned she had a rare form of cancer known as Burkitt lymphoma (a type of non-Hodgkin’s lymphoma), according to ET Online. Now, she’s undergoing her third round of chemo to try to treat her cancer.

Abby (who has been in the hospital since mid-April, per Page Six) shared a closeup of her face bathed in sunlight on Instagram Sunday. “Going outside to feel the sun on my face was wonderful!!!” she wrote. “Kids, never take anything in this world for granted! It can all change so suddenly! The Brilliant Dr. B cleared me for sunning this afternoon! Woo Hoo! Thank you sir!”

Her sweet sunning shot comes just days after she revealed that she was about to start her third round of chemotherapy. “I should be planning a weekend of fun in the sun at the pool!,” she captioned a throwback photo on Instagram. “There’s nothing I enjoy more than swimming and a good tan! Instead, I start round 3 of chemo……… another battle that I must win!!!”

What is Burkitt lymphoma?

In case you’re not familiar with it, Burkitt lymphoma is an aggressive form of non-Hodgkin’s lymphoma, a type of cancer that affects white blood cells, according to the American Cancer Society (ACS).

With Burkitt lymphoma, the cancer usually starts in a person’s abdomen, where it forms a large tumor. It can spread rapidly to the brain and spinal fluid. It is very rare, according to the ACS-making up just 1 to 2 percent of all lymphomas.

“Burkitt lymphoma is very aggressive,” says Jack Jacoub, M.D., a medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, Calif. “It can be lethal in a matter of weeks with no therapy.” Luckily, the ACS says that more than half of patients can be cured by “intensive chemotherapy.”

There’s no word on how much longer Abby’s treatment is expected to take, but for her specific type of cancer, treatment generally involves undergoing chemotherapy cycles for four to five months, Jacoub says. That can include chemotherapy injections into the spine as well as intravenous chemo.

Why did Abby have to avoid sun exposure during treatment?

Jacoub says people who undergo chemo can burn a lot easier and quicker than others. He adds that doctors usually advise patients not receive direct, prolonged sun exposure for several weeks after their last chemotherapy session. However, it’s probably okay to briefly grab a few rays here and there.