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Lymphoma

Lymphomas are cancers that develop in the lymphatic system—the tissues and organs that produce, store, and carry white blood cells. The lymphatic system includes the bone marrow, spleen, thymus, and lymph nodes and a network of thin tubes that carry lymph and white blood cells into all the tissues of the body. Types of lymphoma include non-Hodgkin's, Hodgkin's, and cutaneous T-cell lymphoma.

In non-Hodgkin's lymphoma, the most common form of the disease, cells in the lymphatic system become abnormal. They divide and grow without any order or control, or old cells that should die, don't. Non-Hodgkin's can begin and/or spread to almost any part of the body.

In Hodgkin's disease, cells in the lymphatic system also become abnormal, but the cancer tends to spread in a fairly orderly way from one group of lymph nodes to the next. Eventually, it can spread almost anywhere.

In cutaneous T-cell lymphoma, T-lymphocytes (infection-fighting white blood cells) become cancerous, causing skin problems.

Signs and Symptoms

Lymphoma is accompanied by the following signs and symptoms, by type.

Non-Hodgkin's and Hodgkin's:

bulletPainless swelling in lymph nodes in neck, underarm, or groin
bulletUnexplained fever
bulletDrenching night sweats
bulletTiredness
bulletUnexplained weight loss
bulletItchy skin

Cutaneous T-Cell:

bulletItchiness
bulletDark patches on skin
bulletTumors on skin (mycosis fungoides)
bulletSkin infections

Who's Most At Risk?

People with the following conditions or characteristics are at risk for developing lymphoma, by type.

Non-Hodgkin's:

bulletCongenital immunodeficiency
bulletInfections—Epstein-Barr virus (EBV), Helicobacter pylori, Kaposi's sarcoma herpes virus (HIV-related lymphoma), human T-cell leukemia virus type 1
bulletImmunosuppressive therapy following organ transplant
bulletAutoimmune diseases
bulletPrior chemotherapy or radiation exposure or therapy
bulletExposure to certain chemicals or solvents

Hodgkin's:

bulletViruses—EBV, mononucleosis, HIV
bulletTonsillectomy
bulletGenetic predisposition
bulletWhites more likely than blacks
bulletMen more likely than women
bulletSame-sex siblings—10 times greater risk

Cutaneous T-Cell:

bulletHuman T-cell leukemia virus type 1
bulletExposure to certain chemicals or solvents

What to Expect at Your Provider's Office

If you are experiencing symptoms associated with lymphoma, you should see your health care provider. He or she will carefully check for swelling or lumps in the neck, underarms, and groin. If the lymph nodes don't feel normal, a biopsy will be performed. The doctor will remove a small piece of the lymph node—or, in the case of cutaneous T-cell lymphoma, a growth from the skin—and a pathologist will examine the tissue under a microscope to check for cancer cells.

If cancer is present, more tests will be done to find out if the cancer has spread to other parts of the body (staging). This may involve blood and bone marrow tests, CT scans, and, possibly, a laparotomy, in which the doctor cuts into the abdomen and checks the organs for cancer.

Treatment Options

Treatment Plan

A treatment plan will be based on the diagnosis, the stage of the disease, the size of the tumor, and your general health and age.

Drug Therapies

Your provider may prescribe the following drug therapies.

Hodgkin's and Non-Hodgkin's:

bulletRadiation therapy
bulletChemotherapy, possibly with alpha interferon

Cutaneous T-Cell:

bulletEmollients, moisturizers, topical steroids
bulletChemotherapy
bulletElectron beam therapy
bulletRetinoids and interferon

Surgical and Other Procedures

Bone marrow transplantation and peripheral blood stem cell transplantation are sometimes performed. Radioimmunotherapy, which is treatment with a radioactive substance that is linked to an antibody that will attach to the tumor when injected into the body, is being tested in clinical trials. Surgical removal of the tumor may also be performed.

Complementary and Alternative Therapies

A comprehensive treatment plan for lymphoma may include a range of complementary and alternative therapies. Be sure to ask your team of health care providers about the best ways to incorporate these therapies into your overall treatment plan.

Improved relaxation and decreased stress, through such activities as guided imagery, tai chi, yoga, and meditation are helpful in promoting a sense of well-being. Intimacy and support from others helps promote a positive and empowering attitude.

Nutrition

Eat only organically-raised foods and foods that support detoxification, immunity, and are high in antioxidant nutrients, such as beets, carrots, artichokes, yams, onions, garlic, dark leafy greens, yellow and orange vegetables, shiitake mushrooms, green tea, and filtered water. Avoid refined foods, sugar, alcohol, caffeine, and saturated fats (animal products).

Potentially beneficial nutrient supplements include the following.

bulletVitamin C (1,000 mg four times per day), vitamin E (400 IU twice per day), beta carotene (50,000 IU one to two times per day), coenzyme Q10 (100 mg three times per day), and zinc (30 mg per day)
bulletCoenzyme Q10 and L-carnitine (600 mg three times per day) may reduce toxicity from chemotherapy
bulletSelenium (200 mcg twice per day) and glutathione (500 mg twice per day) may reduce toxicity from chemotherapy
bulletB-complex (50 to 100 mg) for stress
bulletJuicing: In a juicer, combine equal parts romaine lettuce, green pepper, celery, parsley, cucumber, and apple or pear (for flavor). Use organic fruits and vegetables. Drink one glass per day.

Herbs

Herbal remedies may aid detoxification, tumor inhibition, and immune support. Herbs are generally available as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 heaping tsp. per cup of water steeped for 10 minutes (roots need 20 minutes).

Choose one or more of the following.

bulletCommercial Hoxsey-like formulas or trifolium compounds (60 drops two to three times per day for six months or longer)
bulletScudder's Alterative Compound: combine equal parts of corydalis tubers (Dicentra Canadensis), black tag alder (Alnus serrulata), mayapple root (Podophyllum peltatum), figwort (Scrophularia nodosa), and yellowdock (Rumex crispus). Take 30 to 40 drops tincture three to four times per day for six months.
bulletEssiac or Flor-Essence (drink one cup tea twice per day or take 2 tbs. formula twice per day for six months)

Homeopathy

Homeopathy may help reduce symptoms and strengthen overall constitution and may help decrease the side effects of chemotherapy.

Physical Medicine

Contrast hydrotherapy may help enhance immune function and facilitate the transport of nutrients and waste products. End hot showers with one to two minutes of cold-water spray.

Acupuncture

Acupuncture may help strengthen immunity and detoxification. It may also reduce the side effects of chemotherapy.

Prognosis/Possible Complications

Prognosis varies depending on the type and stage of lymphoma. Survival rates for Stage I and II non-Hodgkin's lymphoma and Hodgkin's lymphoma are very high. Potential complications include the following: Hodgkin's sometimes develops into non-Hodgkin's lymphoma; radiation and chemotherapy can cause secondary cancers; infections and pulmonary fibrosis (thickening and scarring of the air sacs of the lungs) may occur.

Following Up

Once you are in remission, it is essential that you be checked for signs of relapse on a regular basis.

Supporting Research

Boik J. Cancer & Natural Medicine: A Texbook of Basic Science and Clinical Research. Princeton, Minn: Oregon Medical Press; 1996:70.

Brinker F. The Hoxsey treatment: cancer quackery or effective physiological adjuvant? J Naturopathic Med. 6(1):9-23.

Cecil RI, Plum F, Bennett JC, eds. Cecil Textbook of Medicine. 20th ed. Philadelphia, PA: W.B. Saunders; 1996.

Dambro MR. Griffith's 5-Minute Clinical Consult. 1999 ed. Baltimore, MD: Lippincott Williams & Wilkins, Inc.; 1999.

DeVita VT, ed. Cancer: Principles and Practice of Oncology. 5th ed. Philadelphia, PA: Lippincott-Raven Publishers; 1997.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.

Goroll AH, ed. Primary Care Medicine. 3rd ed. Philadelphia, PA: Lippincott-Raven Publishers; 1995.

Habif TP. Clinical Dermatology. 3rd ed. St. Louis, MO: Mosby-Year Book; 1996.

McCunney RJ. Hodgkin's disease, work, and the environment. J Occupational Environ Med. 1999; 41(1).

Moss RW. Alternative pharmacological and biological treatments for cancer: Ten promising approaches. J Naturopathic Med. 1996; 6(1):23-32.

Rakel RE, ed. Conn's Current Therapy. 51st ed. Philadelphia, PA: W.B. Saunders; 1999.

Scalzo R. Naturopathic Handbook of Herbal Formulas. 2nd ed. Durango, Colo: Kivaki Press; 1994: 35-36.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings