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Non-Hodgkin Lymphoma: ChemotherapyWhat is chemotherapy?Chemotherapy (chemo) uses anticancer medicines to kill cancer cells. These medicines are made to attack and kill cancer cells, which grow quickly. Some normal cells also grow quickly. Because of this, chemotherapy can also harm those cells. This can cause side effects. When might chemotherapy be used for non-Hodgkin lymphoma?Chemo is a main part of treatment for most people with non-Hodgkin lymphoma. It may be used along with other treatments, such as radiation or targeted therapy. You will see a medical oncologist for chemo. This is a doctor who specializes in using medicines to treat cancer. How is chemotherapy given for non-Hodgkin lymphoma?You can get chemo in many ways:
How you get chemo and how often you get it depends on the medicines used. Most people get chemo in an outpatient part of the hospital or at their doctor's office. But depending on which medicines you're getting and your overall health, you may need to be in the hospital for treatment. You'll likely need to have many IVs put in to get chemotherapy. Because of this, it can be helpful to have a central venous catheter (CVC) put in. This is also called a venous access device (VAD). This device is put in during surgery. It's most often a small drum that sits just under your skin. There's a tube attached to it that goes into a vein near your heart. You may hear it called a port. A needle is put into the drum each time you get chemo. Ports can stay in place for a long time. This means you don't need a new IV each time you get treatment. Talk with your healthcare team about the risks and benefits of having a CVC. You get chemo in cycles over a period of time. This means you get chemo for a set amount of time and then you have a rest period. Each period of treatment and rest is one cycle. You may have several cycles. Having treatment in cycles helps by:
What types of medicines are used to treat non-Hodgkin lymphoma?You'll most likely get more than 1 type of chemo medicine. This is called combination chemotherapy. Taking more than 1 type of medicine reduces the risk that the lymphoma will be resistant to the chemotherapy. That improves your chance of successful treatment. Which medicines you get and how often you get them depends on many factors. These include the type of lymphoma you have, how much cancer is in your body (your stage), and your overall health. B-cell lymphomaThese medicines are most often used for B-cell lymphoma. The first 4 are often combined in a regimen called CHOP:
T-cell lymphomaFor T-cell lymphoma, these are the chemotherapy medicines most often used:
For many types of non-Hodgkin lymphoma, chemo is given along with other medicines called monoclonal antibodies. These include rituximab and brentuximab vedotin. What are common side effects of chemotherapy?Chemo side effects depend on many things. These include the medicines you get, how long you take them, and how your body reacts to them. They also depend on how much cancer is in your body and your overall health. Most side effects get better or go away over time after treatment ends. Talk with your doctor or nurse about what to expect. Ask what you can do to help prevent or ease side effects. Here are some of the more common chemo side effects:
You'll have a lot of blood tests done while you’re getting chemo. This is so your doctor can check that treatment isn't damaging too many healthy cells. Make sure you ask which problems need to be reported to your doctor or nurse right away. For instance, chemo can make you more at risk for infections. So you should call your doctor if you have any of these symptoms:
Chemo for lymphoma can also cause some other side effects. These are less common but serious:
Working with your healthcare providerIt's important to know which medicines you're taking. Write down all your medicines. Ask your healthcare team how they work, and what side effects they might have. Talk with your healthcare providers about what problems to look for, and when to call them. For instance, chemo can make you more likely to get infections. Be sure you know what number to call if you have questions. This includes after office hours, on weekends, and on holidays. Keep a written record of your treatment plan. Also include your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you see your doctor. It will also make it easier for you to work with your healthcare team to manage your side effects. How long is chemo for nonThe treatment usually lasts for at least 6 months. But sometimes you have treatment once a week instead of once every few weeks. In this case the treatment lasts for 3 or 4 months.
How many rounds of chemo is normal for nonIf the lymphoma shrinks, a total of 6 cycles of chemo plus rituximab is usually given. Other options for initial treatment include rituximab alone or chemo alone (either one or several drugs).
How do you feel after chemotherapy for lymphoma?Most people experience some degree of tiredness in the days and weeks following chemotherapy and radiotherapy. Getting plenty of rest and doing a little light exercise each day may help to make you feel better during this time. It is important to listen to your body and rest when you are tired.
What are the long term effects of nonAll survivors of NHL have a higher risk of developing a secondary cancer. This increased risk continues for up to 20 years after treatment. The most common secondary cancers include cancer of the lung, brain, kidney, or bladder; melanoma; Hodgkin lymphoma; or leukemia.
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