Your Treatment Options for Non-Hodgkin Lymphoma
- Actor Jeff Bridges, 73, iconic 1970s film, “Winter Kills” gets a fresh look in an upcoming showing at the Academy Museum in Los Angeles, California. The actor has since battled non-Hodgkin lymphoma and reached remission after undergoing treatment.
- Lymphoma is a cancer of the immune system that affects infection-fighting cells called lymphocytes. Non-Hodgkin lymphoma is more common than Hodgkin lymphoma, and it typically starts later in life. Common symptoms of this disease include fever, night sweats, weight loss, and fatigue.
- Treatment for non-Hodgkin often includes chemotherapy, radiation, immunotherapy, and targeted therapy.
- SurvivorNet experts say using a chemotherapy combination called R-CHOP is an effective treatment for aggressive non-Hodgkin lymphoma. It stands for Rituximab (Rituxan) a monoclonal antibody, Cyclophosphamide (a type of chemotherapy drug), Doxorubicin hydrochloride (hydroxydaunomycin – a type of chemotherapy drug), Vincristine sulfate (Oncovin – a type of chemotherapy drug), Prednisone (a steroid).
- Other effective treatments include targeted therapy which works by using a special protein to deliver medicine directly into the cancer cell designed to kill it.
Actor Jeff Bridges, 73, iconic 1970s film, “Winter Kills” is getting a fresh look thanks to legendary movie director Quentin Tarantino, 60, who is spotlighting the movie for a special showing. It is heartwarming to see Bridges, who is also a non-Hodgkin lymphoma cancer survivor, being recognized for his work years after intense cancer treatment. For others battling this type of blood cancer, SurvivorNet offers added hope by sharing the various treatment options available to aid you on your journey.
Bridges’ character in “Winter Kills” – Nick Kegan – portrays a surviving brother of an assassinated president. The film chronicles a political assassination that is filled with conspiracy theories. Los Angeles Times film critic Mark Olsen says the film is akin to former U.S. President John F. Kennedy’s assassination which occurred several years before the movie was produced.Read More
Bridges’ 1979 “Winter Kills” film showing comes in the wake of his Emmy Award nomination for “Best Actor” for his role in “The Old Man.”
Life after cancer appears to be going well for Bridges which is heartening. Just a few years ago, while battling non-Hodgkin lymphoma, “The Big Lebowski” actor fell ill from the COVID-19 virus which made his cancer recovery more difficult.
He was diagnosed with non-Hodgkin lymphoma in 2020. Lymphoma is different from cancers of specific organs like the lung or breast. It’s not one cancer, but an umbrella term that encompasses several different types.
“The two main classifications I think of in terms of non-Hodgkin lymphoma are lymphomas that are more indolent and those that are more aggressive because those are treated very differently,” Dr. Jennifer Crombie, medical oncologist at Dana-Farber Cancer Institute, tells SurvivorNet.
Indolent lymphomas grow slowly and often don’t cause any symptoms, so they may not need immediate treatment. At the opposite end of the spectrum are aggressive lymphomas, which grow and spread quickly and need to be treated quickly.
“I had a 12-by-9-inch tumor in my body. Like a child in my body. It didn’t hurt or anything,” he previously told People.
Despite his diagnosis, the brave and resilient actor remained positive and said at the time, “The prognosis is good.”
WATCH: What kind of lymphoma do you have?
While undergoing treatment for non-Hodgkin lymphoma, he battled COVID-19 in early 2021. He told People Magazine at the time; that his chemotherapy treatments weakened his immune system allowing the COVID-19 virus to impact him harder than he expected.
He spent nearly five months in the hospital while treating his cancer and managing his COVID-19 symptoms.
“I had nothing to fight it. COVID made my cancer look like nothing,” he said.
Luckily the actor was able to fight through and overcome COVID-19, and his chemotherapy helped shrink the tumor.
In September 2021, Bridges shared that his lymphoma was in remission, according to The Hollywood Reporter.
More on Non-Hodgkin Lymphoma
- Non-Hodgkin Lymphoma Treatment — and Beyond
- Non-Hodgkin Lymphoma Treatment: Finding the Right Fit for You
- Next Steps: What to Do When the First Non-Hodgkin Lymphoma Treatment You Try Doesn’t Work
- Some Types of Non-Hodgkin Lymphoma Treatable With “Boom-Boom” Radiation
- What’s the Risk of Relapse After Non-Hodgkin Lymphoma Treatment?
Treatment Options for Non-Hodgkin Lymphoma
Lymphoma is a cancer of your immune system. It starts in the lymphatic system, a network of vessels, ducts, and nodes that run throughout your body.
This system drains excess fluid and waste from your tissues and drains them into your bloodstream. It also produces disease-fighting white blood cells called lymphocytes that defend your body against infections.
“I always advise that people understand their specific type of lymphoma because there are over 40 different types,” Dr. Elise Chong, medical oncologist at Penn Medicine, tells SurvivorNet.
Lymphoma starts when lymphocytes develop a genetic mutation that makes them multiply much faster than usual. The mutation also makes older cells that would normally die stay alive. The quickly multiplying lymphocytes start to collect and build up in your lymph nodes, the small glands in your neck, armpits, and other parts of your body.
“At the beginning of a conversation with a patient, we have to talk about exactly which type of lymphoma they have,” Dr. Lawrence Piro told SurvivorNet.
“There are some lymphomas that are very treatable, but not curable,” Dr. Piro added.
“On the contrary, there are some lymphomas that, if you don’t treat them, they’ll progress rapidly, and you may succumb to it, yet there are very intensive treatments that you can take that may cure you,” he adds. Diffuse large B-cell lymphoma, the most common type of non-Hodgkin lymphoma is an example of an aggressive but treatable cancer.
There are no screening tests for lymphomas and symptoms can be hard to identify so doctors typically perform a biopsy on a lymph node to accurately determine if non-Hodgkin lymphoma exists. However, some common symptoms of non-Hodgkin lymphoma include:
- Swollen glands
- Night sweats
- Weight loss
How Is Non-Hodgkin’s Lymphoma Treated?
Non-Hodgkin lymphoma treatment depends on the type of lymphoma, the stage, and how fast it is growing. People with aggressive non-Hodgkin lymphoma can expect to get a chemotherapy combination called R-CHOP, which is a drug cocktail consisting of chemotherapy drugs, plus an antibody drug and a steroid to treat diffuse large B-cell non-Hodgkin lymphoma.
Here’s how the acronym breaks down:
- R: Rituximab (Rituxan) is a monoclonal antibody that attaches to a specific protein called CD20, which sits on the surface of
- B cells. It targets the cancerous cells and destroys them.
- C: Cyclophosphamide is a type of chemotherapy drug
- D: Doxorubicin hydrochloride (hydroxydaunomycin) is a type of chemotherapy drug
- V: Vincristine sulfate (Oncovin) is a type of chemotherapy drug
- P: Prednisone is a steroid, which lowers inflammation
Patients receiving R-CHOP receive the drug in six cycles that are three weeks apart.
“R-CHOP is a cocktail of drugs. There are five different drugs in that recipe,” Dr. Jennifer Crombie, medical oncologist at Dana-Farber Cancer Institute, tells SurvivorNet.
WATCH: Understanding R-CHOP treatment.
R-CHOP side effects can include:
- Tiredness and weakness
- Hair loss
- Mouth sores
- Bruising and bleeding
- Increased risk of infection
- Appetite loss and weight loss
- Changes in bowel movements
Using Immunotherapy and Targeted Treatments for non-Hodgkin Lymphoma
Rituximab (Rituxan) was the very first immunotherapy drug approved to treat some forms of non-Hodgkin lymphoma. It’s “Rituximab is the immunotherapy that has been approved the longest and we have the most experience with for lymphoma,” Dr. Elise Chong, medical oncologist at Penn Medicine, tells SurvivorNet.
The immunotherapy drug works by seeking out and sticking to another type of protein called an antigen on the surface of infection-fighting white blood cells, called B cells. The antigen in this case is CD20. Rituxan will only work on cancerous B cells with the CD20 antigen on their surface. Most T-cell lymphomas don’t contain this protein, which is why this treatment isn’t effective against them.
Rituxan can be prescribed as the very first treatment for non-Hodgkin lymphoma, or after you’ve already been on chemotherapy. Your doctor can prescribe this drug on its own (which is called monotherapy), or together with chemotherapy (which doctors call chemoimmunotherapy).
Rituxan does come with side effects which may include fever, chills, swelling under the skin, itching, and mild shortness of breath.
WATCH: How Adcetris helps treat Hodgkin lymphoma and non-Hodgkin lymphoma.
Brentuximab vedotin (Adcetris) is a relatively new targeted treatment for non-Hodgkin lymphoma and Hodgkin lymphoma. This drug is an antibody-drug conjugate that combines an antibody (a type of protein that recognizes foreign substances in the body) with a drug that treats cancer. It uses a special protein to deliver medicine directly into the cancer cell.
When it locks onto that protein, “It has a bit of poison that it injects into the cancer cell to kill the cell,” Dr. Sairah Ahmed, associate professor in the Department of Lymphoma/Myeloma, Division of Cancer Medicine at MD Anderson Cancer Center, tells SurvivorNet.
The main side effects are low levels of certain blood cells, including the white blood cells that help your body fight infections. Your doctor can prescribe growth factors to stimulate your body’s white blood cell production and protect you against infections while you’re on this treatment.
Treating non-Hodgkin Lymphoma with Radiation
Non-Hodgkin lymphoma can also be treated with radiation which aims beams of intense energy at the cancer to stop cancer cells from growing and dividing.
One area where radiation is especially effective is in consolidation therapy. This is when you get radiation after other treatments, to try to get rid of any cancer cells that might still remain in your body.
Radiation works particularly well in people with early-stage non-Hodgkin lymphoma. “For patients with stage I and stage II disease, the outcomes are excellent, approaching 90%,” Dr. Chelsea Pinnix, radiation oncologist at MD Anderson Cancer Center, tells SurvivorNet.
Although radiation therapy is quite helpful for treating non-Hodgkin lymphoma, it does come with side effects. The side effects may include red or blistered skin, mouth sores, nausea, and vomiting.