Coping with an Unexpected Diagnosis
- A healthy 38-year-old who began struggling to finish a half-marathon and experienced night sweats, body aches, and COVID-like symptoms learned he was facing stage 4 non-Hodgkin lymphoma. Despite the shocking diagnosis, he plans to remain positive while he fights the cancer.
- Lymphoma is a blood cancer, specifically of the immune system, that affects infection-fighting cells called lymphocytes.
- Lymphoma treatment largely depends on the nature of your specific diagnosis. For non-Hodgkin lymphoma patients, their cancer is more likely to spread randomly and be discovered in different groups of lymph nodes in the body.
- Treatment for non-Hodgkin often includes chemotherapy, radiation, immunotherapy, and targeted therapy.
- SurvivorNet experts say 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 kind of chemotherapy drug), Vincristine sulfate (Oncovin—a sort of chemotherapy drug), and Prednisone (a steroid).
A fit and healthy 38-year-old who ran a half-marathon says his health “just deteriorated” in four weeks. Although Govind Sandhu didn’t know it at the time, the series of events that included a swollen knee, body aches, night sweats, and COVID-like symptoms were all tell-tell signs of advanced non-Hodgkin lymphoma, a type of blood cancer.
View this post on InstagramRead MoreSandhu has since shared his cancer journey on his popular TikTok and Instagram channels, hoping to spread greater awareness for non-Hodgkin lymphoma.“Just like that, life has forever changed, and I’m about to embark on my biggest challenge to date,” Sandhu explained in an Instagram post.
Sandu explained that leading up to his cancer diagnosis, he noticed some differences in his body’s normal functioning. He said that the run felt harder than usual when he would train for the half-marathon while running trails. Then, he would experience body aches on the back of his neck and down his shoulder. Night sweats became more common.
View this post on Instagram
“Everything that would make you think it was the flu or COVID,” Sandu said.
Concerned by the onslaught on his body, Sandu went to the doctor, who ran several tests. The results came back with stage 4 non-Hodgkin lymphoma.
“Lots of tears, lows & moments of “why me” as you can imagine,” Sandhu said.
Sandu is just a couple of weeks into his cancer journey and understands he has a long journey ahead. However, he remains determined and optimistic.
“Long road ahead, but this won’t be the end of my story. It can’t be! I’m 38 years old, [I’ve] lived the most blessed life to date and have so much more to live for,” he explained.
Expert Resources on non-Hodgkin Lymphoma
Understanding Sandu’s Diagnosis
“Non-Hodgkin lymphoma is a big category,” Dr. Julie Vose, chief of hematology/oncology at the University of Nebraska Medical Center, previously told SurvivorNet.
All non-Hodgkin lymphomas begin in white blood cells known as lymphocytes, which are part of your body’s immune system. From there, doctors separate these cancers into types depending on the specific kind of lymphocytes they grow from B cells or T cells.
WATCH: The type of lymphoma you have matters.
Knowing which of these you have can help steer you to the most appropriate treatment.
One way doctors divide up these cancers is based on how fast they’re likely to grow and spread. “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.
Once you’ve been diagnosed with non-Hodgkin lymphoma, the next question your doctor will want to answer is whether you have B-cell or T-cell lymphoma. That answer is important because it will help determine your treatment.
B-cells and T-cells are two kinds of lymphocytes. They’re both infection-fighting cells, but they work in different ways.
About 85% of non-Hodgkin lymphomas affect B cells. These cells produce antibodies, proteins that react to foreign substances like viruses or bacteria in your body. The antibodies attach to another protein on the surface of the invading cells, called an antigen, to target and destroy them.
Types of B-cell lymphoma include:
- Diffuse large B-cell lymphoma
- Follicular lymphoma
- Small lymphocytic lymphoma (SLL)/chronic lymphocytic leukemia (CLL)
- Mantle cell lymphoma
- Marginal zone lymphomas
- Burkitt lymphoma
- T-cell lymphomas make up only 15% of non-Hodgkin lymphomas. Unlike B-cells,
- T-cells directly destroy bacteria and other invaders.
Types of T-cell lymphoma include:
- T-lymphoblastic lymphoma/leukemia
- Peripheral T-cell lymphomas
- Cutaneous T-cell lymphoma
What Treatment for Non-Hodgkin Looks Like?
Lymphoma treatment largely depends on the nature of your specific diagnosis. For non-Hodgkin lymphoma patients, their cancer is more likely to spread randomly and be discovered in different groups of lymph nodes in the body. Hodgkin lymphoma cancers, on the other hand, are more likely to grow consistently from one group of lymph nodes directly to another.
WATCH: Non-Hodgkin lymphoma treatment options
“There are some lymphomas that are very treatable but not curable,” Dr. Lawrence Piro told SurvivorNet.
Dr. Lawrence Piro is the President and CEO of The Angeles Clinic and Research Institute in Los Angeles, a Cedars-Sinai affiliate. He adds that some lymphomas progress quickly if left untreated.
Non-Hodgkin lymphoma treatment depends on the type, stage, and how fast it grows. 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.
R-CHOP stands for:
- 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 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
Immunotherapy and targeted therapy are also treatment options for non-Hodgkin’s lymphoma patients.
Rituximab (Rituxan) was the first immunotherapy drug approved to treat some forms of non-Hodgkin lymphoma. “Rituximab is the immunotherapy that has been approved the longest, and we have the most experience with lymphoma,” Dr. Chong tells SurvivorNet.
Rituxan has side effects, including fever, chills, swelling under the skin, itching, and mild shortness of breath.
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 particular protein to deliver medicine directly to the cancer cell.
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.
Questions for Your Doctor
If you are dealing with a lymphoma diagnosis, it’s important to ask your doctor a series of questions so you will have an idea of what your next steps will look like. To help you during this difficult time, SurvivorNet has some questions to kickstart your conversation with your physician.
- What type of lymphoma do I have?
- What does my pathology report say about my diagnosis?
- Should I get a second opinion before I explore possible treatment options?
- Based on my diagnosis, what do you anticipate my treatment path?
- What common side effects should I expect when I begin treatment?
- Will I be able to continue working and normal daily activities during treatment?
- Where can I get help working with the insurance company regarding treatment costs?
- Who do you recommend I get mental health help during my treatment?
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