Coping With Treatment for Lymphoma and Oral Cancer
- John Stamos has been a steady source of support for longtime friend and Full House co‑star Dave Coulier, who is now facing his second cancer diagnosis in a year after previously completing treatment for non‑Hodgkin lymphoma.
- During a routine PET scan in October, doctors discovered P16 squamous cell carcinoma at the base of Coulier’s tongue—a type of HPV‑related oropharyngeal cancer.
- HPV is a common virus with many strains, only a few of which are linked to cancers in areas such as the throat, cervix, and anus, according to guidance from the National Cancer Institute, CDC, and specialists like Dr. Allen Ho.
- Coulier has started a 35-session course of radiation therapy for his oral cancer, a treatment that can cause side effects such as fatigue, taste changes, difficulty swallowing, mouth issues, and skin or thyroid changes, according to the National Cancer Institute.
- Radiation oncologists Dr. Subhakar Mutyala explain that radiation works by sending ionizing energy through the body to damage cancer cells’ DNA; while patients typically don’t feel the radiation itself, they may feel discomfort from positioning or applicators used during treatment.
- Non-Hodgkin lymphoma includes many subtypes that begin in lymphocytes, and doctors classify them by the cell type involved (B‑cell or T‑cell) and how quickly they grow, which directly shapes treatment decisions.
- “There are some lymphomas that are very treatable but not curable,” Dr. Lawrence Piro explained
- Many patients with aggressive forms receive R‑CHOP, a five-drug chemotherapy and antibody regimen typically given in six cycles; early-stage cases may complete treatment in about three months with chemo and sometimes radiation.
- “[R-CHOP] is three to four treatments with combination chemotherapy and monoclonal antibody therapy, and then a few weeks of radiation therapy, and you’re done,” medical oncologist Dr. Stephen Schuster says.
“He’s my number one inspiration. This is the second time now,” Stamos told Craig Melvin on the Today Show.
“I saw what those women in my family went through, and I thought to myself, ‘If I can be just 1/10th of a percent as strong as they were, then I’m going to be just fine,’” Coulier told US Magazine.
Coulier’s rise to fame came about when he landed a recurring role on Full House, a popular sitcom that ran from 1987 to 1995. It featured notable stars, including the late Bob Saget, John Stamos, Lori Loughlin, Mary-Kate, and Ashley Olsen. The show focused on a widowed sportscaster (Saget) as he raised his three daughters with help from his rock-and-roll brother-in-law (Stamos) and best friend (Joey).
In October, during a routine check-up, Coulier’s doctors spotted something unusual. “I went in for a PET scan, just a routine check-up, and something flared on the scan. It turned out that I have P16 squamous carcinoma at the base of my tongue,” Coulier shared on the “Today Show.”
According to the American Journal of Surgical Pathology, “Human papillomavirus–related oropharyngeal squamous cell carcinoma (OPSCC) [a type of head and neck cancer] has a favorable prognosis relative to other head and neck squamous cell carcinomas.”
The British Journal of Cancer says, “Squamous cell carcinoma of the head and neck (SCCHN) is a collective term for tumors of several different locations within the head and neck area.”
Coulier himself emphasized, “The prognosis is very good for P16, with a 90-percent curability rate.”
Squamous cell carcinoma of the head and neck (HNSCC) is often linked to high-risk human papillomavirus (HPV). According to the National Cancer Institute, HPV is associated with several cancers, including cervical and throat cancers. The Centers for Disease Control and Prevention (CDC) explains that HPV-related cancers occur in areas where the virus is commonly found, such as the cervix, vagina, vulva, penis, anus, and oropharynx (the back of the throat, including the base of the tongue and tonsils).
Dr. Allen Ho, a head and neck surgeon at Cedars-Sinai, explains the potential impact of HPV. He says, “The vast majority of humans in the U.S., both men and women, will eventually get infected with human papillomavirus. The important thing to know about HPV,” says Dr. Ho, “is that there are many different strains, and only a couple of them tend to be more cancer-inducing.”
WATCH: HPV and Cancer Risk: The Basics
“Probably less than 1% of the population who get infected happen to have the cancer-causing virus that somehow their immune system fails to clear, and over 15 to 20 years [it] develops from a viral infection into a tumor, and a cancer,” explains Dr. Ho.
Fortunately, HPV-related throat cancers tend to respond well to treatment, especially when addressed with radiation and chemotherapy. Preventive tools like the HPV vaccine—such as Gardasil 9—offer protection against nine strains of the virus, including HPV 16, which is responsible for the majority of head and neck cancers.
WATCH: What does radiotherapy feel like for the patient?
Coulier has already begun a series of 35 radiation treatments to fight the disease.
According to the National Cancer Institute, typical side effects of radiation to the head and neck may include:
- Fatigue
- Hair loss
- Changes to the skin or sense of taste
- Difficulty swallowing
- Mouth issues
- A less active thyroid gland
“Radiation therapy is actually ionizing energy, where energy goes through your body, essentially causes DNA damage,” Radiation Oncologist Dr. Subhakar Mutyala explained to SurvivorNet.
“It is a treatment where you don’t feel the treatment itself. Now, sometimes, you might feel the place where we place the tumor. If we’re placing applicators in the cancer, you might feel that. Or if you’re lying on a table and we’re holding you still, you might feel that. But the actual treatment is just ionizing energy,” Dr. Mutyala continued.
Before Oral Cancer, There Was Non-Hodgkin Lymphoma
In November 2024, Coulier revealed that he had been diagnosed with stage 3 non-Hodgkin lymphoma. Lymphoma is a blood cancer, specifically of the immune system, that affects infection-fighting cells called lymphocytes.
“The patients who are diagnosed with lymphoma early, typically it’s luck,” Dr. Elise Chong, medical oncologist at Penn Medicine, tells SurvivorNet.
WATCH: Finding Lymphoma Early: Do you Know the Symptoms and Risks?
The lymphoma patient may have had a symptom that made their doctor check them, or the cancer showed up on a scan or blood test that was done for another reason.
Until an effective screening test becomes available, you can increase your odds of finding lymphoma early by knowing whether you’re at risk and staying alert for symptoms.
You might be at higher risk for this cancer if you:
- Have been infected with the HIV or Epstein-Barr virus
- Had an organ transplant
- Have a family history of lymphoma
- Have been treated with radiation or chemotherapy drugs for cancer in the past
- Have an autoimmune disease
Also, watch out for lymphoma symptoms. The most common ones are:
- Swollen glands in your neck, armpit, or groin
- Fever
- Chills
- Night sweats
- Weight loss without trying
- Feeling tired
- Swelling in your belly
“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: For treatment, 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, told SurvivorNet.
Most non-Hodgkin lymphomas, about 85%, affect B-cells. These cells produce antibodies and 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.
Treating Non-Hodgkin Lymphoma Patients
Dr. Lawrence Piro, the President and CEO of The Angeles Clinic and Research Institute in Los Angeles, a Cedars-Sinai affiliate, previously spoke to SurvivorNet about the different approaches to treating different types of lymphomas.
“There are some lymphomas that are very treatable but not curable,” he explained.
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.
Understanding R-CHOP Treatment for Non-Hodgkin Lymphoma
Dr. Piro says 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 non-Hodgkin lymphoma, including 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 that 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. Crombie tells SurvivorNet.
For stage 1 or 2 cancer, the whole treatment should take about three months. “It’s three to four treatments with combination chemotherapy and monoclonal antibody therapy, and then a few weeks of radiation therapy, and you’re done,” Dr. Stephen Schuster, medical oncologist at Penn Medicine, tells SurvivorNet.
You may also receive six treatments of the combination chemotherapy without any radiation, Dr. Schuster adds.
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 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.
Coulier’s Chemo Experience for Non-Hodgkin Lymphoma Treatment
Coulier received chemotherapy that spanned several months to treat non-Hodgkin lymphoma.
He lost his hair during treatment – a common chemotherapy side effect.
WATCH: Coping with hair loss during chemo.
Hair loss can take a significant emotional toll on cancer patients, affecting self-esteem and confidence. Experts emphasize the importance of preparing for this change and finding ways to cope during the cancer journey.
“For cancer patients, losing one’s hair can be unbelievably stressful. To start with, the dread of losing one’s hair can lead to some sleepless nights and feelings of anxiety,” says Dr. Samantha Boardman, a New York-based psychiatrist and author.
Hair loss from chemotherapy typically begins three to four weeks after treatment starts and continues throughout the process. This occurs because chemotherapy targets rapidly dividing cells—including both cancer and hair cells. While regrowth usually begins four to six weeks after treatment ends, patients may notice changes in color and texture when their hair returns.
Chemotherapy can take a serious toll on energy levels, something Dave Coulier experienced firsthand during his treatment. Fatigue became one of the most challenging side effects for him, a feeling familiar to many undergoing cancer therapy.
Dr. Zachary Reese, a medical oncologist at Intermountain Healthcare, describes the pattern of exhaustion many patients face:
“What I typically tell patients is that [chemotherapy] is a bit of a roller coaster ride. You’re going to feel tired about a week into treatment, and that’s when you’ll hit bottom. And then you’ll start to come back up again just in time to do it all over.”
Although fatigue varies for each person, it typically lasts seven to ten days after treatment, depending on the number of chemotherapy cycles completed. However, patients can take steps to manage their energy levels and support their recovery.
Strategies for Coping with Fatigue
- Prioritize a healthy diet – Eating fruits, vegetables, and whole grains ensures proper nutrition while maintaining energy.
- Commit to quality sleep – Keeping a consistent sleep schedule supports healing and reduces fatigue.
- Stay active – Though exercise might seem counterintuitive, it can boost energy and improve overall well-being.
Dr. Reese encourages patients to keep moving, even if it means starting small.
“This doesn’t mean that anyone expects chemotherapy patients to run a 5K or a marathon, but getting out and doing 30 minutes of exercise a day can go a long way,” he says.
If 30 minutes feels overwhelming, patients can begin with just 10 minutes, gradually increasing their activity over time. The key is choosing an activity they enjoy—whether it’s walking, swimming, or yoga—to make movement feel less like a task and more like self-care.
While chemotherapy-induced fatigue can be difficult, maintaining a balanced routine can help patients not only manage their energy levels but also navigate the rest of their treatment with greater resilience.
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 to be?
- What common side effects should I expect when I begin treatment?
- Will I be able to continue working and performing 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 from during my treatment?
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