Lymphoma Treatment Planning
Following a diagnosis of lymphoma, we work carefully to determine the best treatment options for you and to prepare a treatment plan personalized for your needs. We try to maximize treatment success while minimizing the impact that diagnosis and treatment can have on your life.
Treatment for lymphoma varies greatly depending on the stage (or extent) of your lymphoma, whether it’s slow-growing or aggressive, and your preferences and goals.
Some people with early stage 1 Hodgkin disease may get abbreviated drug therapy (chemotherapy) with radiation therapy.
Those with stage 3 or 4 may get more cycles of drug therapy, possibly with radiation therapy.
If lymphoma returns after treatment, one option is to get higher-dose chemotherapy combined with a bone marrow transplant. Immunotherapy, another drug therapy that helps the immune system defeat lymphoma, is also an option.
WHAT TO KNOW ABOUT LYMPHOMA TREATMENT PLANNING
1Getting Started In Your Care
2Getting Your Diagnosis
3Planning Your Treatment
Considering Your Options
4Undergoing Treatment & Follow-Up
Select your type of treatment below.
Assessment
Evaluating Options
Choosing Treatment
The team evaluates different options for your treatment plan, based on the details of your diagnosis, including:
- Stage of the lymphoma
- Whether it has spread (metastasized) to the lymph nodes (small glands that filter bacteria, viruses, cancer cells, and other impurities from the body) or other parts of the body
- Type of lymphoma you have: invasive or noninvasive
- Markers, such as growth factors, that provide genetic information about the subtype of the cancer
Learn more about this condition - Your age and overall health
- Whether you have had cancer before
- There are a number of other consideration which may impact your treatment plan
Learn more about treatment planning
We discuss different types of treatment and how to combine them in a sequence that will best treat the cancer.
a. Your doctors may prescribe a treatment plan that combines one or more of the three main types of treatment: surgery, radiation therapy, and drug therapy (medications that travel through the bloodstream to attack cancer anywhere in the body). The combination of treatment types may need to take place in a specific order to best treat your specific condition.
Learn about treatments for lymphoma
b. Your treatment options will also be determined by the stage of your cancer. We can treat all the stages of lymphoma, from the least to the most severe.
Choosing your treatment
Your care team will explain the options and the possible treatment sequence. Your doctors will help you make an informed decision about which options may be right for you. An oncologist leads your team and remains your main doctor throughout treatment.
The best treatment for one person might not be the best treatment for another. There are three topics to consider when discussing with your doctor what works best for you.
Medical goals
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for lymphoma have different goals, such as:
- Slowing or stopping the growth of cancer
- Destroying cancer cells
- Destroying any cancer cells that may have spread (metastasized) to other areas
- Delaying or preventing cancer from coming back (recurrence)
- Managing symptoms of incurable cancer
Personal treatment goals
As you and your care team discuss and make decisions about your treatment plan, it helps to think about your goals for treatment. These goals are different for each person, but health and quality of life are likely at the top of your list. Within those two priorities, there are several questions to consider:
- What’s important to me?
- What do I value?
- What do I need from my relationships?
- What do I want from the treatment experience?
It’s important for your loved ones to understand your treatment goals and wishes, so talk to them. You can ask family and friends for emotional support and help with a variety of issues during your care journey.
The effect of treatment on everyday life
Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. Issues specific to your health include:
- Treatment: How cancer and treatments will affect you and your ability to continue your everyday activities at work and home
- Side effects and symptoms: How to manage and cope with disease symptoms and treatment side effects
- Balance: Ways to balance aggressive treatment that prolongs survival with side effect management that maintains a good quality of life
Other important issues to consider include:
- Communication: Ways to talk to your family, friends, and others (such as co-workers) about your diagnosis, and how to ask for help
- Emotional well-being: How to manage your own emotions and the emotional impact of your diagnosis on your family and friends
- Relationships: How to maintain relationships with your partner, family, and friends, including intimacy, everyday activities, and responsibilities
- Appearance and body image: Ways to cope with changes that may result from treatment and the cancer itself
- Daily activities: How to take care of yourself, look after your family, and balance work responsibilities while undergoing lymphoma treatment
- Travel and distance: How to manage family and work responsibilities if you are coming to Stanford from outside the Bay Area
The team evaluates different options for your treatment plan, based on the details of your diagnosis, including:
- Stage of the lymphoma
- Whether it has spread (metastasized) to the lymph nodes (small glands that filter bacteria, viruses, cancer cells, and other impurities from the body) or other parts of the body
- Type of lymphoma you have: invasive or noninvasive
- Markers, such as growth factors, that provide genetic information about the subtype of the cancer
Learn more about this condition - Your age and overall health
- Whether you have had cancer before
- There are a number of other consideration which may impact your treatment plan
Learn more about treatment planning
close Assessment
We discuss different types of treatment and how to combine them in a sequence that will best treat the cancer.
a. Your doctors may prescribe a treatment plan that combines one or more of the three main types of treatment: surgery, radiation therapy, and drug therapy (medications that travel through the bloodstream to attack cancer anywhere in the body). The combination of treatment types may need to take place in a specific order to best treat your specific condition.
Learn about treatments for lymphoma
b. Your treatment options will also be determined by the stage of your cancer. We can treat all the stages of lymphoma, from the least to the most severe.
close Evaluating Options
Choosing your treatment
Your care team will explain the options and the possible treatment sequence. Your doctors will help you make an informed decision about which options may be right for you. An oncologist leads your team and remains your main doctor throughout treatment.
The best treatment for one person might not be the best treatment for another. There are three topics to consider when discussing with your doctor what works best for you.
Medical goals
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for lymphoma have different goals, such as:
- Slowing or stopping the growth of cancer
- Destroying cancer cells
- Destroying any cancer cells that may have spread (metastasized) to other areas
- Delaying or preventing cancer from coming back (recurrence)
- Managing symptoms of incurable cancer
Personal treatment goals
As you and your care team discuss and make decisions about your treatment plan, it helps to think about your goals for treatment. These goals are different for each person, but health and quality of life are likely at the top of your list. Within those two priorities, there are several questions to consider:
- What’s important to me?
- What do I value?
- What do I need from my relationships?
- What do I want from the treatment experience?
It’s important for your loved ones to understand your treatment goals and wishes, so talk to them. You can ask family and friends for emotional support and help with a variety of issues during your care journey.
The effect of treatment on everyday life
Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. Issues specific to your health include:
- Treatment: How cancer and treatments will affect you and your ability to continue your everyday activities at work and home
- Side effects and symptoms: How to manage and cope with disease symptoms and treatment side effects
- Balance: Ways to balance aggressive treatment that prolongs survival with side effect management that maintains a good quality of life
Other important issues to consider include:
- Communication: Ways to talk to your family, friends, and others (such as co-workers) about your diagnosis, and how to ask for help
- Emotional well-being: How to manage your own emotions and the emotional impact of your diagnosis on your family and friends
- Relationships: How to maintain relationships with your partner, family, and friends, including intimacy, everyday activities, and responsibilities
- Appearance and body image: Ways to cope with changes that may result from treatment and the cancer itself
- Daily activities: How to take care of yourself, look after your family, and balance work responsibilities while undergoing lymphoma treatment
- Travel and distance: How to manage family and work responsibilities if you are coming to Stanford from outside the Bay Area
close Choosing Treatment
Overview
Every cancer is different, even in the early stages. The best treatment for one person might not be the best treatment for another. Your doctor will help you make an informed decision about which options may be right for you. Your treatment plan may consist of one or any combination of the following:
Drug Therapy
Drug therapy, also called systemic or medical therapy, is treatment that works throughout the body to fight lymphoma. These drugs slow the growth of cancer cells or destroy them. You can receive drug therapy:
- By mouth (orally) as a pill
- Through the blood vessels (intravenously, or IV) as an injection or infusion
Types of Drug Therapy
At Stanford, our medical oncologists use several types of drug therapy, including:
Chemotherapy
A broad range of medications that slow or stop the growth of cancer cells.
Chemotherapy Resources
Chemotherapy is a treatment option lymphoma. We are here to help you prepare and guide you through the process.
Immunotherapy
These medications slow the growth and spread of cancer by provoking the body’s immune system to fight disease. Immunotherapy treatments are the newest class of anti-cancer drugs.
Drug therapy scheduling
If your treatment plan involves drug therapy, you will have routine visits to have lab work done, see your doctor, and receive medication. You may need to come in once or twice per week. If you need an infusion, you will visit one of Stanford’s infusion treatment centers, where a nurse specializing in lymphoma care will provide your treatment.
Immunotherapy Resources
Should immunotherapy be part of your care plan, we are here to help you prepare and guide you through the process.
Drug therapy side effects
Side effects from drug therapies vary depending on the type of medication you receive. For example, chemotherapy may affect your hair and nails, because it slows their growth as it slows the growth of cancer cells. Fatigue is also possible. Ask your care team – we can help you manage or prevent many symptoms and side effects that can affect your everyday life.
Radiation Therapy
Radiation therapy is painless treatment that uses high-energy X-rays or other types of radiation to destroy cancer cells. Our radiation oncologists have years of experience safely and effectively treating lymphoma with radiation. Using the latest technology, we can precisely target tumors and minimize damage to nearby healthy tissue.
Radiation therapy may provide effective treatment for the type of lymphoma you have. If so, your doctor will speak with you about the best options. The types of radiation therapy we use for lymphoma treatment at Stanford include:
External radiation uses a machine called a linear accelerator (LINAC) to deliver radiation to the area where the cancer cells are found. Some of the types of external radiation we use include:
Radiation Therapy Resources
Should radiation therapy be part of your care plan, we are here to help you prepare and guide you through the process.
What to expect during external radiation therapy and how to prepare
- 3D (3-dimensional) conformal radiation therapy (3D-CRT)
With this method, 3D images help the doctor better target the tumor. The images are created using a special machine — a computed tomography (CT) or magnetic resonance imaging (MRI) machine. The radiation beams can be aimed from many different angles to match the exact shape of the cancer.
- Intensity-modulated radiation therapy (IMRT)
This method is like the first method, but the doctor can adjust how much radiation you get from each beam. In certain situations, this allows for better avoidance of nearby normal cells, and fewer potential side effects.
- Electron therapy: This method uses electrons, which are small negatively charged particles, to treat superficial tumors such as lymphomas of the skin. This may be to only a limited area of the skin where the tumor is, or to the entire skin surface (i.e. Total Skin Electron Beam Therapy or TSEBT).
Receiving radiation treatments
Radiation therapy does not cause pain, so you won’t feel anything during your treatments. Radiation does not make you radioactive, and you can safely be around other people, including children.
The exact number and timing of your radiation treatments depends on the type of lymphoma you have and the type of radiation therapy you need:
- Typically, you will be treated once a day, Monday through Friday, over a few weeks.
- Most treatment sessions take 15 to 30 minutes, but some may take up to 1 hour.
- We offer treatment sessions between 8 a.m. and 5 p.m. at our Cancer Centers in Palo Alto, Pleasanton, South Bay, and Turlock.
Radiation therapy side effects
Everyone has a different response to radiation therapy. It may cause short-term side effects during treatment or long-term side effects after treatment ends.
The side effects of treatment depend on the type of radiation you receive, the dose, and your overall health. Common side effects that you may experience after radiation treatment include:
- Fatigue
- Nausea
- Sore throat
- Dry cough
- Skin irritation
- Indigestion
- Diarrhea
- Swelling in your arms or legs (lymphedema)
No matter what you experience, your care team can help ease the side effects of treatment. At least once a week, your radiation oncology team will meet with you to discuss your progress and any side effects that you may have.
Clinical Trials
At Stanford, our doctors are always working to improve care for people with lymphoma. As an academic medical center, we conduct clinical trials to evaluate new medical techniques, devices, medications, and other treatments for safety and effectiveness.
For lymphoma, we study new approaches to preventing, screening, detecting, diagnosing, and treating lymphoma. Some clinical trials look at new methods, while others evaluate new combinations of approved, existing approaches.
Depending on your individual circumstances, a clinical trial may provide a treatment option for you. Like any treatment, clinical trials have possible risks and benefits, including:
Possible benefits of joining a clinical trial:
- Access to a new treatment that isn’t widely available
- Expert care from our world-renowned cancer specialists and their teams
- Low- or no-cost treatment
- Participation in research that can save lives in the future
Possible risks of a clinical trial:
- Treatment that may not work for you
- Side effects that may be unexpected or worse than current standard-of-care treatments
- Additional doctor visits, meaning more time and travel
- Additional tests, which may be uncomfortable or time consuming
- Extra expenses if your health insurance does not cover all patient costs for a trial
To learn more about Stanford’s clinical trials for lymphoma, speak with your care team. We can help you decide if a clinical trial may be right for you.
Stage 1-2
Stage 3-4
Recurring lymphoma
Treatment may be chemotherapy or chemotherapy combined with radiation therapy.
For stages 3 and 4, chemotherapy is used. Radiation therapy also may be recommended.
For lymphoma that returns after previous treatment has ended, stronger therapy may be recommended.
That can include:
- High-dose chemotherapy drugs followed by a bone marrow transplant, and radiation therapy
- A different kind of drug therapy called immunotherapy, sometimes also combined with chemotherapy and radiation therapy
Treatment may be chemotherapy or chemotherapy combined with radiation therapy.
close Stage 1-2
For stages 3 and 4, chemotherapy is used. Radiation therapy also may be recommended.
close Stage 3-4
For lymphoma that returns after previous treatment has ended, stronger therapy may be recommended.
That can include:
- High-dose chemotherapy drugs followed by a bone marrow transplant, and radiation therapy
- A different kind of drug therapy called immunotherapy, sometimes also combined with chemotherapy and radiation therapy
close Recurring lymphoma
We bring together the right experts to create a care plan tailored to your needs. Our lymphoma doctors specialize in several different areas of cancer treatment and work together to create a coordinated and comprehensive plan. This group is known as a multidisciplinary team and includes:
- Medical oncologists: Cancer doctors who treat cancer with medications such as chemotherapy and targeted therapy
- Radiation oncologists: Cancer doctors who treat cancer with radiation therapy
- Radiologists: Specialists who perform and read imaging tests, such as mammograms and MRI scans, to diagnose and treat cancer
- Pathologists: Doctors who specialize in reading laboratory tests and evaluating tissue samples to diagnose cancer
Your treatment plan will address the following:
- Location, size, and stage of the cancer
- Treatment goals
- Treatment options, their possible side effects, and ways to minimize or relieve side effects
- Expected length of treatment
- Follow-up care after treatment
- Psychiatrist: Doctor who specializes in diagnosing and treating mental illness, with a background in cancer care
- Genetic counselor: Licensed health care professional with specialized training in cancer genetics, testing, and counseling
If you want a second opinion
If you already have a diagnosis of lymphoma and want a second opinion about treatment options, we can usually schedule you within 14 days. Your reason for seeking a second opinion will help us determine which specialist(s) you should see:
- If you are still deciding where you will receive treatment, you will see a medical oncologist and a surgeon.
- If you need a second opinion about drug therapy, you will see a medical oncologist.
- If you need a second opinion about surgery, you will see our core doctors.