Our Treatment Approach
A distinguishing area of our expertise is in determining how to integrate therapies, including identifying types of disease that do not require immediate treatment, determining the optimal cycles of chemotherapy, whether to change the combination of drugs during certain cycles, and whether to include radiation, biologic therapy, and/or a stem cell transplant. This is a highly complex process that requires expertise, and we continually reassess your treatment plan as your therapy progresses.
We closely monitor you for treatment-related toxicities to ensure that the potential side effects from your therapy impact your life, hobbies, work, and interests as little as possible. Certain treatments may also heighten the risk of developing other conditions in the future. We are careful to factor this into treatment plans, especially for younger patients.
- As part of your long-term treatment plan, we will screen you for possible side effects from treatment, such as heart disease and diabetes.
- We will work with your primary care doctor to reduce these risks as much as possible.
Multidisciplinary Team
At Dana-Farber Brigham Cancer Center's Adult Lymphoma Program, our experts manage your diagnosis and treatment plan as a close-knit team to decide what approach will best treat your particular disease at each stage. Because we are a highly specialized center, your testing, care, and follow-up are coordinated from your first appointment.
Your care team includes medical oncologists, radiation oncologists, oncology nurses, nurse practitioners, stem cell transplant physicians and nurses when appropriate, research scientists, psychiatrists, nutritionists, and social workers. All of these team members work together to make sure your care is as seamless as possible.
At our weekly lymphoma forum, specialists meet and discuss every new case. These specialists review your care plan to reach a consensus recommendation, which we share with you. We review particularly challenging cases at a division-wide conference with members from across specialty areas. They have expertise in standard therapies and emerging therapies and work to ensure that your care plan offers the best possible outcomes.
Our team also connects with renal cancer specialists, oncocardiologists, and nephrologists when indicated to align your care.
Personalized Treatment
As a highly specialized program within Dana-Farber Brigham Cancer Center's Center for Hematologic Oncology, we focus on the distinct needs of patients with lymphoma. We provide a very personalized approach to your care. For example, if you are likely to have a specific side effect from treatment, we take care to tailor your therapy to keep your quality of life at the center of the treatment plan.
We view every patient as an individual, with unique needs and expectations. We take time to involve you and your family in each step of the treatment process. As you go through treatment phases, you and your family will have access to a wide range of support resources — from nutrition services to integrative therapies.
Your Care
All outpatient therapy is provided at the Yawkey Center for Cancer Care at Dana-Farber Cancer Institute, one of the most advanced outpatient cancer centers in the country.
If you need to be hospitalized during your care, or if you undergo stem cell transplantation, you will be admitted to Brigham and Women's Hospital (BWH) or the Dana-Farber Inpatient Hospital located within BWH. Your primary oncologist and nurse will closely monitor your care and will coordinate your care with the inpatient team and additional specialists, who will address any other symptoms you may be experiencing. This model ensures seamless care from the outpatient to the inpatient setting. Learn more about your stay.
If radiation therapy is part of your care plan, Radiation Oncology has two units, one at Brigham and Women's Hospital and the other at Dana-Farber.
Treatment Options for Non-Hodgkin Lymphoma
Today, patients have a number of therapy options, including different forms of chemotherapy, radiation therapy (radiotherapy), new oral drugs, and many other new agents that are accumulating at an incredibly fast pace. New treatment approaches, including immunotherapy (the use of therapies that spur the immune system) to attack cancerous lymphocytes, are showing considerable promise.
Treatment for non-Hodgkin lymphoma depends on the subtype, and doctors may use a combination of chemotherapy and immunotherapy with or without radiation therapy. The majority of patients need more than one kind of therapy.
The treatment plan is based on the cumulative diagnostic findings about your disease (including whether the cancer is indolent or aggressive), genomic and biological factors, symptoms, the likely progression of the disease, other medical conditions, and your own preference.
- Indolent: Most patients respond well and have long-lasting remissions, but treatment does not cure the disease.
- Aggressive: Treatment is usually a combination of chemotherapies and immunotherapy, often with the hope of curing disease. If there is a large mass, you may have radiation therapy with chemotherapy.
For pregnant women with non-Hodgkin lymphoma, treatment is carefully chosen to protect the fetus. Treatment decisions are based on the mother's wishes, the stage of the disease, and the age of the fetus.
Treatments can include:
Treatment Options for Relapsed Non-Hodgkin Lymphoma
Fortunately, there is an expanding number of treatment options available for people with relapsed lymphoma, and you will have the opportunity to speak with your physician about which regimen is most appropriate for you.
Options can include, immunotherapy such as CAR T-Cell therapy and targeted therapy.
Disease-Modifying Therapies for Precursor Conditions of Lymphoma
Our researchers are studying the genomic, genetic, and epigenetic factors that characterize precancerous conditions at our Center for Early Detection and Interception of Blood Cancers (formerly the Center for Prevention of Progression).
We created this Center to understand, at the molecular level, why some patients go on to develop disease, while others do not — and to develop non-toxic targeted therapies to prevent progression, or even eliminate the disease before it leads to symptoms. For example, we are examining how these factors play a role in preventing the progression of early-stage, asymptomatic low-grade lymphomas. This molecular information will allow us to accomplish two goals: to enhance our ability to determine a prognosis and to predict a patient's response to novel therapies.
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