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Health Protocols

Lymphoma

Lymphomas are a surprisingly diverse group of cancers that arise from cells of the immune system called lymphocytes, which are a type of white blood cell. Lymphomas can be categorized as non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL).

HL has a high cure rate of about 75% overall and up to 90% in young patients. The average 5-year relative survival rate for NHL is about 71%.

For those undergoing active treatment, integrative therapies such as selenium, green tea, and mistletoe extract may improve outcome.

Causes and Risk Factors

  • Immunosuppression is the most well-established risk factor:
    • Autoimmune disease
    • Immunodeficiency syndromes
    • HIV infection
    • Organ or stem cell transplantation
  • Male gender
  • Older age
  • Obesity
  • Diets high in trans-fatty acids, processed meats, and high-fat dairy products were associated with increased NHL risk. Diets high in omega-3 fatty acids and fresh fish and seafood have been associated with reduced NHL risk. A high intake of vegetables lowers the risk of lymphoma by 30%.
  • Men who drink ≥1 serving of soda daily, whether diet or regular (sugar-sweetened) soda, have an increased risk of NHL.

Signs and Symptoms include:

  • Lymphadenopathy (swelling of the lymph nodes)
  • Unexplained fever
  • Night sweats
  • Weight loss

Diagnosis

Diagnosis of lymphoma may involve a number of clinical and laboratory tests, including:

  • Medical history
  • Physical examination
  • Imaging studies
  • Tissue biopsy
  • Blood tests such as complete blood count (CBC), chemistry panel, and erythrocyte sedimentation rate (ESR)
  • Laboratory techniques such as immunohistochemistry
  • Assessment for infection

Conventional Treatment includes:

  • Hodgkin Lymphoma:
    • HL is treated typically with radiation and chemotherapy.
  • Non-Hodgkin Lymphoma:
    • Treatment options for NHL patients range from a "watch and wait" strategy to hematopoietic stem cell transplantation.
  • Rituximab is often administered in conjunction with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). The combination of all 5 agents is referred to as “R-CHOP.”

Novel and Emerging Strategies include:

  • Interleukin (IL)-6 inhibitors: Plasma IL-6 levels are significantly lower in patients whose lymphomas are in complete remission as compared to those in partial remission or those having progressive disease.
  • Regular use of aspirin was associated with a considerably reduced risk of HL. Acetaminophen use was actually linked to an increased risk of the disease.
  • In combination with rituximab, pixantrone has been shown to be superior to other single-agent therapies for the treatment of relapsed/refractory aggressive NHL.

Integrative Interventions include:

  • Caloric restriction. An experiment in mice that develop cancers resembling Burkitt’s lymphoma and a form of NHL found that a reduced calorie diet (75% of normal intake) combined with a targeted therapy decreased the number of circulating lymphoma cells.
  • Selenium. One clinical study reported that in patients with newly diagnosed NHL, 200 mcg/kg/day of sodium selenite significantly increased overall survival time. The selenium-supplemented patients had a significant reduction in swollen lymph nodes, decrease in spleen size and bone marrow infiltration, and a significant increase in lymphoma cell death.
  • Green tea. Physicians at Mayo Clinic discovered that four patients with low-grade lymphomas began consuming over-the-counter green tea products containing epigallocatechin gallate (EGCG) on their own initiative. Subsequently, three of the four patients with low-grade B-cell lymphomas who used EGCG fulfilled the criteria for partial response.
  • Curcumin. Preclinical studies report that curcumin is a radiosensitizer and chemosensitizer for lymphoma, making chemotherapy and radiation therapy work better against the cancer while protecting normal, healthy cells.
  • Mistletoe extract. Clinical results showed that half of B-cell lymphoma patients receiving long-term mistletoe treatment had a continuous complete remission, whereas only 2/15 patients in the short-term mistletoe treatment group had a complete remission. The doses of mistletoe extract varied from 5–30 mg per subcutaneous injection.