NOTE : This is only general information! Each therapy should be discussed in detail with the responsible doctor and decided together!
Introduction
The treatment of lymph node cancer is highly dependent on the type and stage of spread of the cancer at the time of diagnosis and on the patient’s age and condition. For this reason, a staging procedure is performed before each therapy begins, which shows the exact spread of the disease. As a rule, chemotherapy, radiotherapy (radiation) and surgery are available as therapeutic options.
These can also be combined. If the tumor has already metastasized to other tissues (metastases), it is usually no longer attempted to cure the cancer, but rather to provide the patient with the best possible quality of life with a therapy. This is then called palliative treatment.
General therapy options
Lymph node cancer is divided into two subgroups: 1. Hodgkin’s lymphoma and 2. non-Hodgkin’s lymphoma Hodgkin’s lymphoma occurs with a frequency of 3 new cases per 100,000 people. Non-Hodgkin’s lymphoma occurs more frequently with a frequency of 12 per 100,000 inhabitants.
Today, there is a whole range of treatment strategies, mainly consisting of chemotherapy and radiation. In very early stages, surgery can also be considered in which the cancerous lymph node is removed. An individual therapy adjustment is necessary for each patient.
Factors such as: play an important role in the decision on how to treat the patient. Every therapy should be carried out in the context of a clinical trial and there are special therapy protocols, i.e. for each cancer stage certain guidelines according to which the therapy is determined.
- Age
- Other concomitant diseases
- Stage of the disease and
- Formation of metastases
Removal of lymph gland cancer by means of surgery is recommended only in early stages of the cancer and only in so-called non-Hodgkin lymphomas.
The cancer must not be too large and not have spread, must be located in an easily accessible place in the body and the risks of surgery must not be too great. If, for example, only one lymh node on the neck is affected by the cancer and the lymh gland cancer is not located in the direct vicinity of large, important vessels and nerve tracts, surgical removal of the lymph gland cancer is possible in principle. Another decisive factor in deciding for or against an operation is whether the operation will cause damage to neighboring organs and structures so that they would no longer be able to function properly.
In this case, surgery would not be justified, as the disadvantage would be greater than the benefit. Since every operation involves risks, this therapeutic option should be discussed in detail with the doctor. The treatment of lymph node cancer usually consists of chemotherapy and radiation treatment.
Both are performed in close succession. The treatment is usually divided into several cycles, separated by short breaks in chemotherapy. The treatment is carried out in so-called treatment studies and is based on treatment protocols.
In addition to the chemotherapy cycles, you will be taken to hospital, where the drugs are usually given to you in the form of infusions. In most cases, chemotherapy is administered according to the ABVD scheme, the CHOP scheme or the BEACOPP scheme. The letters stand for the initial letters of the corresponding chemotherapeutic agents.
In stage 1 and 2, therapy with the ABVD regimen is given for 29 days and then repeated. The ABVD scheme represents the four chemotherapeutic agents Adriamycin, Bleomycin, Vinblastine and Dacarbazin. Afterwards, two radiotherapy sessions are usually carried out, with the patient coming to the hospital for the sessions.
If it is a more advanced stage, the so-called BEACOPP regimen is used. This consists of 6 chemotherapeutic agents and cortisone. A repetition takes place somewhat earlier, namely after day 22.
The chemotherapeutic agents used here include Bleomycin, Etoposide, Adriamycin, Cyclophosphamide, Vincristine, Procarbacin and as a non-chemotherapeutic drug Prednisolon. In so-called non-Hodgkin’s lymphomas, the CHOP regimen is usually used, which consists of the four drugs cyclophosphamide, hydroxydaunorubicin, vincristine and the cortisone-like drug prednisolone.You can find more information here: Chemotherapy Despite the constant development of chemotherapeutic drugs, which are increasingly less prone to side effects, nausea and vomiting still occur, often also gastrointestinal problems such as diarrhea and loss of appetite, unspecific discomfort, weight loss and sleep disorders. Radiation therapy is usually performed after chemotherapy for lymph gland cancer.
If the chemotherapy alone is very successful and causes a quick and good destruction of the cancer cells, radiotherapy can also be dispensed with in some cases. As with the other treatment options, it depends most on the stage of the lymph node cancer and this is what determines whether radiation therapy is used. You can find more information about this here: Treatment with radiotherapy and radiotherapy planning Not only does chemotherapy have some side effects and intolerances, but also radiotherapy.
For example, local skin irritation and redness (similar to sunburn) can occur after radiation therapy. In addition, loss of appetite and nausea frequently occur. There may also be irritation of the organs located in the vicinity of the irradiated area. For example, if a lymph gland cancer of the neck is irradiated, radiotherapy may also cause irritation of the oesophagus.
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