“Diagnosing lymphoma is challenging because the tumors often resemble a normal immune-system reaction to an infection or other illness,” explains hematopathologist Ahmet Dogan. Dr. Dogan recently participated in a CancerSmart lecture on lymphoma. The program also included Anas Younes, Chief of the Lymphoma Service, and radiation oncologist Joachim Yahalom.
But the outlook for people with lymphoma is also changing. “Now we can perform over 50 different specialized tests to reach an accurate diagnosis,” Dr. Dogan explains.
Throughout the CancerSmart program, the panelists describe the impact of molecular and genetic tumor testing on the diagnosis and treatment of lymphoma, a cancer that begins in the immune system’s white blood cells.
Lymphoma is typically classified as either Hodgkin or non-Hodgkin, but approximately 60 biologically distinct subtypes have been identified. “Subtyping is critical to determining a patient’s risk for aggressive disease and to predicting which treatment may be most effective,” says Dr. Dogan. “Thanks to the development of new genetic technologies, we are seeing a completely different picture regarding the molecular makeup of these tumors.”
New Treatment Approaches
Insights into the biology of lymphomas have also transformed treatment approaches. For example, doctors have learned that lymphomas are highly responsive to much lower doses of radiation than were typically given in years past. Today our doctors also use sophisticated technologies such as IMRT (intensity-modulated radiation therapy) to deliver radiation directly to tumors with pinpoint precision. Another approach, called radioimmunotherapy, combines a radioactive substance with an antibody to target tumor cells throughout the body.
Increasingly, chemotherapy is used to enhance the effectiveness of radiation therapy, or when lymphoma has spread. Researchers are also working to develop more-targeted therapies. “Our approach to treating lymphoma is rapidly changing as we discover more molecular targets that can be treated with drugs,” says Dr. Younes. “More than 600 new lymphoma drugs are in the pipeline, including targeted therapies that are more convenient and cause fewer side effects than chemotherapy.”
Patients at Memorial Sloan Kettering who qualify for a clinical trial may have access to some of these new lymphoma therapies before they are widely available.
“We have learned how to combine lymphoma treatments to get the best of each modality,” Dr. Yahalom explains. And at Memorial Sloan Kettering, patients benefit from the collective expertise of a team that works in a highly coordinated fashion to personalize care.
Watch the discussion, or explore specific videos on lymphoma-related topics.