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Lymphoma Lymphoma Treatment NHL Treatment

Falling Short: Under-Treatment in Non-Hodgkin's Lymphoma


Medically Reviewed On: November 01, 2010

When a new cancer treatment is being tested, patients are closely followed in clinical trials. This way, researchers can determine the optimal dose, which is one that offers the least amount of side effects and the best shot at survival. But once people start getting that treatment outside the sheltered setting of a study, doctors often make adjustments and it's not always known if the treatment being delivered matches the treatment the trials found most effective. The difference might ultimately affect the how well people do after receiving these potentially life-saving treatments.

That's why Gary H. Lyman, MD, a professor of medicine and oncology at the University of Rochester in New York, and colleagues decided to look at records of more than 4,500 people with an aggressive form of non-Hodgkin's lymphoma. The researchers wanted to see if the patients were getting chemotherapy at the doses and on the schedule that is recommended by the trial, and if not, why not.

Last year, Dr. Lyman and his colleagues reported on a breast cancer study that found more than half of women getting chemotherapy after right after surgery were being under-treated. "We were shocked with the results in breast cancer, so we decided we would also look at another curable type of cancer, aggressive non-Hodgkin's lymphoma, because we know from the randomized, controlled trials that patients who are treated appropriately have a good chance of long-term survival and possible cure," Dr. Lyman says.

In the non-Hodgkin's lymphoma study, which was published in September in the online version of the Journal of Clinical Oncology, the researchers reported that about half of the patients, particularly older people, were under-treated, and that many of them were not getting the appropriate supportive therapy for their treatment side effects.

"There's enormous variability in how aggressively patients are supported and how well treatment guidelines are followed around the country," Dr. Lyman says. Below, Dr. Lyman discusses his findings and how to ensure that more patients with non-Hodgkin's lymphoma get the right treatment, so that they have the best possible chance of being cured.

What is non-Hodgkin's lymphoma?
Non-Hodgkin's lymphoma is one of the most common types of lymphoma; lymphomas are cancers of the lymph glands and nodes that can occur virtually anywhere in the body. While Hodgkin's disease can often occur in younger patients, non-Hodgkin's disease occurs in a somewhat older population, around age 60, but it can occur almost at any age. We don't know all the reasons for this, but it is one of the cancers that has increased in incidence over the last two or three decades and now affects approximately 50,000 individuals throughout the United States each year.

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