“It is an exciting time in the field of
lymphoma,” said board-certified medical
oncologist Dr. Bilal Ahmed with CalvertHealth
Hematology & Oncology. “We are able to cure
many patients even with aggressive lymphomas
using targeted therapies, immunotherapies and
new combinations of existing drugs. There’s a
lot of optimism in this area.”
Recently, Dr. Ahmed sat down to answer some
of the most frequently asked questions about
lymphoma, including the different types, what
to watch for and how research is finding better
ways to treat it with fewer side effects.
Q: What is lymphoma?
Lymphoma is cancer that begins in the infection-fighting
cells of the immune system, called lymphocytes. These cells
are in the lymph nodes, spleen, thymus, bone marrow and are
stationed all across the body to fight infection. Usually, most
lymphoma patients will notice swelling in a lymph node in the
neck or groin that doesn't go away.
Q: What are the different types of lymphoma?
There are two main types: Hodgkin’s and Non-Hodgkin’s
(most people with lymphoma have this type). Both kinds of
lymphoma involve different types of lymphocyte cells. Hodgkin’s
is a very treatable lymphoma with a 90 percent cure rate. Non-
Hodgkin’s (NHL) is basically a conglomerate of a number of
lymphomas that are divided into aggressive and non-aggressive
types. Treatment can vary depending on the type of lymphoma
and its stage. I have patients with NHL who have been under
observation for 10 years without requiring any treatment. It is
more like a chronic condition where we monitor it closely.
Q: How common is lymphoma?
We see more cases of lymphoma each year. It is the fifth
most common cancer diagnosed with some 74,000 new cases in
the United States each year. Although it is found in all age groups,
lymphoma strikes adolescents 15-19 more than any other kind
of cancer. Lymphoma is also common in people over 55. As our
population ages, the incidence of lymphoma increases.
Q: What are the first signs
of lymphoma?
In addition to swelling of the lymph
nodes, lymphoma can also cause
what we call B symptoms that affect
the whole body such as night sweats,
unintentional weight loss and fever.
Many of these symptoms can also be
warning signs of other illnesses. So, see
your doctor to find out for sure if you
have lymphoma.
Q: What’s new in
lymphoma treatment?
The main treatments for lymphoma
are chemotherapy, radiation, targeted
therapy and immunotherapy. In the
past 10 years, we have moved away
from chemotherapy and concentrated
more on targeted therapy and
immunotherapy. Usually, treatment is
determined by the kind of lymphoma,
the molecular profile of the lymphoma
and the age of the patient. Through
something called “next generation
sequencing” we’re able to personalize
treatment based on the gene changes
found in the patient’s lymphoma cells.
One of the most exciting drugs that
research has come up with is what we
call a BTK inhibitor. It has enabled
lymphoma doctors to treat people
with very little side effects, especially
older patients who have other chronic
conditions. Today, I saw a patient
who is 90-years-old, who had a very
aggressive NHL. She took a pill once a
day for six months and now her PET
scan shows she is in remission and has
a very good chance for being cured.
A few years ago, when we didn’t have
these targeted treatments, this patient
would have gone into hospice care.
Now, that immunotherapy has
come into the mix I would not be
surprised within the next five to 10
years if most lymphomas are cured
with targeted treatment. Even now, we
cure a lot of these stage 4 lymphomas.
One that has shown encouraging
results in clinical trials is CAR T-Cell
therapy. In this treatment, immune
cells called T-cells are removed from
the patient’s blood and altered in the
lab so they will attack the cancer cells.
Q: How is collaboration
enhancing patient care?
My job is to get the best care for my
patients. So, I try to collaborate with
the top cancer centers in the country
to come up with treatment plans.
Most often I work with Johns Hopkins
or MD Anderson (Cancer Center).
Our goal is for them to get treatment
close to home while ensuring they are
receiving the highest quality of care.
How Genetic Testing Benefits Treatment
One of the biggest advancements and
areas of research is targeting genetic
mutations for treatment. “That’s stateof-
the-art medicine to target the cancer
to cut off its pathways, which leads to
fewer complications and less side effects,”
said Sandra Cassell-Corbin, CRNP of
CalvertHealth Hematology & Oncology.
Cassell-Corbin has more than 30
years of experience in cancer care and
specializes in genetic testing. She is
the only full-time genetic counselor in
Southern Maryland. She can help assess
your risk, explain your options and address
how the results can impact your care.
Predictive testing is used to look
for inherited gene mutations that might
put a person at a higher risk of getting
certain kinds of cancer.
If you test positive, a genetic
counselor can discuss the best ways to
help manage your risk. CalvertHealth’s
high-risk clinics are designed as an
additional resource for patients who are
at increased risk for cancer, providing
added surveillance, management and
education on risk-reducing strategies.
CalvertHealth is proud to offer
full-time genetic counseling and testing
services to our community.
To find out if cancer genetic testing is
right for you, call 410.414.4717.