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Targeted Therapies

Offer Promise for Treating Lymphoma

“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.
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