Introduction
Malignant lymphoma is a kind of cancer derived from lymphatic network organization and closely related to immunity; it mainly occurs in lymph nodes but can also occur outside lymph nodes and nonlymphoid tissues, such as lung, stomach, and intestines. It is divided into two categories: Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Its incidence increases year after year. Lymphoma is more sensitive to chemoradiotherapy, so treatment focuses on chemoradiotherapy. Generally, surgery is not considered.
Treatments
1.Radiotherapy
1.1 Hodgkin’s lymphomas
Radiotherapy is mainly used for large masses before chemotherapy or residual cancer after chemotherapy. Hodgkin’s lymphoma has metastasis from the primary site to the adjacent lymph nodes in sequence, except for minority of cases with intervals in swollen lymph nodes. As a result, the radiotherapy area should also include the possible invaded lymph nodes and tissues, in addition to the involved lymph nodes and tissues.
1.2 Non-Hodgkin’s lymphomas
The multicentric occurrence tendency of non-Hodgkin’s lymphoma makes multiple clinical stage values of non-Hodgkin’s lymphoma and treatment effects of expanded irradiation inferior to Hodgkin’s lymphoma, which decides that its treatment strategy should focus on chemotherapy.
2.Chemotherapy
2.1 Hodgkin’s lymphomas
Controlled studies have shown that the efficacy of combination chemotherapy for Hodgkin’s lymphoma is not less favorable than radiotherapy, it is even better than radiotherapy, and chemotherapy does not affect the child’s development and also avoids laparotomy damage in patients for pathological staging. As a result, for Hodgkin’s lymphoma patients at stages Ib, IIb, III, and IV, even if patients have mediastinal masses or belong to the type of lymphocytic depletion, chemotherapy must be used. For huge masses or residual tumors after chemotherapy, local radiotherapy can be added.
2.2Non-Hodgkin’s lymphomas
Chemotherapy is the primary treatment. The efficacy depends on pathological tissue types. According to the malignant degree of pathological classification, different combinations of chemotherapy are selected.
3.Hyperthermia
Malignant lymphoma is very sensitive to radiation and chemotherapy. Heating also can enhance the sensitivity to radiation and chemotherapy drugs and overcome tumor resistance. Whole-body hyperthermia has a good effect on systemic malignant lymphoma and improves systemic immunity. Hyperthermia in combination with standard radiotherapy and chemotherapy has been applied clinically with some specific effects.
4.Chelation Detoxification Therapy
Chelation detoxification and hyperthermia applied at the same time can significantly increase efficacy and be more conducive to the removal of toxins. Chelation detoxification can also reduce the side effects of chemoradiotherapy. Whole-body hyperthermia + chelation detoxification is preferred for lymphomas.
5.Medical Ozone Therapy
Medical ozone can stimulate the autoimmune system; directly kill cancer cells in blood, lymphatic vessels, and metastases; and reduce the side effects of radiotherapy and chemotherapy. Medical ozone acupoint injection can also be selected, and the selection of points is the same as that for acupuncture.
6.Traditional Chinese Medicine
For the syndrome of coldness and dampness coagulation, the prescription recommended is Yanghe Decoction. For the syndrome of qi and phlegm stagnation, the prescription recommended is modified Shugan Kuijian Decoction. For the syndrome of blood dryness and wind hotness, the prescription recommended is modified Qinggan Luhui Pill. For the syndromes of yin deficiency of liver and kidney and deficiency of both qi and blood, the prescriptions recommended are Liuwei Dihuang Pill and Herong Sanjian Pill.
7.Acupuncture
The therapeutic principle for lymphoma should focus on dispelling wind and removing obstruction in the meridians, clearing away toxic substances and resolving mass, nourishing liver and kidney, as well as benefiting qi and nourishing blood.
8.Medicated Diet, Nutrition, and so on
If patients have good general conditions and can orally take food, medicated diet of syndrome differentiation and food therapy are carried out for conditioning. If patients have difficulty eating, ostomy is needed to inject nutritious meals through the gastric tube. If medium-advanced patients have severe malnutrition and have difficulty eating, total parenteral nutrition is given.
9.Others
Qigong, tai chi, music, and psychotherapy can be practiced to make patients cooperate with the treatment and fight against cancer with a calm, positive, and optimistic attitude.
Typical Case
55 year old male patient. In April 2006, patient showed non-incentive abdominal pain; presenting persistent distending pain, accompanied with left lumbar sour pain; anorexia of stodge; non-acid regurgitation; belching; occasional nausea; and fever, night sweats and weight loss of more than 10 kg. Electronic gastroscope examination revealed: erosive gastritis with duodenal inflammation; upper abdominal MRI showed mass shadow at the right front top of the left kidney of retroperitoneum; and possible lymphoma. Exploratory laparotomy was carried out in the Surgery Department of Clifford Hospital showing: a mass of about 12cm×15cm was seen at the tail of the pancreatic body, with uneven surface and hard. Masses were palpable at the side of hilar and abdominal aorta. An abdominal lymph node biopsy immunohistochemistry pathology report as follows: diffuse large B-cell lymphoma (center cell type) with moderate malignance; diffuse large B-cell lymphoma: CD20(+), CD79a(+), Bcl-6(+), CD30(-), CD15(-), EMA(+), CD3(-), CD43(-) and ALK-1(-).
Diagnosis: Diffuse B-cell lymphoma (center cell type), intermediate malignance of Phase III B.
Integrative treatment prescription: in view of patient already suffering malnutrition and hypoalbuminemia in addition to a poor appetite postsurgery, he was given albumin and total parenteral nutrition. When patient’s physical strength was restored, CHOP chemotherapy program was administered in combination with green combination therapy. Whole body hyperthermia was carried out on the second day of chemotherapy. Abdominal local hyperthermia began 3 days after whole body hyperthermia, once every other day. Chelation detoxification and intravenous medical ozone alternately were carried out, once every other day. Herbal medicine and acupuncture treatment were given immediately upon admission. Patient was encouraged to practice medical Qigong and maintain a positive outlook. Throughout his treatment, herbal cuisine and nutrients were prepared according to his specific need. The treatment program was successfully completed.
Treatment outcome: on admission, patient was in poor general condition, with weight loss and hypoproteinemia. TCM and nutritional therapy were given to strengthen his immune system in preparation for chemotherapy. At an optimum time, effective chemotherapy was introduced to effectively eliminate pathogen. Hyperthermia as well as the application of chelation detoxification and medical ozone were integrated into treatment to create the best therapeutic outcome. TCM was used to strengthen the vital Qi. In between chemotherapy, integrative treatment was practiced to enhance recovery and rebuild the immune system in preparation for further treatment. After six cycles of treatment, CT scan revealed the abdominal tumor decreased by 2/3, with no adhesion to surrounding organs. Pleural effusion disappeared. Local radiotherapy + hyperthermia therapy continued in the event of recurrence and metastasis of residual tumor, aiming to completely cured it. Patient had weight increase of 6 kg at discharge with soft abdomen; no palpable abdominal mass, no tenderness; and resumed his physical strength, contributing to a positive mental state. Karnofsky performance score was 100. Patient returned monthly to the Hospital after discharge for 5 day treatment of whole body hyperthermia, chelation detoxification, medical ozone, and other appropriate comprehensive treatments. Follow up Treatment gradually prolonged one year after follow-up. Annual review of the upper abdominal CT and chest X-ray found no abnormalities. Now the patient is tumor free.
