Robert Zakar gives back to community
8 Ways To Strengthen Your Body During Follicular Lymphoma Treatment
1. Quit smoking. Studies show that smoking cigarettes puts you at a higher risk for follicular lymphoma. It also raises your chances of dying from the disease.
2. Take vitamin D. It's important to check your vitamin D level before treatment. One study found that people with low vitamin D levels before follicular lymphoma treatment didn't do well. They also are more likely to relapse quicker than those with healthy levels of vitamin D.
3. Exercise regularly. Physical activity can help during treatment for follicular lymphoma. A couple of studies found that exercise during chemotherapy for lymphoma greatly improved a person's quality of life. Stick to moderate activities such as strengthening movements, cardio, balance, coordination, and flexibility activities. You can try things like:
4. Protect yourself from germs. Your risk of infection is higher with lymphoma. It isn't possible to protect yourself completely from infections. But there are some things you can do to lower your risk:
5. Eat healthy foods. A nutritious diet can help keep you healthy mentally and physically. During follicular lymphoma treatment, a healthy diet can also help you better tolerate treatment, like chemotherapy. You should keep a good balance of carbohydrates, protein, fat, fiber, dairy, vitamins, minerals, fruits, and vegetables on your plate.
It's best to stick with lean and grilled meats instead of fatty and fried options. Some studies suggest that a lot of red and processed meat can lead to a higher risk of cancer. Experts recommend that you get no more than 70 grams of processed or red meat a day. If you don't eat meat or dairy, there are many vegan and vegetarian options that will help you meet your nutritional needs.
6. Stay away from unclean and raw food. Treatment for follicular lymphoma can lower your immune system. This can put you at risk for illnesses from food. To make sure your food is safe:
7. Stay hydrated. It's important to drink plenty of liquids during treatment. Experts usually suggest around 6-8 glasses each day. Water is best, but it can be any type of drink except alcohol. Just be careful with tea, coffee, and sodas because these drinks usually have a lot of caffeine.
8. Reduce sleepiness. Lymphoma treatment may cause you to feel very tired. This can make daily activities very difficult. To fight the fatigue, start an exercise routine to keep you energized. You can also think of the activities that make you more sleepy and avoid these until you feel more awake. If this doesn't help, ask your doctor about other ways to help end your fatigue.
Access To Therapies Through Clinical Trials 'a Blessing' For Lymphoma, Other Cancers
After undergoing rounds of chemotherapy for follicular lymphoma, a common form of non-Hodgkin lymphoma, Juan Yee considered stopping treatment based on his experience with side effects, but the arrival of his grandson — and the opportunity to participate in a clinical trial — gave him a new lease on life.
In 2018, Yee participated in a clinical trial where he was treated with Lunsumio (mosunetuzumab-axgb), a CD20xCD3 T-cell engaging bispecific antibody and a new class of fixed-duration cancer immunotherapy. Since then, the Food and Drug Administration has approved Lunsumio in December 2022 for the treatment of adults with relapsed or refractory follicular lymphoma after receiving two or more lines of systemic therapy.
Yee, who works for the United States Postal Service and is married with three sons, is grateful for the chance to participate in the clinical trial in addition to his now-three-year-old grandson, who was the main driver of him starting treatment again.
"I was done (with treatment)," he said. "I didn't want to do anything anymore until I found out that my son's girlfriend was pregnant. I knew I had to try because I want to meet my grandkids, so he was a miracle for me."
In addition to being open to people about his cancer treatment experience, he also urged patients to speak with their oncologists about clinical trials.
"If I could do anything to help others, I will do it," Yee said. "I'm used to telling everybody my story and I will talk to people. And now that I did (the clinical trial at) City of Hope, … when (people) come to me with breast cancer or prostate (cancer), I always tell them to talk to their oncologist. There's probably something out there. There's a clinical trial."
Diagnosis and Early TreatmentYee was experiencing symptoms including fatigue, decreased appetite, night sweats and swollen lymph nodes, which he originally attributed to several factors like working long hours and issues with his tonsils when he was younger. Although he put off seeing a doctor, he went to go see a family friend of his, who is a doctor in Tijuana, when he woke up one morning and his testicles were "the size of a watermelon," he said.
After he performed some tests, within a couple days, his doctor said it may be cancer — non-Hodgkin lymphoma — and to see a doctor.
Yee made an appointment with his doctor through Kaiser Permanente, who reviewed the paperwork from the doctor he saw in Tijuana. He confirmed the likelihood of cancer but urged Yee to see an oncologist. He was eventually diagnosed in March 2012 with stage 4 follicular lymphoma.
"Once he said it was cancer, I remember crying, my tears were just coming and I don't remember anything else," Yee said. "I just remember the doctor saying, 'We need to start chemo right away. Pop over tomorrow.'"
He underwent eight rounds of chemotherapy and experienced some side effects along the way like fatigue, fever and loss of appetite. Yee also received Benadryl alongside chemotherapy to address a reaction he had during his first round. He said, "I started jumping in the bed like a fish out of water. My body was reacting to chemo."
Yee continued working with the United States Postal Service, which is where he works to this day. Back in 2012, he only worked there for six years and was worried about potential time he could miss from work due to side effects.
"I was a supervisor, I wasn't a (mail) carrier anymore, so I stayed inside the office, answered phone calls," he said. "My boss and my coworkers were pretty good. They really took care of me. But it was tough. …I would just go to work (after chemo) because I didn't want to miss (work). My boys were still young back then. … My wife wasn't working, so I was the sole provider."
Yee also found it difficult to accept help at home from his family.
"Your whole family is suffering because my wife, my wife's family, my in-laws, my family, they all wanted to be here," he said. "They all wanted to support, they all wanted to help. So to me, that was hard. My brother that came up to me and said, 'You're always helping, you're always there for us. Now we want to do it for you.' But I wasn't used to that."
Cancer RecurrenceAfter undergoing eight rounds of chemotherapy, Yee started maintenance therapy with Rituxan (rituximab) until 2016, when the cancer returned. His oncologist recommended six rounds of chemotherapy and a bone marrow transplant, for which he was referred to a specialist. Yee learned what is involved before, during and after a bone marrow transplant and decided that it was too hard for him to go through. The specialist agreed with this decision, especially since he was still young, so he proceeded with six rounds of chemotherapy followed by maintenance therapy with Rituxan again.
"By that time, I was tired of the Rituxan. I was tired of doing it," Yee said. "I was always afraid of needles and cancer put me through all this."
In 2018, Yee noticed his lymph nodes were swollen again and he felt weak, so he made an appointment with his oncologist, although he didn't tell his family about it this time. Stage 4 follicular lymphoma returned again.
Upon hearing that he would have to start chemotherapy again — or even a bone marrow transplant — he decided that he no longer wanted to proceed with treatment.
"I don't want to do anything. I'm tired," Yee said. "Not only I'm putting myself through all of it, I'm putting my whole family through it. … I said, 'How long would I live?' And he said, 'Well, it's still early. I don't know, a year or so. I can't tell you that.' I'm not doing anything anymore. That's it. I'm done."
Deciding to Try a Clinical TrialA month after hearing the news from his oncologist, which he kept to himself, he found out some other news: his daughter-in-law was pregnant with Yee's first grandchild. This was a turning point for him and what motivated him to start treatment.
Yee told his family about his recurrence, and then went to his oncologist with his wife to discuss treatment options. His oncologist referred him to a clinical trial assessing Lunsumio that was being conducted at City of Hope. He met with a doctor there, who explained to Yee and his wife how the drug works, what the clinical trial entails and what he can expect with treatment. Both Yee and his wife felt positive about what they've learned, so they decided to proceed with the trial.
Yee also understood how his participation in this clinical trial could allow him to impact treatment for future patients with follicular lymphoma.
"When they offered me the clinical trial, that's one of the things that came to my mind," he said. "I said I hope it would work and if it works, I want other people to try it, other people to benefit from it."
About a month later, after he underwent some lab work, he started treatment. Despite the reassurance he received from the doctor at City of Hope, Yee was still worried that he would experience the same side effects on Lunsumio as he did with chemotherapy.
"I was surprised. The next day, I was OK, a little bit tired," Yee said. "I would blame it more on the Benadryl they were giving me before the treatment than anything else. I didn't lose the hair. I didn't lose my appetite. I didn't lose nothing. I just felt fine. … I was 100%. I had a normal life."
Since the drug has been approved late last year, Yee hoped that other patients with follicular lymphoma can have the opportunity to be treated with this therapy.
"It worked," he said. "So not only did it benefit myself — I mean, I'm fine. I didn't have to go through chemo, and now it got approved. I want other people to try it … and be able to not have to go through chemo and all the hard stuff when you have chemo."
Currently, Yee still sees the teams at Kaiser Permanente and City of Hope for regular check-ups, but he has a clean bill of health. He considers himself lucky to be given the opportunities he has been given through his cancer journey.
"I don't know if God is watching over me, but I was able to get this treatment. It was a blessing," he said.
For more news on cancer updates, research and education, don't forget to subscribe to CURE®'s newsletters here.
What Is Mesenteric Lymphoma?
Mesenteric lymphoma is a cancer that develops in a layer of tissue inside your abdomen. It often causes a noticeable lump and stomach pain. Other symptoms include cramping, loss of appetite, and unintentional weight loss.
Mesenteric lymphoma is a cancer that develops in lymph nodes inside of your mesentery. The mesentery is a folded membrane that's attached to your intestines and abdominal wall to keep them in place.
The most common type of mesenteric lymphoma is follicular lymphoma. Follicular lymphoma is the second most common type of non-Hodgkin's lymphoma. It develops in a kind of white blood cells called B cells.
Mesenteric lymphoma is referred to as primary mesenteric lymphoma when it develops in your mesentery. It's called secondary mesenteric lymphoma if it spreads to your mesentery from other parts of your body. Most cases of mesenteric lymphoma are secondary.
Read on to learn more about mesenteric lymphoma including what causes it, potential symptoms, and treatment options.
Lymphoma is a group of cancers that develop in your lymph system and are characterized by the uncontrolled replication of white blood cells. It's broadly divided into two main categories: non-Hodgkin's and Hodgkin's lymphoma.
Mesenteric lymphoma is when lymphoma develops in the lymph nodes inside of your mesentery. Mesenteric tumors are very rare. A 2010 study estimates that they affect 1 out of 200,000 to 350,000 people. They make up about 1% to 3.6% of all gastrointestinal lymphomas.
The most common type of lymphoma to develop in your mesentery is called follicular lymphoma. Follicular lymphoma accounts for about 30% of all lymphomas.
A more aggressive type of lymphoma called diffuse large B-cell lymphoma can also develop in your mesentery.
Mesenteric lymphoma often causes a noticeable abdominal mass and abdominal pain. Other symptoms can include:
Dermatitis herpetiformisA gluten insensitivity disease called dermatitis herpetiformis — which is an itchy, blistering rash — can increase your chance of developing lymphoma. The most common type of lymphoma associated with dermatitis herpetiformis is enteropathy-associated T-cell lymphoma.
ThrombocytopeniaIn rare cases, people with mesenteric lymphoma may also develop thrombocytopenia. Thrombocytopenia is when your body produces a fewer than normal level of platelets and your blood doesn't clot properly. Symptoms include easy bruising or unexpected or prolonged bleeding.
Mesenteric panniculitisMesenteric panniculitis is also strongly associated with cancer, especially lymphoma and colorectal cancer. Mesenteric panniculitis is an inflammatory disease of the fat tissue of your mesentery that can cause symptoms such as:
Bowel obstructionIn rare cases, mesenteric lymphoma can lead to bowel obstruction. Bowel obstruction is when a blockage prevents food and water from moving through your bowel.
In a 2022 case study, researchers presented a case of a woman in her 60s with mesenteric lymphoma. She reportedly experienced nausea, vomiting, and abdominal pain for several days. Examination revealed she had bowel obstruction caused by two mesenteric lymphoma tumors.
Researchers aren't exactly sure why some people develop mesenteric lymphoma, but the most common type of mesenteric lymphoma is follicular lymphoma.
In most cases, it's not known why follicular lymphoma develops. It's more common in white Americans than Asian or African Americans, and about half of people are over the age of 55 when they're diagnosed. It's rare in people under 20.
Exposure to some pesticides and herbicides are known risk factors.
Your doctor will begin a diagnosis by asking you about your symptoms and reviewing your medical history. They may be able to feel a lump in your abdomen during a physical exam.
The next step of the diagnostic process involves imaging scans. Your doctor will likely order computed tomography (CT) scans to help identify enlarged lymph nodes as well as the size and location of your tumor.
A characteristic feature of mesenteric lymphoma on a CT scan is the "sandwich sign" or "hamburger sign" named after the shape of the mass.
To confirm that you have cancer, a surgical biopsy is usually needed. A biopsy can often be performed laparoscopically through a small incision.
After a surgical biopsy is performed, a pathologist will examine the retrieved specimen under a microscope to determine if it is cancerous or noncancerous. If it is cancerous, a pathologist can often determine the origin of the cancer.
Mesenteric lymphoma is primarily treated with surgery to remove the tumor followed by chemotherapy.
A mixture of chemotherapy drugs is often administered. In a 2019 study published in Clinical Lymphoma Myeloma and Leukemia, 23 people with diffuse large B-cell mesentery lymphoma were treated with R-CHOP or R-EPOCH chemotherapy followed by radiation therapy.
The R-Chop regimen contains:
And the R-EPOCH regimen contains:
Three of the 23 participants in the study also received a bone marrow transplant.
Due to its rarity, it's not clear what the outlook is for most people with mesenteric lymphoma. Most of the research that's available comes from individual case studies or small series.
The 5-year relative survival rate of follicular lymphoma in general is 90%. It's 97% for people with cancer localized to one area. The 5-year relative survival rate is a measure of how many people with the cancer are alive 5 years later compared to people without the cancer.
The 5-year relative survival rate for diffuse large B-cell lymphoma is 73% and 74% for people with cancer contained in one area.
Mesenteric lymphoma develops in the lymph nodes of a layer of tissue in your abdomen called the mesentery.
The most common subtype is follicular lymphoma, but a more aggressive type of lymphoma called diffuse large B-cell lymphoma has also been reported.
More research is needed to fully understand the best way to treat mesenteric lymphoma and its long-term outlook. Some people have successfully been treated with surgery and chemotherapy.
Comments
Post a Comment