Stage 3 Cancer: Definition, Diagnosis, Treatment, Prognosis
Diffuse Large B-Cell Lymphoma
SOURCES:
American Cancer Society: "Non-Hodgkin Lymphoma," "Non-Hodgkin Lymphoma Risk Factors," "Treating B-Cell Non-Hodgkin Lymphoma," "Thoughts, emotions, and chemo," "Eating right can help you get through cancer treatment."
Leukaemia Foundation: "Diffuse large B-cell lymphoma (DLBCL)."
Lymphoma Research Foundation: "Diffuse Large B-Cell Lymphoma (DLBCL)," "Emotional Well-Being."
University of Texas M.D. Anderson Cancer Center: "Diffuse large B-cell lymphoma."
Medscape: "Diffuse Large Cell Lymphoma."
National Cancer Institute: "Adult Non-Hodgkin Lymphoma Treatment (PDQ)."
Tholstrup, D. Leukemia & Lymphoma, March 2011.
UpToDate: "Patient information: Diffuse large B cell lymphoma in adults (Beyond the Basics)."
The Oncologist: "2016 ASH Annual Meeting Highlights: R-CHOP Remains the Standard of Care in Previously Untreated Diffuse Large B-Cell Lymphoma."
OncLive: "R-CHOP Remains Frontline Standard in DLBCL, Says Expert."
ASCO Post: "Treatment of Diffuse Large B-Cell Lymphoma Continues to Evolve."
Oncologist: "Lenalidomide in Relapsed or Refractory Diffuse Large B-Cell Lymphoma: Is It a Valid Treatment Option?"
Annals of Hematology: "R-CVP regimen is active in frail elderly patients aged 80 or over with diffuse large B cell lymphoma."
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News release, FDA: "FDA approves CAR-T cell therapy to treat adults with certain types of large B-cell lymphoma."
Kourtney Kardashian Documents Seeing Her 'First' Blink-182 Show At Coachella — See The Photos!
The Kardashians star shared a carousel of photos and videos taken at Blink-182's Coachella set over the weekend
© Provided by People Jeff Bottari/Zuffa LLC via Getty Kourtney Kardashian is husband Travis Barker's number one fan!
The Kardashians star, 43, documented her experience at Coachella on Friday, as her husband took the stage during Blink-182's debut set at the festival's Sahara stage.
"My first @blink182 show!" Kardashian captioned her post. (Blink 182's performance marked the first time the punk-rock group's original members Mark Hoppus, Barker, 47, and Tom DeLonge were on stage together since 2015, when DeLonge, also 47, left the group.)
In one video, Kardashian can be seen wrapping her arms and legs around Barker in a hug, as another shows her view from the side and front of the stage as the band performed.
The mother of three also shared photos of Barker's broken drum mallet and a photo of her husband onstage, as well as a photograph of herself posing with Barker's son, Landon Barker, and his girlfriend, Charli D'Amelio.
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Related:Blink-182 Performing at Coachella 2023 with Original Tom DeLonge, Travis Barker and Mark Hoppus Lineup
Coachella made the surprise announcement on Thursday that Blink-182 would be added to its Friday lineup in an Instagram post displaying a calendar of performances for the day.
"Take off your pants and jacket ☀️," the festival captioned the photo, referring to one of the band's songs.
Blink-182, who came back together when they found out Hoppus had been diagnosed with stage 4 diffuse large B-cell lymphoma in April 2021, announced in October that they would be releasing new music and embarking on a world tour with a cheeky video teasing "Edging," the alternative rock band's new single.
However, the band hit a snag when Barker injured his finger twice in less than a month while preparing for the tour.
Related:Travis Barker Gets Ready for Surgery and Shares Graphic Photos of His Injured Ring Finger
This prompted the band to announce last month that it postponed its tour around Latin America, which was supposed to kick off on March 11.
Rolling Stone reported that the tour will now instead begin on May 5 in Saint Paul, Minnesota, finishing its North American leg in Nashville on July 16. It will then embark on its European leg in September, before touring Australia beginning February 2024.
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Combination Therapy For DLBCL
Diffuse large B-cell lymphoma (DLBCL) grows fast, so you usually start treatment right away. The type you get depends on your overall health and stage of your cancer. For DLBCL, most people have chemotherapy (chemo) and immunotherapy using several cancer medicines. Or they might have chemo plus radiation.
It's normal to worry about having chemo. It helps to know what side effects to expect and the best way to handle them. Also, keep in mind that many people with DLBCL have no signs of cancer after treatment.
R-CHOPThis is the most common treatment for DLBCL. It's made of three cancer medicines -- cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), and vincristine (Oncovin) -- plus the steroid prednisone.
The "R" stands for a medicine called rituximab, an immunotherapy that specifically targets cancer cells.
Most chemo treatments use a combination of cancer medicines because each one attacks cancer in a different way.
Sometimes the medicines in R-CHOP need to change, especially if you're older or have other health problems. For instance, doxorubicin can damage your heart. So if you have heart trouble, you may have a treatment called R-CEOP instead. The "E" stands for a medicine called etoposide (Etopophos).
Being pregnant could mean changes in your treatment, too. You and your doctor will choose a treatment that's safe for both you and your baby.
What to expect. You get the first four R-CHOP medicines in an IV and take prednisone in pill form. You have this treatment about six times across a few months. If your cancer's in the early stages, you may need less chemo. But it may be combined with radiation that directly targets the tumor.
Sometimes your doctor may inject chemo into the fluid around your spine. This is called intrathecal chemotherapy. No matter how it's given, you only have R-CHOP every 3 weeks. This gives your body time to recover between treatments.
Side effects. R-CHOP causes side effects for most people. Some are medical emergencies:
Febrile neutropenia. This is a fever along with low levels of white blood cells called neutrophils. It can be life-threatening. If you're getting chemo and have a temperature above 100.4 F, call your doctor right away.
Nausea and vomiting. You're likely to have some after R-CHOP. You'll get medicine before and after treatment to help ease it a bit.
Hypersensitivity reaction. This might happen after your first chemo treatment. It can cause, among other things:
Your doctor may give you certain medicines to make these less severe.
Tumor lysis syndrome. This happens when tumor cells die and release toxins into your blood. You might have nausea, vomiting, heart trouble, bloody pee, or seizures. You're given medicine before treatment to help lower your chances of having these symptoms.
Other problems. Chemo can damage your heart or nerves or make it harder to have children. It can also raise your chance of having other types of cancer.
After treatment. Your doctor will watch you closely to see if your treatment worked. You'll have a physical exam and imaging tests like PET or CT scans. If R-CHOP hasn't worked, a clinical trial may be an option. This is a research study that tries to find the best treatment for a disease. It allows you try new medicines that aren't on the market yet. Your doctor can tell you more.
When Cancer Comes BackSometimes, DLBCL goes away and then comes back. If this happens, your doctor will likely try another chemo treatment. If it works, you might have the option of having a stem cell transplant. This offers the best chance for a cure. But a stem cell transplant is really hard on your body. It can cause severe side effects and even death.
It's hard emotionally, too. You need to spend weeks in a special room in the hospital so you don't get an infection. And your chance of infection remains high even after you go home. Many people aren't healthy enough for a stem cell transplant. Or it may not seem worth it.
When at least two previous treatments have failed, a treatment called CAR (chimeric antigen receptor) T-cell therapy is sometimes used in adults. It's a type of gene therapy, where a person's own T cells are genetically modified in the lab, reproduced and then infused back into the patient to target the lymphoma cells.
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