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Lymphoma (HL & NHL)

CISS relies strongly in its evaluations below on impartial analyses by the International Cochrane Collaboration and the British Medical Journal’s Clinical Evidence Group – two groups of researchers who specialise in Evidence Based Medicine.

Conventional medicine supports the paradigm that states that the tumour is the first stage of cancer; therefore treating and removing the tumour should cure the cancer. Unfortunately statistics show this is rarely the case. Conventional medicine also advocates treatment should only be used if supported by appropriate clinical trials showing efficacy. Evidence based medicine suggests that the only reliable evidence for efficacy comes from properly run randomised controlled trials (RCTs). Again, none of the RCTs evaluating conventional intervention for cancer has shown any clear benefit. Therefore the conventional cancer paradigm needs to be questioned.

Much of the following descriptions are based on the conventional cancer paradigm with comments from CISS inserted where claims have not been verified by evidence.

Lymphoma is cancer that begins in cells of the lymph system. The lymph system is part of the immune system that helps the body fight infection and disease. Because lymph tissue is found all through the body lymphoma can begin almost anywhere.

Risk factors: The causes of lymphoma are not yet known. Exposure to radiation and certain chemicals puts some people at higher risk. For people whose immune system is supressed, exposure to viruses such as the Epstein-Barr virus or HIV increases the risk of developing lymphoma (Australian Cancer Council). Risk factors are usually based on correlation factors between lifestyle and cancer incidence so there is rarely any causal factor established (CISS).

The two main types of lymphoma are Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). These can occur in both children and adults. (NCI)

Hodgkin Lymphoma (HL) (or Hodgkin’s Disease HD)

Most people with Hodgkin lymphoma have the classic type. With this type, there are large, abnormal lymphocytes (a type of white blood cell) in the lymph nodes called Reed-Sternberg cells. Hodgkin lymphoma can usually be cured. – NCI. (CISS questions this claim by the NCI because it is based on an invalid definition of the term “cured”. The NCI states if you remain in complete remission – where all signs and symptoms of cancer have disappeared – for 5 years or more, some doctors may say that you are cured.)

The following tests and procedures may be used to detect (find) and diagnose adult Hodgkin lymphoma:

  • Physical exam and history
  • Complete blood count (CBC)

Three types of standard treatment are used for adult Hodgkin lymphoma:

  • Chemotherapy

Note. Research by Morgan et al concluded that chemotherapy in Hodgkin’s lymphoma may give 35.8% of patients an increased percentage 5 year survival benefit.

  • Radiation therapy

Note: radiation has been shown to reduce recurrence with many types of cancer but this rarely results in increased survival. (The efficacy of radiotherapy, DJ Benjamin).

Morgan et al have claimed that radiotherapy increases 5 year survival from Hodgkin lymphoma from 80% to 95%.

  • Surgery

Signs and Symptoms: Signs of adult Hodgkin lymphoma include swollen lymph nodes, fever, night sweats, and weight loss. These and other signs and symptoms may be caused by adult Hodgkin lymphoma or by other conditions.

Childhood Hodgkin lymphoma is a disease in which malignant (cancer) cells form in the lymph system. The two types of childhood Hodgkin lymphoma are:

  • Classical Hodgkin lymphoma.
  • Nodular lymphocyte-predominant Hodgkin lymphoma.

Epstein-Barr virus infection increases the risk of childhood Hodgkin lymphoma.

Tests that examine the lymph system are used to detect (find) and diagnose childhood Hodgkin lymphoma.

Signs of childhood Hodgkin lymphoma include swollen lymph nodes, fever, night sweats, and weight loss.

Five types of standard treatment are used:

  • Chemotherapy

Note: Research by Morgan et al concluded that chemotherapy in Hodgkin’s lymphoma may give 35.8% of patients an increased percentage 5 year survival benefit.

  • Radiation therapy

Note: radiation has been shown to reduce recurrence with many types of cancer but this rarely results in increased survival. (The efficacy of radiotherapy, DJ Benjamin).

  • Targeted therapy
  • Surgery
  • High-dose chemotherapy with stem cell transplant

Prognosis: An individual’s prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. For people diagnosed with Hodgkin lymphoma in Australia prognosis is generally good with a five year survival rate of more than 87%. (Australia Cancer Council). It is not known what proportion of this is due to treatment (CISS).

Non-Hodgkin Lymphoma (NHL) (Burkitt Lymphoma, Follicular Lymphoma, Mantle Cell Lymphoma, CTCL Mycosis Fungoides and Diffuse B Cell Lymphoma)

There are many different types of NHL that form from different types of white blood cells (B-cells, T-cells, NK cells). Most types of NHL form from B-cells. NHL may be indolent (slow-growing) or aggressive (fast-growing). The most common types of NHL in adults are diffuse large B-cell lymphoma, which is usually aggressive, and follicular lymphoma, which is usually indolent.

Mycosis fungoides and the Sézary syndrome are types of NHL that start in white blood cells in the skin. Primary central nervous system lymphoma is a rare type of NHL that starts in white blood cells in the brain, spinal cord, or eye. The treatment and the chance of a cure depend on the stage and the type of lymphoma.

The following tests and procedures may be used to help detect (find) and diagnose adult non-Hodgkin lymphoma:

  • Physical exam and history
  • Flow cytometry
  • Bone marrow aspiration and biopsy
  • Lymph node biopsy

Adult non-Hodgkin lymphoma is classified in four stages from Stage I – Stage IV.

Adult non-Hodgkin lymphomas may be grouped for treatment according to whether the cancer is indolent or aggressive and whether affected lymph nodes are next to each other in the body.

Seven types of standard treatment are used:

  • Radiation therapy

Note: radiation has been shown to reduce recurrence with many types of cancer but this rarely results in increased survival. (The efficacy of radiotherapy, DJ Benjamin).

  • Chemotherapy

Note: Research by Morgan et al conclude that chemotherapy in Non-Hodgkin lymphoma may give 10.5% of patients an increased percentage 5 year survival benefit

  • Targeted therapy
  • Plasmapheresis
  • Watchful waiting
  • Antibiotic therapy
  • Surgery

Signs and symptoms of adult non-Hodgkin lymphoma include swelling in the lymph nodes, fever, night sweats, weight loss, and fatigue. These signs and symptoms may be caused by adult non-Hodgkin lymphoma or by other conditions.

The 4 major types of childhood non-Hodgkin lymphoma are:

  • B-cell non-Hodgkin lymphoma (Burkitt and Burkitt-like lymphoma) and Burkitt leukemia.
  • Diffuse large B-cell lymphoma.
  • Lymphoblastic lymphoma.
  • Anaplastic large cell lymphoma.

Some cancer treatments cause side effects months or years after treatment has ended.

Four types of standard treatment are used:

  • Chemotherapy

Note: Research by Morgan et al conclude that chemotherapy in Non-Hodgkin lymphoma may give 10.5% of patients 5 year survival benefit

  • Radiation therapy (in certain patients)

Note: radiation has been shown to reduce recurrence with many types of cancer but this rarely results in increased survival. (The efficacy of radiotherapy, DJ Benjamin).

  • High-dose chemotherapy with stem cell transplant
  • Targeted therapy (NCI)

Prognosis: An individual’s prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. For people diagnosed with non-Hodgkin lymphoma in Australia prognosis is a five year survival rate of 71% (Australia Cancer Council). It is not known what proportion of this is due to treatment (CISS).

Overdiagnosis: There is little overdiagnosis of lymphoma although there are occasionally other non-fatal conditions that are misdiagnosed as lymphoma.

Before deciding on one of these treatments you would benefit from asking your physician three questions:

Question 1: What are my treatment options? – these should include doing nothing.

Question 2: What are the possible outcomes of those options? – including benefits and side effects.

Question 3: How likely is each of the outcomes to occur?

If you feel your doctor or other health practitioner is not able to answer these questions, or shows that he or she is not comfortable with you asking these question, it suggests they are not practising evidence based medicine and you should consider getting another opinion.

These three questions can be expanded.

Alternative Cancer Therapies

As mentioned above, conventional medicine supports the paradigm that the tumour is the first stage of cancer; therefore treating and removing the cancer should cure the cancer. Another paradigm states that cancer is a systemic disease and the tumour is only a late stage symptom, element or manifestation of that disease. Therefore treating the disease should be systemic and wholistic (meaning treating the whole body) and should include the following principles:

  1. Treatment should cause no harm
  2. Treatment should be Wholistic (ie consider the whole person – body, mind, emotions and spirit)
  3. The person with cancer needs to take control of their own health. This latter paradigm is supported by CISS (See Introduction to CISS)

Alternative cancer therapies are generally consistent with the above principles. In fact those believed to be the most effective in controlling cancer – psychotherapy and immunotherapy – also have the strongest supporting evidence from randomised controlled trials.

There are approximately 200 alternative cancer therapies that have been shown or anecdotally reported to help a person with cancer have reduced morbidity and mortality. The following are those used for lymphoma with the most scientific evidence for benefit. What is important in any cancer treatment is to both understand and believe in your chosen therapy.

There are a few alternative cancer therapies claimed to produce benefits with lymphoma. Those claimed to have the most benefits include:

  • Psychotherapy

Many randomised controlled trials have shown survival benefits from psychotherapy for people with many types of cancer. This suggests that psychotherapy is effective in dealing with one of the known contributory factors to the systemic cancer process – chronic stress.

One particular randomised controlled trial of 94 patients newly diagnosed with hematologic malignancies (ie lymphoma and leukemia) found a significant increase survival among those given a psychotherapeutic intervention1.

  • Immunotherapy

       Iscador – Similarly many randomised controlled trials have shown survival benefits from iscador immunotherapy for people with many types of cancer, again suggesting that immunotherapy is effective in dealing with another of the contributory factors to the systemic cancer process – a weakened immune system.

Two particular case studies have demonstrated the efficacy of Iscador with a particular type of lymphoma – Primary Cutaneous B-Cell Lymphoma.2 (See also below)

References:

  1. Richardson JL, Shelton DR, Krailo M, et al. The effect of compliance with treatment on survival among patients with hematologic malignancies. J Clin Oncol. 1990; 8:356–64
  2. Maurice Orange M et al , Durable Regression of Primary Cutaneous B-Cell Lymphoma Following Fever-inducing Mistletoe Treatment: Two Case Reports. Glob Adv Health Med. 2012 Mar; 1(1): 18–25.

       Issel’s Wholebody therapy – Although not based on RCTs the most successful therapy for late stage cancers was Issels’ Whole Body Therapy that focussed on restoring the body’s immune systems. Wholebody immunotherapy was used by Josef Issels up to the 1970s.

It was estimated that a representative sample (252) of Issels’ patients with late stage cancers showed a 16.6% five year survival following his treatment and 15% 15 years survival in good health. Two of those with leukemia and Hodgkin’s lymphoma were among those who survived 15 years.

Ralph Moss, Cancer Therapy, The Independent Consumers Guide to Non-Toxic Treatment and Prevention, reports the following alternative therapies have also been shown to benefit people with lymphoma.

  1. Monoclonals – Monoclonal antibodies are laboratory creations. They are produced by fusing B lymphocytes with cells from multiple myeloma, producing a new hybrid cell that turns out an ant- cancer substance which can then be harvested as drugs.

Treatment trials with monoclonals alone have been a bit disappointing in many cancers, and long lasting responses have only been seen in lymphoma. In early trials, monoclonals that were combined with radioactive isotopes also produced some remissions in leukemia and lymphoma.

References:

Dillman R. monoclonal antibodies for treating cancer. Ann Int Med. 1989;111:592-603.

Wittes R. (Ed.). Manual of oncologic therapeutics 1991/1992. Philadelphia: J.B. Lippincott, 1991:478.

  1. Phototherapy – This is the use of light in the treatment of diseases such as cancer. Phototherapy causes the destruction of tumours through the administration of a “photosensitising agent” that is retained in tumours. This relatively harmless substance is then activated by shining a light on the tumour in order to generate cell-killing agents on the spot.

Dr Richard L Edelson wrote an excellent article in the Scientific American (8/1988) where he explains how light plus 8-MOP are now being used to treat cutaneous T-cell lymphoma, a white blood cell malignancy which previously had a poor prognosis. The original work on this was done by Barbara Gilchrest at the Harvard Medical School and has been extended by Edelson and his colleagues.

References:

Gasparro FP, et al. Effect of monochromatic UVA light and 8-methoxypsoralen on human lymphocyte response to mitogen. Photodermatol.1984;1:10-7.

Gasparro FP, et al. Phototherapy and photopharmacology. Yale J Biol Med.1985;58:519-34.

Santella RM, et al. Monoclonal antibodies to DNA modified by 8-methoxypsoralen and ultraviolet A light. Nucleic acids Res.1985;13:2533-44.

  1. Bestatin – This is a powerful immune stimulant discovered by Japanese scientists in 1976. It was isolated from a broth of the ‘strep’ organism Streptomyces Olivoreticuli.

Bestatin stimulates T lymphocyte cells, activates the scavenger macrophages and stimulates certain blood producing cells in the bone marrow called erythroid progenitors as well as other parts of the blood renewal system.

Not surprisingly, both Natural Killer (NK) cell levels and Lymphocyte Activated Killer (LAK) cell levels were seen to be significantly lowered in patients with cancers of the blood. Both of these cell populations normalised when Bestatin was administered.

References:

Ota K. Review of ubenimex (Bestatin): clinical research. Biomed Pharmacother.1991;45:55-60.

Aoki I, et al. Effects of ubenimex on erythroid progenitors (CFU-E and BFU-E) in human bone marrow. Exp Hematol.1991;19:893-8.

Yamazaki T, Sugiyama KIchihara K. Effect of ubenimex on the immune system of patients with haematological malignancies. Biomed Pharmacother.1991;45:105-12.

  1. Coley’s Toxins – These are mixed bacterial vaccines developed by William Coley MD after he observed that many people with cancer went into remission after having an acute infection that caused a fever. They are effective with a wide range of cancers. His results included 67% five-year survival with Hodgkin’s lymphoma. (References: 2-4, p.412) (This figure was well above that achieved with conventional treatments at the time. CISS.)

Reference: Nauts H. Bacteria and cancer – antagonisms and benefits. Cancer Surv. 1989; 8: 713-23.

  1. Hydrazine Sulphate – Hydrazine Sulphate is a prohibited import in Australia. This is a chemical designed to interrupt the process in the liver whereby the waste product lactic acid is converted to glucose. It is believed that tumours are more dependent on a continuous supply of glucose than other cells. This thereby interrupts the process called cachexia, a wasting away of the body produced by tumours starving the rest of the body of glucose and causing up to 40% of late stage cancer deaths. It has been shown to be effective for most solid tumours, including metastasised tumours. (Reference 13, p. 319)

A study measuring objective response in 740 patients treated up to 1988, from age 16 to 72, having common, widespread solid tumours, including recurrent and metastatic tumours, malignant lymphomas and recurrent desmoids. The largest groups consisted of patients with disseminated lung cancers (200), gastric cancer (138), breast cancer (66), recurrent Hodgkin’s disease (63) and melanoma (31). Objective response was observed in neuroblastoma, recurrent desmoid, Hodgkin’s disease, lung cancer, fibrosarcoma and other tumours.

References:

(Ref13:) Filov V et al : “Results of Clinical Evaluation of Hydrazine Sulfate” [Voprosy Onkologii 1990; 36:721-726,]

Filov V et al “Experience of the treatment with Sehydrin (Hydrazine Sulfate, HS) in the advanced cancer patients” Investigative New Drugs 13:89-97, 1995.

  1. Splenopentin – This is a hormone derived from the spleen that is active in the immune system. In an Italian study involving 41 patient with Hodgkin’s disease with a severe immunodeficiency who had chemo- and/or radiotherapy, splenopentin resulted in a significant increase in their white blood cells.

Reference: Chisesi T et al. The effect of thymic substances on T circulating cells of patients treated for Hodgkin’s disease. J Biol Regul Homeost Agents 1988; 2; 193-8.

  1. Immunotherapy – The clinical experiences with Iscador P were systematically documented in 191 patients with non-Hodgkin’s lymphomas (61 patients with follicular NHL, 130 patients with non-follicular NHL) in correlation with the corresponding laboratory tests. Clear evidence was revealed for the safety (no triggering or progression) and efficacy (partial or complete remissions) of monotherapy with Iscador. Likewise, under combination therapy (chemotherapy and Iscador) remissions could be observed despite a bad prognosis.

References:

Kuehn JJ: Treatment responses to Viscum album pini (Iscador P) in Non-Hodgkin’s Lymphoma. Exploring a new therapeutic route. MEDICINA (Buenos Aires) 2007; 67 (Supl. II), 107-114

Kuehn JJ. Favorable long-term outcome with mistletoe therapy in a patient with centroblastic-centrocytic non-Hodgkin lymphoma. Dtsch Med Wochenschr. (Nov 26) 1999; 124(47):1414-8. German.

Prevention

There are no specific treatments designed to prevent lymphoma. However there are several general approaches that are suggested might be useful in preventing all types of cancers.

Based on the above information it would seem that preventing cancer, including lymphoma, involves mainly dealing with the emotional causes of cancer. See Cancer Prevention.

Choosing the right treatment for you

If you or someone close to you has just been diagnosed with lymphoma it is important that you research and understand your chosen treatment, whether that be conventional, alternative or a mixture of both. For the best results your treatment should include physical , mental, emotional / psychological and spiritual treatments.

If you don’t know where to begin in your journey to wellness then we suggest you read Where To Start. This provides an introduction to the alternative approach to treating cancer and also information about some evidenced based alternative cancer treatments.

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