Chemotherapy is the use of drugs to kill cancer cells or slow their growth. It can be used in various ways depending on the grade and type of lymphoma.
Chemotherapy can be given on its own or in combination with other drug therapies, such as steroids, targeted therapy and immunotherapy, or with radiation therapy.
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You can find information about chemotherapy protocols at eviq.org.au, although your specialist may need to tailor the plan to your individual situation. Your treatment team will give you information about your schedule.
Ways to have chemotherapy
Intravenous (IV) chemotherapy
Chemotherapy drugs are usually given as a liquid through a drip inserted into a vein (intravenous infusion). The drugs may be injected through a cannula, which is a small plastic tube inserted in a vein, or through a type of central venous access device (CVAD).
The type of device used will depend on how often you need chemotherapy, how long it will take to give each dose, and the length of time you will be having chemotherapy.
Central venous access device
This is a thin plastic tube that stays in the vein throughout the course of treatment. Common types include:
- PICC (peripherally inserted central catheter) – a thin tube that is inserted into the upper arm
- port-a-cath (port) – a small device that is surgically inserted under the skin of the chest or arm to give access to the veins
- central line (central venous catheter or CVC) – a thin tube with several openings that is inserted into a vein in the neck or chest.
Oral chemotherapy
Some chemotherapy drugs for lymphoma are given as tablets that you swallow.t is low (called neutropenia or lymphopenia), you may be given injections of granulocyte-colony stimulating factor (G-CSF). G-CSF is a substance that helps to increase your white cell count and protect you from infection. Sometimes, you may need to delay your chemotherapy until your white cell count improves.
Learn more about chemotherapy.
Having chemotherapy
You will usually have a combination of chemotherapy drugs given over 4–6 months. For Hodgkin lymphoma, the treatment is sometimes completed in 8 weeks.
The drug combination and treatment schedule will depend on the type of lymphoma. Usually, chemotherapy is given over a few days, followed by a rest period of a few weeks. This is called a cycle. The rest period lets your blood counts return to normal.
Throughout your treatment, you will be closely monitored by your doctor, and you will have tests to see how well the chemotherapy drugs are working.
As chemotherapy can reduce the number of blood cells in your body, you will have regular blood tests to check your blood count, as well as your liver and kidney function. You may also be given injections of a drug known as granulocyte-colony stimulating factor (G-CSF). This helps increase your white blood cell count and reduce your risk of infection.
Even if tests show the cancer is in remission after 2 or 3 cycles, chemotherapy may still be repeated several times to help reduce the chance of the lymphoma coming back.
Occasionally, non-Hodgkin lymphoma is treated with chemotherapy that goes into the fluid around the spinal cord. This is called intrathecal chemotherapy. It’s given through a lumbar puncture, where a doctor gently puts a needle into your lower back. The aim is to treat or stop lymphoma from spreading to the brain or spinal cord.
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→ READ MORE: Side effects of chemotherapy
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Dr Ian Bilmon, Haematologist, Westmead Hospital and Sydney Adventist Hospital, NSW; Suzanne Basha, Consumer; Jo Cryer, Clinical Nurse Consultant Haematology, St George Hospital, NSW; Jessica Elliott, Senior Social Worker, Youth Cancer Services, Crown Princess Mary Centre Westmead, NSW; Dr Robin Gasiorowski, Haematologist, Concord and Macquarie University Hospitals, NSW; Prof Angela Hong, Radiation Oncologist, Chris O’Brien Lifehouse, Melanoma Institute Australia, GenesisCare, and Clinical Professor, The University of Sydney, NSW; Karen Maddock, CAR T Cell and Cell Therapy Nurse Practitioner, Westmead Hospital, NSW; Jenn Partenfelder, 13 11 20 Consultant, Cancer Council NSW; Elise Toyer, Clinical Nurse Consultant Haematology, Blacktown Hospital, NSW.
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