Stephen J. Schueler, M.D.

Overview Incidence Risk Factors Symptoms Evaluation staging Treatment chemotherapy questions for doctor radiation therapy specialist Home Care anorexia diet pain control taking control warning signs Outlook Complications Underlying Cause Types Anatomy

Lymphoma Home Care

Home care for lymphoma includes:

  • Drink plenty of fluids.
  • Follow a cancer diet:
    • Good nutrition can boost the immune system and help make your treatments more effective.
  • Follow an exercise plan developed with your doctor.
  • Acetaminophen for pain
  • Nonsteroidal anti-inflammatory medications for pain:
  • Take prescribed medications as directed:
    • Don't skip doses of your medication. This makes them less effective.
    • Be aware of the common side effects that may be caused by your medication.
  • Learn everything you can about lymphoma:
    • The more you know about your condition, the easier it will be to participate with your doctor in making treatment decisions.
    • Ask your doctor about good sources for information.
    • Write down questions to ask your doctor
  • Create a support group:
    • Include family and friends
    • Learn about support groups in your community or contact your local chapter of the American Cancer Society.

Lymphoma Anorexia

Many patients with lymphoma will suffer from anorexia, which means loss of appetite. Anorexia is a problem with many forms of cancer, because cancer can affect the body's hormones, digestive system and brain. It is also a common side effect of chemotherapy and radiation therapy.

Good nutrition is an important part of successful cancer treatment. Adequate nutrition can boost the immune system and help increase the effectiveness of cancer therapy.

Home care for anorexia includes:

  • Avoid stomach irritants such as aspirin or ibuprofen.
  • Avoid excessive caffeine and other stimulants.
  • Check with your doctor about drinking alcohol.
  • Do not force yourself to eat at standard times. Eat when you are hungry instead.
  • Concentrate on eating a healthy diet. Avoid junk foods.
  • Select healthy, high-calorie foods that you enjoy.
  • Eat more frequent, smaller meals.
  • Get some exercise every day.
  • Keep a daily log of your weight.
  • Don't smoke. Nicotine can suppress the appetite.
  • Ask your doctor or nutritionist about dietary supplements.
  • Ask your doctor if any medications you may be taking can cause anorexia.
  • Take any prescribed medications as directed.
  • Anti-nausea medications:
  • Appetite stimulants:

Lymphoma Diet

Adequate nutrition is essential for the body to maintain its immune system, strength, and vitality. This is even more important for those with lymphoma.

National Cancer Institute general guidelines include:

  • Avoid obesity by losing excess weight.
  • Consume alcoholic beverages in moderation, if at all.
  • Include a variety of fruits and vegetables in the daily diet.
  • Increase fiber to 20-30 grams/day with an upper limit of 35 grams.
  • Minimize consumption of salt-cured, salt-pickled, and smoked foods.
  • Reduce fat intake to 30 percent of calories or less.

Goals of Nutritional Management
There are two main goals for a cancer diet. The first is the achievement and maintenance of reasonable weight. The second is the prevention or correction of nutritional imbalances and deficiencies.

Adequate calories to meet energy requirements, sufficient protein to permit tissue growth, fats, minerals, vitamins, and fluids all must be supplied in appropriate amounts to meet the patient's requirements. Careful attention to nutrition is important because malnutrition induced by cancer and its treatment adversely affects the patient and complicates further treatment of the disease.

Appetite loss in cancer is apparently a varied symptom, with diverse causes. Attention must be paid to the individual causes. The following steps are recommended:
  • Determine symptoms that might be related to appetite loss
  • Probe for specific food likes and dislikes
  • Patients should be given nutritional and dietary counseling

Practical guidelines for eating:
  • Atmosphere Does Make a Difference. An attractively set table with flowers or other such items can take your mind off a slumping appetite. Good odors also help such as baking bread and cakes. A glass of wine or beer with your doctor's approval prior to meals is helpful in generating an appetite.
  • Avoid Foods That Don't Interest You.
  • Discuss Your Eating Problems With Your Doctor. Before you try home remedies, be sure your problems are not symptoms needing medical attention, or unwanted side effects associated with the chemotherapeutic agent. Do not hesitate to ask your physician questions and to tell the doctor what seems to be bothering you.
  • Give Food A Chance. Remember that what sounds unappealing today may sound good tomorrow.
  • Make Use of Time Savers. Take advantage of time saving and effort saving foods and appliances. These include foods that can be prepared as a meal in a dish with little preparation and cooking. Frozen dinners, when served with a fruit, milk, and canned foods, such as soups, spaghetti sauce, or gravies, can be mixed easily with fresh cooked meat for a good dinner.
  • Stay Away From Raw Eggs and Raw Meats. This is particularly important if your chemotherapy makes you more susceptible to infection (most do).
  • Take Advantage of the Up Times. When you feel well, take advantage of it by eating well and by preparing meals that you can freeze for the down days. On the good days, eat when you feel hungry, even if it isn't mealtime. It is important to eat foods with good nutritional value; many nutrients can be stored in your body for later use.

Benefits of proper nutrition during chemotherapy:
  • Improves tolerance of therapy. A well-nourished body is stronger and more resilient than a poorly nourished one. Studies have shown that nutrition can decrease the severity and duration of chemotherapy side effects such as vomiting, nausea, weakness, lowered immunity, and susceptibility to infection. There may be other specific side effects, but in general, people who eat well while on chemotherapy tend to feel better and stay more physically active and alert mentally.
  • Increases the effectiveness of therapy. When patients feed themselves they also feed their cancer cells. Studies have shown that "well fed" cancer cells multiply more readily and are more susceptible to anticancer drugs than are slow growing undernourished cells. A good nutritional status may allow patients to withstand higher doses of drugs and increase the effectiveness of the therapy.
  • Regulates your weight. Many patients lose weight on chemotherapy, but some gain weight. Either case is undesirable for the chemotherapy patient. Both of these conditions can lead to weakness, lethargy, depression, embarrassment, and a lack of self-esteem.
  • Speeds recovery from treatment. Nutrients are the building blocks the body uses to rebuild the normal tissues that have been affected by the chemotherapy. If the proper nutrients in the adequate amounts are available, this recovery process takes place much more quickly and efficiently than when deficiencies are present.

Lymphoma Pain Control

Medications commonly used to control pain and inflammation in adults with lymphoma include:

  • Acetaminophen decreases fever and pain, but does not help inflammation.
  • Adult dosing is 2 regular strength (325 mg) every 4 hours or 2 extra-strength (500 mg) every 6 hours.
  • Maximum dose is 4,000 mg per day.
  • Avoid this drug if you have alcoholism, liver disease or an allergy to the drug. See the package instructions.
  • Common brand names include Tylenol, Panadol, and many others.





NSAID Precautions

Lymphoma Taking Control

The successful treatment of lymphoma requires your participation. Here are answers to some important questions.

Do you have control over your health and wellness?
Many people believe they have no control over their health and wellness. Many ignore personal health decisions or simply leave them to their doctors, relatives, or friends. In reality, you have the greatest potential to determine your relative health.

How is this possible? Do people really have control of their own health? The biggest killers are heart disease and cancer. Although many of these diseases seem to strike at random, our lifestyle choices greatly influence personal risk.

How can you participate in your health care?
To participate you must:

  • Learn to take responsibility for your own health.
  • Learn to partner with your doctor.
  • Learn how to make active decisions about your health.

How can you learn what you need to know?
  • Educate yourself.
  • Be skeptical: Learn to separate fact from fiction.
  • Billions of dollars are spent each year marketing dietary supplements, vitamins, and new medical treatments. Much of this is unnecessary and wasteful.
  • Be careful about where you get your health information.
    • Some of the best sources for health information on the web are professional societies and non-profit organizations.
    • Ask your doctor what he or she recommends.
  • Examine the credentials of the authors.
    • If you are reading about symptoms and disease, your best source is a licensed physician.
    • Pay attention to when the content was last updated.
    • Make sure the person is not just trying to sell you something.

Important questions you need to answer:
  • What things in your control can increase your risk for disease?
  • What can you do to decrease this risk?
  • What are vaccines and how can they help you?
  • How do your lifestyle choices increase your risk for disease?
  • How can you reduce stress?
  • What minor health problems can you treat at home?
  • When is a medical problem "serious"?
  • When should you call the doctor?

How can you find the right doctor?
Key points:
  • Everyone should have a primary care physician or family doctor. A primary physician is usually a family practitioner, internist, or pediatrician.
  • Establish a relationship in advance with your doctor.
  • Make sure you are comfortable with your primary care physician.
  • The internet contains many resources where you can do research to locate the doctor that is best for you.
  • You may wish to schedule a brief visit with the doctor to see if he or she is right for you.
    • Be open-minded, and allow your doctor to know you well. This will improve communication.

Important information you need to make your decision:
  • Physician credentials:
    • Internship and residency training is usually best from respected institutions, universities, and major hospitals.
    • Look for board certification in the specialty.
    • Ask about membership in medical societies.
  • Community and professional reputation are also important.
    • Are other patients happy with the doctor?
    • Has the doctor been disciplined by hospitals or agencies?
    • How long has the doctor been in practice?
    • In general, more than a few malpractice suits over a 5-10 year period should trigger caution.
  • Does the doctor communicate well? Are your questions answered during busy times?
  • Does the doctor welcome you to help make decisions about your care?
  • Is the doctor available when you need care?
  • What is the doctor's after-hours coverage?
  • Is he or she a member of a large group?
    • Do the doctors' cross-cover one another?
  • Where do they admit patients?

What is shared decision making?
You and your doctor must work together to jointly decide the best course of action to manage your health. This process is called "shared decision making". Your doctor becomes a guide and teacher and helps steer you toward the best treatment. Most doctors welcome this partnership. You must learn about your illnesses for shared decision-making to work.

For any recommended test, medication, or surgery, remember to ask:
  • How will this help me?
  • How much will it cost?
  • Is it covered by your insurance?
  • What are the potential side effects and risks?
  • What are my alternatives?

For tests, remember to ask:
  • Is it done in the office or at another facility?
  • Is it painful?
  • How will the results of this test influence my care?

For surgery or other procedures, remember to ask:
  • How long will it take to heal?
  • How many cases has the doctor done?
  • What would your doctor do if he or she were the patient?
  • Where is it done?
  • Who will perform it?
  • What are the doctor's qualifications?

What should you expect?
Shared decision making becomes impossible if you do not know what to expect from your doctor.

The American Hospital Association has published a "Patient's Bill of Rights" that is a good guide. It states that you have the right:
  • To be spoken to in words that you understand
  • To be told what's wrong with you
  • To know the benefits of any treatment and any alternatives
  • To know what a treatment or test will cost
  • To share in treatment decisions
  • To read your medical record
  • To refuse any medical procedure

What should you do before an office visit?
  • Bring all important medical information with you to the visit.
  • Make sure you can answer questions about the following:
    • Allergies and side effects to medicines
    • Current medicines you are taking. This includes herbs and vitamins. Make a list if necessary.
    • Insurance information
    • Marital and sexual history
    • Past injuries and hospital stays
    • Past medical problems
    • Past surgeries and operations
    • Pre-visit questionnaires
    • Use of tobacco, alcohol and drugs
    • Work history

What should you expect from the visit?
  • You should plan to wait if you go without an appointment. Emergencies or sick patients in the hospital may interrupt your doctor.
  • Bring along a book or toys for the kids. You may also have to wait during busy times.
  • Tell your doctor about your problem in a clear manner. Start from the beginning and go through each symptom as it appeared.
  • Before the visit, think about what makes your problem better or worse. Your doctor will probably ask you questions about this.
  • Most doctors ask many questions about unrelated symptoms. These questions help assure that there are no other problems that need attention.
  • Be sure to answer all questions truthfully. This includes sensitive questions about smoking, drug use, sexual activity, and work. Your history is the most important part of deciding what is wrong with you.
  • If you have any difficulty communicating your concerns, bring a family member or friend to assist in this task.
  • Talk to your doctor and do not leave the office without asking necessary questions. Your doctor can make you more comfortable if he or she understands your concerns.

What should you know about your medications?
Every year many people become ill because of problems with medications.

Remember to ask:
  • What side effects to expect.
  • What drug interactions are possible.
    • Find out if a new medicine reacts with those that you are taking now.
    • Many over-the-counter drugs and dietary supplements can also cause serious side effects and drug interactions.
    • Some drugs interact with certain foods, vitamins, nicotine, and alcohol.
  • Make sure you can drive or operate machines safely while taking a medicine.
  • Ask your doctor how much a prescription costs.
    • Is there a less expensive option or a generic version?

What is a treatment plan?
A treatment plan is what you and your doctor decide to do for an illness. A treatment plan cannot be effective without your participation.

Three simple questions can help you get the most from your treatment plan:
  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do these things?

Other important points:
  • Be sure you understand your treatment plan.
  • Stick with the treatment plan and allow time for improvement.
  • Don't stop medicines when you feel better; check with your doctor first.
  • Call your doctor if your condition is becoming worse.
  • Your doctor should tell you what to expect and when to follow-up or call the office.

Lymphoma Warning Signs

Notify your doctor if you have lymphoma and any of the following:

Continue to Lymphoma Outlook

Last Updated: Mar 10, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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  3. Martin-Duverneuil N, Mokhtari K, et al. Intravascular malignant lymphomatosis. Neuroradiology. 2002 Sep;44(9):749-54. [12221446]
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  6. Yamanaka R, Tanaka R. Advances for the treatment of primary central nervous system lymphoma (review). Oncol Rep. 2004 Sep;12(3):563-8. [15289838]
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