Primary CNS Lymphoma
This summary discusses the treatment of primary central nervous system lymphoma.
Lymphoma is a disease in which cancer (malignant) cells are found in the lymph system. The lymph system is made up of thin tubes that branch, like blood vessels, into all parts of the body. Lymph vessels carry lymph, a colorless, watery fluid that contains white blood cells called lymphocytes. Along the network of vessels are groups of small, bean-shaped organs called lymph nodes. Clusters of lymph nodes are found in the underarm, pelvis, neck, and abdomen. The lymph nodes make and store infection-fighting cells. The spleen (an organ in the upper abdomen that makes lymphocytes and filters old blood cells from the blood), the thymus (a small organ beneath the breastbone), and the tonsils (an organ in the throat) are also part of the lymph system.
Primary central nervous system (CNS) lymphoma is found in the brain and/or spine, and has not spread to other parts of the body. This disease is often seen in patients who have acquired immunodeficiency syndrome (AIDS) or other disorders of the immune system. Treatment is critical for patients with primary CNS lymphoma.
Treatment for primary CNS lymphoma is more successful for patients who are able to walk, are younger than 60 years old, and who do not have AIDS or other disorders of the immune system. When the tumor continues to grow, it usually does not spread beyond the CNS or the eye.
There are 3 types of treatments used for patients with primary CNS lymphoma:
Surgery (removing the cancer).
Radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells and shrink tumors).
Chemotherapy (using drugs to kill cancer cells and shrink tumors).
Surgery usually does not benefit the patient because CNS tumors are spread throughout the brain and/or spine. Standard therapy for primary CNS lymphoma is radiation therapy. Despite treatment, the lymphoma is likely to return. Other treatment includes intrathecal chemotherapy (drugs put directly into the brain or spinal fluid) and standard chemotherapy, with or without radiation therapy.
High-dose radiation therapy to the brain can make it difficult for patients to think and reason. Chemotherapy, however, given alone or before radiation therapy may lower the risk that this will happen.
Patients who have AIDS-related primary CNS lymphoma usually have very advanced immunodeficiency virus (HIV) infections, and are unable to survive other infections despite receiving treatment for lymphoma. Radiation therapy (with or without chemotherapy) appears to be most beneficial for patients who are HIV-positive without having prior infections or tumors, and patients who have no symptoms other than those caused by primary CNS lymphoma (refer to the PDQ summary on AIDS-Related Lymphoma Treatment for more information).
To Learn More
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.
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PDQ is a comprehensive cancer database available on Cancer.gov.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at Cancer.gov, the NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about new treatments, the risks involved, and how well they do or do not work. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard."
Listings of clinical trials are included in PDQ and are available online at Cancer.gov. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.