Lymphoma Diagnosis and Treatment

A doctor speaking with one of his patients in front of a window at OHSU.
Dr. Kevin Yee has advanced training in blood disorders, including lymphoma and other blood cancers.

The OHSU Knight Cancer Institute offers unmatched care for lymphoma. Our team has extensive experience treating this complex cancer. You’ll find:

  • A team-based approach that brings specialists together to develop the best possible treatment recommendations for your needs.
  • The latest CAR T-cell immunotherapy, developed in part by OHSU researchers, for types of lymphoma.
  • An emphasis on research and access to leading-edge clinical trials.
  • Oregon’s only donor-based bone marrow transplants,  giving you more options if needed.

Lymphoma treatment overview

Your care team will tailor your treatment to your specific condition. Some treatments aim to cure lymphoma. In other cases, the best option is to try to manage it. After treatment, your team will use blood tests to monitor how much cancer remains. If needed, they will recommend further treatment.

A team approach: Your care team will include doctors, nurses and other providers. They hold a weekly meeting called a tumor board to go over treatment options together, one patient at a time. This makes sure that you benefit from the full team’s knowledge. Experts on your team may include:

  • Hematologists, doctors who are experts in blood diseases
  • Hematopathologists, doctors who diagnose blood diseases, their specific type and activity
  • Medical oncologists, doctors who treat cancer using medications
  • Radiation oncologists, doctors who treat cancer with radiation therapy

Diagnosing lymphoma

Our team uses advanced molecular testing at the Knight Diagnostic Laboratories. This helps us pinpoint your lymphoma type so we can recommend the most effective treatments. Other diagnostic tests may include:

  • Blood chemistry can measure traits such as blood cell size and appearance. Variations can indicate different diseases.
  • Complete blood count measures total numbers of red and white blood cells and platelets. Abnormal white blood cells or cell counts help your doctors gauge your blood’s infection-fighting abilities.
  • Cytogenic analysis looks at the DNA in cells to detect abnormalities.
  • Fluorescence in situ hybridization (FISH) uses fluorescent probes (molecules that absorb light) to find genetic changes that can be targeted in treatment.
  • Immunoglobulin testing measures infection-fighting antibodies in blood to help doctors identify lymphoma types.
  • Immunophenotyping looks for markers called antigens on the surface of a blood cell. We compare the cells to normal cells to diagnose the type of lymphoma.
  • Quantitative polymerase chain reaction (qPCR) helps doctors understand genetic variations that can explain lymphoma types.
  • Lymph node biopsy: Your doctor uses a hollow needle or incision to remove all or part of a lymph node. The tissue is checked under a microscope for cancer cells. Lymph nodes act as filters and can trap circulating cancer cells.
  • Spinal tap (lumbar puncture): Your doctor uses a hollow needle to take a sample of fluid from your spinal canal. Abnormal cells in the fluid could indicate that cancer has spread to your brain.
  • Thoracentesis: Your doctor uses a hollow needed to take fluid from your chest. The fluid is checked for cancer cells that have spread.
  • Paracentesis: Your doctor uses a hollow needed to take fluid from your abdomen to check for cancer cells.

Doctors analyze bone marrow, where white blood cells are made, to understand the stage and extent of lymphoma. These tests use a hollow needle inserted into bone.

  • Bone marrow aspiration collects fluid.
  • Bone marrow biopsy collects tissue.
Dr. Stephen Spurgeon
Dr. Stephen Spurgeon is an expert in blood cancers. He has a particular focus on lymphoma both in the lab and in patient care.
  • Bone scans involve injecting a tiny amount of a safe radioactive solution that highlights bone cancer on images.
  • Chest X-rays can show signs of disease or infection.
  • Computed tomography (CT) scans produce clear images of organs and lymph nodes.
  • Magnetic resonance imaging (MRI) produces detailed images of organs, tissues, vessels and bones, which can help doctors find cancer.
  • Positron emission tomography (PET) scans help doctors identify cancer cells. We inject a sugar solution containing a safe amount of radioactive dye into your body. The cancer cells absorb the solution faster than normal cells and show on the scans.
  • Ultrasound uses sound waves to take pictures of organs and tissue to show any abnormal shapes or growths.

Lymphoma treatments

Dr. Brandon Hayes-Lattin specializes in lymphoma, bone marrow transplants and treating young adults with cancer.
Dr. Brandon Hayes-Lattin specializes in lymphoma, bone marrow transplants and treating young adults with cancer.

Monitoring: If you have a slow-growing lymphoma and no symptoms, you may need only monitoring. Your doctor will do regular exams, blood tests and scans.

Chemotherapy: Single or combined medications, usually given by mouth or IV, kill cancer cells nearly anywhere in the body.  Medication can also be placed directly where needed. Intrathecal chemotherapy, for example, uses an injection to put medication in the fluid surrounding the spinal cord.

Immunotherapy: Immunotherapy medications help your body’s immune system weaken or destroy cancer cells while sparing healthy cells. One type, CAR T-cell therapy, was developed in part by OHSU scientists. A patient’s own immune system T cells are genetically modified to fight cancer, then returned by IV. It’s approved for some types of non-Hodgkin lymphoma. Other types of immunotherapy can treat both Hodgkin and non-Hodgkin lymphoma.

Targeted therapy: These medications target abnormal cells at the molecular level, mostly leaving healthy cells alone. Different types are given by IV or pill.

Radiation therapy: We use external beam radiation therapy to treat lymphoma. This treatment uses a machine to send high-energy radiation beams toward the body to destroy advanced or aggressive lymphoma cells. We also may use radiation therapy to relieve cancer symptoms and improve quality of life for lymphoma patients.

Bone marrow transplant: After destroying cancer cells with chemotherapy or radiation, a specialist transplants new, healthy cells into your body. The new cells help you fight infection and disease. Your doctor may recommend a bone marrow transplant if other treatments aren’t effective or if cancer comes back after treatment.

Surgery: We might recommend a splenectomy, or removing your spleen, if lymphoma started in or enlarged your spleen. The spleen is an immune system organ that filters your blood. An enlarged spleen can be painful and lead to decreased blood cell counts. Organs such as the liver and the lymph nodes can take over for the spleen if it is removed, but you may be more prone to infections.

Additional services

OHSU and the Knight Cancer Institute offer many services to support you and your family. They include:

  • Cancer care for young adults: We offer the only program in Oregon for cancer patients who were age 15 to 39 when diagnosed. Our Adolescent and Young Adult Oncology Program connects patients with peers and addresses specific concerns.
  • Fertility preservation: Our fertility specialists can offer a range of options to protect your ability to have children after cancer treatment.
  • Palliative careExperts in cancer care can help you and your family relieve symptoms and stress.
  • Rehabilitation: We offer specialized rehabilitation care to help you recover from cancer and cancer treatment.

Learn more

For patients

Call 503-494-7999 to:

  • Make an appointment
  • Seek a second opinion
  • Ask questions

Locations

Parking is free for patients and their visitors.

Center for Health & Healing Building 2
3485 S. Bond Ave.
Portland, OR 97239
Map and directions

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