Treatment Option Overview
There are different types of treatment for patients with mycosis fungoides and the Sézary syndrome cancer.
Different types of treatment are available for patients with mycosis fungoides and the Sézary syndrome. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Six types of standard treatment are used:
Photodynamic therapy is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells. For skin cancer, laser light is shined onto the skin and the drug becomes active and kills the cancer cells. Photodynamic therapy causes little damage to healthy tissue. Patients undergoing photodynamic therapy will need to limit the amount of time spent in sunlight.
In one type of photodynamic therapy, called psoralen and ultraviolet A (PUVA) therapy, the patient receives a drug called psoralen and then ultraviolet radiation is directed to the skin. In another type of photodynamic therapy, called extracorporeal photochemotherapy, the patient is given drugs and then some blood cells are taken from the body, put under a special ultraviolet A light, and put back into the body.
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
Sometimes, total skin electron beam (TSEB) radiation therapy is used to treat mycosis fungoides and the Sézary syndrome. This is a type of radiation treatment in which the skin over the whole body is treated with rays of tiny particles called electrons.
The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Sometimes the chemotherapy is topical (applied to the skin in a cream, lotion, or ointment). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
See Drugs Approved for Non-Hodgkin Lymphoma 1 for more information. (Mycosis fungoides and the Sézary syndrome are types of non-Hodgkin lymphoma.)
Topical corticosteroids are used to relieve red, swollen, and inflamed skin. They are a type of steroid. Topical corticosteroids may be applied in a cream, lotion, or ointment.
Retinoids, such as bexarotene, are drugs related to vitamin A that can slow the growth of certain types of cancer cells. The retinoids may be taken by mouth or applied to the skin.
See Drugs Approved for Non-Hodgkin Lymphoma 1 for more information. (Mycosis fungoides and the Sézary syndrome are types of non-Hodgkin lymphoma.)
Biologic therapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
Specific types of biologic therapy used in treating mycosis fungoides and the Sézary syndrome include the following:
- Interferon alfa: A substance that interferes with the division of cancer cells and can slow tumor growth.
- Denileukin diftitox: A biologic therapy that combines diphtheria toxin and interleukin-2 protein to target and kill cancer cells.
See Drugs Approved for Non-Hodgkin Lymphoma 1 for more information. (Mycosis fungoides and the Sézary syndrome are types of non-Hodgkin lymphoma.)
Targeted therapy is a treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibody therapy is a type of targeted therapy used in the treatment of mycosis fungoides and the Sézary syndrome.
Monoclonal antibody therapy uses antibodies made in the laboratory, from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.
See Drugs Approved for Non-Hodgkin Lymphoma 1 for more information. (Mycosis fungoides and the Sézary syndrome are types of non-Hodgkin lymphoma.)
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site 2.
Ultraviolet B radiation therapy
Ultraviolet B (UVB) radiation therapy uses a special lamp or laser that directs UVB radiation at the skin.
High-dose chemotherapy and radiation therapy with stem cell transplant
This treatment is a method of giving high doses of chemotherapy and radiation therapy and replacing blood-forming cells destroyed by the cancer treatment. Stem cells (immature blood cells) are removed from the bone marrow or blood of the patient or a donor and are frozen and stored. After therapy is completed, the stored stem cells are thawed and given back to the patient through an infusion. These reinfused stem cells grow into (and restore) the body's blood cells.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Glossary Termsabdomen (AB-doh-men)The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.antibody (AN-tee-BAH-dee) A protein made by plasma cells (a type of white blood cell) in response to an antigen (a substance that causes the body to make a specific immune response). Each antibody can bind to only one specific antigen. The purpose of this binding is to help destroy the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen.bexarotene (bek-SAYR-uh-teen) A drug used to treat skin problems caused by cutaneous T-cell lymphoma that have not gotten better after other treatment. It is also being studied in the treatment of other types of cancer. Bexarotene is a type of retinoid. Also called LGD1069 and Targretin.biological therapy (BY-oh-LAH-jih-kul THAYR-uh-pee) Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called biological response modifier therapy, biotherapy, BRM therapy, and immunotherapy.blood (blud) A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.bone marrow (bone MAYR-oh) The soft, sponge-like tissue in the center of most bones. It produces white blood cells, red blood cells, and platelets.cancer (KAN-ser) A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.catheter (KA-theh-ter) A flexible tube used to deliver fluids into or withdraw fluids from the body.cavity (KA-vih-tee) A hollow area or hole. It may describe a body cavity (such as the space within the abdomen) or a hole in a tooth caused by decay.cell (sel) The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.cerebrospinal fluid (seh-REE-broh-SPY-nul FLOO-id) The fluid that flows in and around the hollow spaces of the brain and spinal cord, and between two of the meninges (the thin layers of tissue that cover and protect the brain and spinal cord). Cerebrospinal fluid is made by tissue called the choroid plexus in the ventricles (hollow spaces) in the brain. Also called CSF.chemotherapy (KEE-moh-THAYR-uh-pee) Treatment with drugs that kill cancer cells.clinical trial (KLIH-nih-kul TRY-ul) A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.corticosteroid (KOR-tih-koh-STAYR-oyd) Any steroid hormone made in the adrenal cortex (the outer part of the adrenal gland). They are also made in the laboratory. Corticosteroids have many different effects in the body, and are used to treat many different conditions. They may be used as hormone replacement, to suppress the immune system, and to treat some side effects of cancer and its treatment. Corticosteroids are also used to treat certain lymphomas and lymphoid leukemias.denileukin diftitox (DEH-nih-LOO-kin DIF-tih-tox) A drug used to treat cutaneous T-cell lymphoma that can bind the cytokine IL-2 and that has not responded to other treatment. It is also being studied in the treatment of other types of cancer. Denileukin diftitox is made by combining a part of IL-2 with a bacterial toxin. The IL-2 part of the drug attaches to the cancer cells and then the toxin kills the cells. Denileukin diftitox is a type of immunotoxin and a type of fusion toxin. Also called Ontak.diagnosis (DY-ug-NOH-sis) The process of identifying a disease, such as cancer, from its signs and symptoms.dose (dose) The amount of medicine taken, or radiation given, at one time.drug (drug) Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.external radiation therapy (...RAY-dee-AY-shun THAYR-uh-pee) A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.extracorporeal photopheresis (EK-struh-kor-POR-ee-ul FOH-toh-feh-REE-sis) A procedure in which blood is removed from the body and treated with ultraviolet light and drugs that become active when exposed to light. The blood is then returned to the body. It is being studied in the treatment of some blood and bone marrow diseases and graft-vs-host disease (GVHD). Also called photopheresis.follow-up (FAH-loh-up) Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.immune system (ih-MYOON SIS-tem) The complex group of organs and cells that defends the body against infections and other diseases.inflammation (IN-fluh-MAY-shun) Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.infusion (in-FYOO-zhun) A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion.injection (in-JEK-shun) Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."interferon (in-ter-FEER-on) A biological response modifier (a substance that can improve the body's natural response to infections and other diseases). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and -gamma. The body normally produces these substances. They are also made in the laboratory to treat cancer and other diseases.interleukin-2 (in-ter-LOO-kin...) One of a group of related proteins made by leukocytes (white blood cells) and other cells in the body. Interleukin-2 is made by a type of T lymphocyte. It increases the growth and activity of other T lymphocytes and B lymphocytes, and affects the development of the immune system. Aldesleukin (interleukin-2 made in the laboratory) is being used as a biological response modifier to boost the immune system in cancer therapy. Interleukin-2 is a type of cytokine. Also called IL-2.internal radiation therapy (in-TER-nul RAY-dee-AY-shun THAYR-uh-pee) A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, implant radiation therapy, and radiation brachytherapy.laser (LAY-zer) A device that forms light into intense, narrow beams that may be used to cut or destroy tissue, such as cancer tissue. It may also be used to reduce lymphedema (swelling caused by a buildup of lymph fluid in tissue) after breast cancer surgery. Lasers are used in microsurgery, photodynamic therapy, and many other procedures to diagnose and treat disease.monoclonal antibody (MAH-noh-KLOH-nul AN-tee-BAH-dee) A type of protein made in the laboratory that can bind to substances in the body, including tumor cells. There are many kinds of monoclonal antibodies. Each monoclonal antibody is made to find one substance. Monoclonal antibodies are being used to treat some types of cancer and are being studied in the treatment of other types. They can be used alone or to carry drugs, toxins, or radioactive materials directly to a tumor.mycosis fungoides (my-KOH-sis fun-GOY-deez) A type of non-Hodgkin lymphoma that first appears on the skin and can spread to the lymph nodes or other organs such as the spleen, liver, or lungs.NCI NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. It conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://www.cancer.gov. Also called National Cancer Institute.non-Hodgkin lymphoma (non-HOJ-kin lim-FOH-muh) Any of a large group of cancers of lymphocytes (white blood cells). Non-Hodgkin lymphomas can occur at any age and are often marked by lymph nodes that are larger than normal, fever, and weight loss. There are many different types of non-Hodgkin lymphoma. These types can be divided into aggressive (fast-growing) and indolent (slow-growing) types, and they can be formed from either B-cells or T-cells. B-cell non-Hodgkin lymphomas include Burkitt lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), diffuse large B-cell lymphoma, follicular lymphoma, immunoblastic large cell lymphoma, precursor B-lymphoblastic lymphoma, and mantle cell lymphoma. T-cell non-Hodgkin lymphomas include mycosis fungoides, anaplastic large cell lymphoma, and precursor T-lymphoblastic lymphoma. Lymphomas that occur after bone marrow or stem cell transplantation are usually B-cell non-Hodgkin lymphomas. Prognosis and treatment depend on the stage and type of disease. Also called NHL.ointment (OYNT-ment) A substance used on the skin to soothe or heal wounds, burns, rashes, scrapes, or other skin problems. Also called unguent.organ (OR-gun) A part of the body that performs a specific function. For example, the heart is an organ.photodynamic therapy (FOH-toh-dy-NA-mik THAYR-uh-pee) Treatment with drugs that become active when exposed to light. These activated drugs may kill cancer cells.psoralen (SOR-uh-len) A substance from plants that is sensitive to light (or can be activated by light). Psoralens are used together with UV light to treat psoriasis, vitiligo, and skin nodules of cutaneous T-cell lymphoma. They are also being studied in the treatment of graft-versus-host disease. Psoralen is a type of furocoumarin. An example of a psoralen is methoxsalen.psoralen and ultraviolet A therapy (SOR-uh-len…UL-truh-VY-oh-let A THAYR-uh-pee) A type of photodynamic therapy used to treat skin conditions such as psoriasis, vitiligo, and skin nodules of cutaneous T-cell lymphoma. The patient receives psoralen (a drug that becomes active when it is exposed to light) by mouth or applied to the skin, followed by ultraviolet A radiation. Psoralen and ultraviolet A therapy may increase the risk of getting skin cancer. Also called PUVA therapy.radiation (RAY-dee-AY-shun) Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).radiation therapy (RAY-dee-AY-shun THAYR-uh-pee) The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.radioactive (RAY-dee-oh-AK-tiv) Giving off radiation.radioactive seed (RAY-dee-oh-AK-tiv...) A small, radioactive pellet that is placed in or near a tumor. Cancer cells are killed by the energy given off as the radioactive material breaks down and becomes more stable.recur (ree-KER) To come back or to return.regional chemotherapy (REE-juh-nul KEE-moh-THAYR-uh-pee) Treatment with anticancer drugs directed to a specific area of the body.retinoid (REH-tih-noyd) Vitamin A or a vitamin A-like compound.Sezary syndrome (say-zah-REE SIN-drome) A cancer that affects the skin. It is a form of cutaneous T-cell lymphoma.side effect (side eh-FEKT) A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.stage (stayj) The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.standard therapy (... THAYR-uh-pee) Treatment that experts agree is appropriate, accepted, and widely used. Also called best practice, standard medical care, and standard of care.stem cell (stem sel) A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.steroid (STAYR-oyd) Any of a group of lipids (fats) that have a certain chemical structure. Steroids occur naturally in plants and animals or they may be made in the laboratory. Examples of steroids include sex hormones, cholesterol, bile acids, and some drugs.systemic chemotherapy (sis-TEH-mik KEE-moh-THAYR-uh-pee) Treatment with anticancer drugs that travel through the blood to cells all over the body.targeted therapy (TAR-geh-ted THAYR-uh-pee) A type of treatment that uses drugs or other substances, such as monoclonal antibodies, to identify and attack specific cancer cells. Targeted therapy may have fewer side effects than other types of cancer treatments.therapy (THAYR-uh-pee) Treatment.tissue (TIH-shoo) A group or layer of cells that work together to perform a specific function.topical (TAH-pih-kul) On the surface of the body.total skin electron beam radiation therapy (TOH-tul skin ee-LEK-tron beem RAY-dee-AY-shun THAYR-uh-pee) A type of radiation therapy using electrons that is directed at the entire surface of the body. This type of radiation goes into the outer layers of the skin, but does not go deeper into tissues and organs below the skin. Also called TSEB radiation therapy.toxin (TOK-sin) A poison made by certain bacteria, plants, or animals, including insects.ultraviolet radiation therapy (UL-truh-VY-oh-let RAY-dee-AY-shun THAYR-uh-pee) A form of radiation used in the treatment of cancer.vein (vayn) A blood vessel that carries blood to the heart from tissues and organs in the body.vitamin A (VY-tuh-min …) A nutrient that the body needs in small amounts to function and stay healthy. Vitamin A helps in vision, bone growth, reproduction, growth of epithelium (cells that line the internal and external surfaces of the body), and fighting infections. It is fat-soluble (can dissolve in fats and oils). Vitamin A is found in liver, egg yolks, and whole milk dairy products from animals and in fish oils. It can also be made in the body from a substance found in some fruits and vegetables, such as cantaloupes, carrots, spinach, and sweet potatoes. Vitamin A is being studied in the prevention and treatment of some types of cancer. Also called retinol.x-ray (EX-ray) A type of radiation used in the diagnosis and treatment of cancer and other diseases. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer. |
Table of Links | |
| 1 | http://www.cancer.gov/cancertopics/druginfo/non-hodgkin |
| 2 | http://cancer.gov/clinicaltrials |
