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UNDERSTANDING THE FORMS OF LYMPHOMA

Q: I am 74 years old, and I was diagnosed with lymphoma. Please give me some information on this disease and how it progresses.

I am treated with Leukeran 2 mg, four days a month, 12 pills a day, and prednisone 5 mg, eight days a month, 12 pills a day.
-- C.N., Laval, Quebec

A: There are many kinds of lymphomas that range widely in the severity of the disease. I hope that you have one of the least severe forms and your treatment is successful. Lymphomas are usually divided into two major categories: Hodgkin's disease and non-Hodgkin's lymphomas.

Because you didn't mention Hodgkin's disease, I will assume you were diagnosed with non-Hodgkins lymphoma. I hope that the general information I provide will be helpful in better understanding the different forms of this group of diseases.

Lymphomas are cancers of the lymphocytes. These are a type of white blood cell that detect and destroy foreign substances like infections. Your body makes about 1 billion new lymphocytes every day. AIDS is another problem caused by abnormalities in the lymphocytes but it is a totally unrelated process.

Symptoms may include swollen but not always painful lymph nodes, fever, excessive night sweating and unintended weight loss. Abdominal pain and a feeling of fullness are also seen.

In the early stages following diagnosis of some types of lymphoma, treatment is often directed only at relief of symptoms. In other types and as the disease progresses, a more definitive treatment plan may become necessary. This is a very individualized plan based on the type and extent of the lymphoma and the ability of the person to tolerate the therapy.

From what you've said about your medicines, your treatment plan includes what is called pulse-dose combination chemotherapy. Pulse doses (intermittent high doses) are thought to be safer and more effective than smaller daily doses of the same combination of drugs.

Radiation is the recommended treatment for some other lymphomas, and bone marrow transplants are considered in special circumstances. Treatment with monoclonal antibodies has shown promise in some studies, but the results have varied.

Certainly, early detection is a key to success, as is the strength to persevere through this difficult time in your life.

If you want information about your type of lymphoma, consider contacting the American Cancer Society at (800) ACS-2345. Also, to get support from others with lymphoma go on-line to the Cancer Community of the Better Health and Medical Network on America Online.

Q: I recently saw a TV program where the speaker said very few of the pills people take benefit them, because most go through the body and are eliminated without breaking down from the pill form.

After hearing the program, I have begun to chew my Premarin, Geritol and ibuprofen tablets before I swallow them. They taste terrible. But I want to be sure the medication benefits my system.
-- J.W., Daytona Beach, Fla.
A: It's probably all right to chew the medications you mentioned before you swallow them. Most medicines in tablet form can be chewed with no ill effects. There are some oral medicines in capsule form, such as timed-release medications that may be adversely affected by being chewed.

But why do it? First, as you say, those medicines and most others don't taste very good. Second, the medicines are formulated to do their work without being chewed.

New drugs are tested in the same form they will be used. Most forms of oral drugs are meant to break down in the stomach to be able to enter the bloodstream. If they didn't break down the way they're supposed to, the drugs would be considered ineffective and not approved to be marketed.

In you have any questions on other drugs, especially how to take them, check with your pharmacist.

Update: Can you believe it? Sometimes when you try to do one thing that's good for your health, you cause some other problem. Well, that's what a recent study in the British Journal of Sports Medicine is telling us.

It turns out that sports drinks -- drinks that are marketed to be used during and after strenuous exercise -- can dissolve your teeth. That's because they are very acidic -- 100 times more so than what is consider safe for the enamel.

But there are a couple of things you can do to prevent the problem and still get the replenishing benefit of these drinks: 1) Drink the liquid fairly rapidly without swishing it around in the mouth and 2) Rinse your mouth with water -- a good idea really for almost anything you drink.

Dr. Allen Douma welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Douma in care of Tribune Media Services, 435 N. Michigan Av., Suite 1400, Chicago, Ill. 60611.

This column is for informational and educational purposes only. It is not intended to provide medical advice or take the place of consultation with a doctor or other health care provider.

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