There are more than 70 different kinds of lymphoma, a cancer of the immune cells 1. As such, the path from diagnosis to the end of life can vary quite a bit. Hodgkin lymphoma is very curable, while some non-Hodgkin lymphomas are more difficult to treat 48. Stage IV lymphoma is the most advanced, but this can mean very different things for different people -- including living a fulfilling life for many years, in some cases. If the disease does progress toward the end of life, people go through stages that include changing the focus of therapy, emphasis on quality of life and symptom control, and providing support and comfort up to the last day of life.
More aggressive stage IV or recurrent lymphoma often requires more intensive treatment, such as stem cell transplantation with high-dose chemotherapy. Doctors use a variety of tools to help people with cancer balance the risks and potential gains from anti-cancer therapy. People react differently to a poor prognosis, but some decide to focus on quality of life and maximizing the fullness of their remaining days rather than continuing with anti-cancer therapies.
Continuing care focuses on preserving the quality of a person's life, rather than prolonging it, but this does not mean giving up. Many people don't realize that the final process of dying is relatively short, occurring over just a few days. Until a person enters this phase, life can be close to normal -- although the person is obviously sick, with fatigue being very common. A pain-management plan developed by specialists can enable individuals to live their final days comfortably. As the end of life draws near, some people opt for home care by loved ones, while others prefer hospice care, which draws on the support of people who have both medical training and, oftentimes, considerable experience with end-of-life issues.
Changes in Body Function
As lymphoma spreads throughout the body, therapies that were previously used to treat the cancer may be used as a means of controlling symptoms 1. For example, if lymphoma spreads to the bones, radiation may be used to relieve pain. Chemotherapy may be advantageous in shrinking distant tumors that are blocking the function of organs, such as the bowels. Organs containing tumors may eventually fail to function properly, which can lead to such problems as difficulty breathing or swallowing, diminished mental capacity, infections, pain or fatigue.
Support and Preparation
Despite advances in medicine, unpredictable events and complications -- like infections -- can make it very difficult for doctors to say for sure when a person will live his last day. This unpredictability in the timing of death makes it important to have final arrangements well planned early on. Making personal decisions ahead of time and setting up a strong support network will optimize the time remaining for an individual to share with loved ones.
- National Cancer Institute: Lymphoma
- National Cancer Institute: Adult Hodgkin Lymphoma Treatment
- National Cancer Institute: Adult Non-Hodgkin Lymphoma Treatment
- Cancer.net: Lymphoma – Non-Hodgkin: Stages
- American Cancer Society: Cancer Facts & Figures 2015
- Cancer Research UK: Statistics and Outlook for Non Hodgkin Lymphoma
- American Cancer Society: Making End-of-Life Decisions
- American Cancer Society: If Treatment for Non-Hodgkin Lymphoma Stops Working
- Canadian Virtual Hospice: What Can Be Expected With Non-Hodkin’s Lymphoma?
- American Cancer Society: Choosing Hospice Care
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