Preventive Chemotherapy Slashes the Risk of Lymphoma Spreading to the Central Nervous System

What does treatment for central nervous system lymphoma entail?

The central nervous system is like a sanctuary for cancer cells because most traditional chemotherapies cannot penetrate the blood-brain barrier (hence our saying in oncology, “Chemotherapy in the vein does not penetrate the brain”). While the blood-brain barrier naturally protects the central nervous system from bacteria and viruses, it doesn’t keep all pathogens out … or necessarily allow cancer-fighting drugs in. This requires us to take a more direct approach in administering chemotherapy to the central nervous system. Beyond chemotherapy, treatment can also entail surgical removal of the tumor(s) and/or targeted radiation therapy.

Is preventive therapy available?

Yes, preventive therapy is critical for individuals who are at high risk for central nervous system lymphoma. We start by proactively identifying those who are most likely to be affected and then administer a low dose of chemotherapy directly into the cerebrospinal fluid through a series of lumbar punctures. This enables the chemotherapy to penetrate the blood-brain barrier and enter the central nervous system. This preventive measure can reduce the likelihood of a patient developing brain metastases by approximately 90%.

How do you instill hope in patients facing a difficult prognosis despite these advancements?

I focus on sharing stories from other patients who have rallied and done much better than anticipated, even when they were in statistically tough situations. I also encourage them to believe in the power of positivity. Of course we don’t have statistics to measure that, but I will tell you people who have a positive outlook seem to do much better overall. I encourage them to fight on and be optimistic as we use every resource available – including new advances in medicine happening all the time – to provide the best possible outcome.