Right now, there are a number of treatment options available for mantle cell lymphoma (MCL): chemotherapy (with/without immunotherapy), stem cell transplants, and targeted therapy. Yet despite these options, this cancer can be notoriously difficult to treat. If you have MCL, you may be asking why this is and what your doctor can do to get the highest quality (and most effective) treatment possible.

Obstacles to Treatment and Care

According to an article on WebMD, one of the reasons why MCL can be so tough to manage is because it is fast-growing. Cancer is usually grouped into stages: I, II, III, and IV, with III and IV being later-stage (advanced or metastatic). Regardless of the type of cancer, it is easiest to treat in earlier stages. But people with mantle cell lymphoma may not show symptoms in these early stages. Some individuals may experience persistent lymph node inflammation in the neck, throat, elbows, shoulders, and chest.

In earlier lymphoma stages, the cancer is typically limited to one side of the body, even though it may have progressed to additional lymph nodes. By the time stage III approaches, the cancer has spread to both sides of the body; by stage IV, the cancer is no longer contained solely to lymph nodes. When it has spread, it makes it more difficult to treat.

Doctors may choose treatment options based on what stage your cancer is at, where it is located, your age, symptoms, and comorbidities. If you are still in earlier stages, doctors might want to actively monitor your MCL and only start treatment once symptoms appear. As your cancer progresses, you may be treated with intensive chemotherapy with rituximab, an immunotherapy. The issue is that MCL becomes chemotherapy-resistant over time. Ultimately, this means that treatment may take longer or that you may experience poor treatment results. If your cancer fails to respond to treatment, or recurs, you may be put on another combination treatment.

Right now, there are a number of targeted therapies being explored in clinical studies that can hopefully overcome existing treatment barriers.

What is Mantle Cell Lymphoma (MCL)?

Mantle cell lymphoma exists under the greater umbrella of non-Hodgkin’s lymphoma (NHL), which means that it is a cancer of the lymphatic system. In MCL, the cancer begins in lymphocytes (a type of white blood cell) within the mantle zone of the lymph nodes, giving it its name. Doctors don’t know the exact cause of mantle cell lymphoma. Some believe that it is genetically-oriented, with mutations causing too much cyclin D1 protein to be released. This protein causes B cells to grow uncontrollably. MCL is more common in males and older individuals.

When symptoms do appear, they may include:

• Nausea and vomiting
• An enlarged liver, spleen, and tonsils
• Appetite loss and sense of fullness
• Unintentional weight loss
• Recurrent fever
• Heartburn and indigestion
• Lower back pain/pressure that may continue down the leg(s)
• Swollen lymph nodes
• Diarrhea
• Headache
• Changes in mood, behavior, or personality
• Dizziness