Goldman Sachs Group Inc. Chief Executive Officer Lloyd Blankfein said today that he’s starting treatment for a "highly curable" form of the blood cancer lymphoma, a group of diseases that starts in the immune system and is diagnosed in about 80,000 people in the U.S. each year. Here is what you need to know about it:
What is lymphoma?
The immune system is the body’s natural defense against infection. In lymphoma, damaged cells rapidly proliferate, crowding out their healthy peers and accumulating in the lymph nodes. While there are more than two dozen different kinds, the two main forms are non-Hodgkin’s lymphoma, which is more common, and Hodgkin’s lymphoma, which is more curable.
How many people have the disease?
Each year, about 70,800 people are diagnosed with non-Hodgkin’s lymphoma and 9,190 with Hodgkin’s lymphoma, according to the Leukemia and Lymphoma Society. It’s slightly more common in men. An estimated 584,133 Americans are living currently with non-Hodgkin’s lymphoma and 177,526 with Hodgkin’s lymphoma.
How deadly is it?
Twenty-nine percent of patients with non-Hodgkin’s disease die within five years of diagnosis, and the cancer kills almost 19,000 Americans each year, according to the National Cancer Institute. Most people with Hodgkin’s disease survive, with about 12 percent dying within five years.
What treatments do patients get?
Radiation, either alone or with chemotherapy, is the standard treatment for early-stage disease, Otis Brawley, chief medical officer of the American Cancer Society, said in an interview with Bloomberg. For more advanced lymphoma, a combination of chemotherapy medicines available since the 1970s is typical. The drugs are mainly intravenous infusions and a pill, prednisone, that are given in cycles every two weeks to a month, depending on the type of cancer.
What type of lymphoma does Blankfein have?
The Goldman CEO hasn’t said publicly, and it’s impossible to know. Brawly, who hasn’t treated Blankfein and doesn’t know the details of his condition, said that from parsing the statement the odds may be good for recovery. "He said ‘highly curable,’" Brawley said. "That’s code for, you are going to give four to six cycles, hope to go into complete remission, and probably never be bothered by this again."
How long is treatment?
Patients undergo at least six months of drug cycles, during which they often receive therapies for several days, then go for several weeks or a month before returning for another round, Brawley said. If they aren’t in remission within a year, doctors may try other options, including a bone marrow transplant.
Can you work while undergoing chemotherapy?
Many people feel tired and depleted on the day of treatment and the day following, although advances in treating the side effects can keep problems like nausea, vomiting and dry mouth at bay. Most people are out of work for only a short time. Some do well enough that they want to drive themselves home after chemotherapy.
What are the treatments’ side effects and risks?
A patient’s immune system is often depressed after several rounds of chemotherapy, making infections like cold and flu more likely, according to the Mayo Clinic. They are advised to avoid crowds and anyone who might be ill. Secondary cancers, those that arise from the treatment itself, can develop in some patients, and about 2 percent to 3 percent of patients may be diagnosed with acute myeloid leukemia, which is particularly difficult to treat.
Are there any advanced therapies in development?
Researchers have struggled to find medications that are more effective than what’s currently available. Because the drugs are so potent and get so many patients into a complete remission, it’s unethical to give something else as a first-line treatment, said Brawley. One of the most recent new medicines is Roche Holding AG and Biogen Idec Inc.’s Rituxan, approved in the 1990s for a select group of patients with a specific form of non-Hodgkin’s lymphoma.
What happens after treatment? What if therapy doesn’t work?
Once a patient is in a complete remission, meaning there are no signs of disease, they are closely monitored for years to make sure they don’t relapse. If a relapse occurs, there are other therapies to try. One option is an autologous bone marrow transplant, in which doctors take bone marrow from the patient and then use high-dose chemotheraphy to kill off all the cancer and the immune system. They then rebuild a healthy immune system with the bone marrow that was previously removed. While the approach is often successful, it is also highly toxic and can itself be deadly.