Sharon Apel’s Story: How Radioimmunotherapy Works for Lymphoma
When 38-year-old Sharon Apel started feeling exhausted and drained, she brushed off her symptoms as being a side effect from working a full-time job as a nurse and taking care of her three young children. In 1985, she attended a workshop on how to use specialized ultrasound machinery to view the interior of a patient’s common carotid arteries. All those who were involved in the workshop took turns practicing on one another; however, when Apel’s turn came, something strange appeared in her ultrasound. It showed a massive clump of lymph nodes in her neck.
“I knew what it was as soon as they told me,” said Apel. She underwent a lymph node biopsy that confirmed her diagnosis of non-Hodgkin B-cell lymphoma. Since her cancer had spread to her lymph nodes and her groin, her doctors informed her that she had 5-10 years left to live. “My goal was to see all of my kids graduate from high school,” said Apel.
A year and a half following her first remission from chemotherapy, Apel started to experience night sweats. Her cancer had returned and over the course of 10 years, she would undergo six more separate rounds of chemotherapy. Every cancer-free phase that she went through was a little shorter than the previous one, as her lymphoma cells were fighting hard to dodge each round of chemotherapy.
Deciding to try a new therapy after multiple failures
By 1995, Apel decided that she would undergo an experimental type of cancer therapy called radioimmunotherapy, which was made available at Stanford Hospital. Radioimmunotherapy combines radiation therapy and immunotherapy to treat non-Hodgkin’s B-cell lymphoma and other types of cancer. It involves the use of monoclonal antibodies - molecules used by the body’s immune system to fight off infection - and radiotracers, to target harmful foreign substances, such as bacteria and viruses. Once the antibody has targeted the foreign substance, it attaches to it and signals the body’s immune system to destroy it.
In the early stages of some types of lymphoma, the cancer may be limited to one or two areas of the lymph node regions and it may be treated with radiation. In other types of lymphoma, chemotherapy may be required.
Since non-Hodgkin lymphoma is a fairly devious cancer, it tends not to present any obvious symptoms until the cancer has spread to other areas of the body. The most common symptom of B-cell lymphoma is swelling of the lymph nodes in the neck, under the arms, and in the groin. Other symptoms may include tiredness, fever, weight loss, abdominal fullness, and night sweats. In such instances, medical experts recommend chemotherapy in combination with radiation to help push the cancer into remission. However, as in Apel’s case, the response is generally temporary. When the cancer recurs, a new round of chemotherapy is used in combination with different drugs. Unfortunately, drugs that are both effective and tolerable tend to run out.
Read on to learn more about Sharon's story and about radioimmunotherapy for lymphoma.