Tag: Weill Cornell Medical College

Fertility and Lymphoma

By Rebecca Elstrom, MD and Glenn Schattman, MD

Dr. Elstrom is an Assistant Professor of Medicine at Weill Cornell Medical College whose clinical and research interests focus on the treatment of patients with lymphoma. Dr. Schattman is an Associate Professor of Obstetrics and Gynecology at Weill Cornell Medical College, specializing in reproductive endocrinology/infertility.

Preservation of fertility is a major concern in many patients with lymphoma, as many patients are within their child-bearing years at diagnosis. Furthermore, many young patients with lymphoma have a significant chance of being cured, making consideration of quality of life issues after lymphoma a critical aspect of care.  Reliable data regarding the likelihood of infertility after chemotherapy however, have been difficult to come by.  While many women may regain their menstrual cycles and possibly fertility, premature ovarian failure (POF), or menopause before age 40, can shorten the window of potential child-bearing following cancer treatment. Unfortunately, most studies use resumption of menstrual bleeding as a measure of fertility, though it is not a reliable indicator.

These issues are particularly relevant to patients with Hodgkin lymphoma, as peak incidence occurs at approximately 20 years of age, and most patients, even those with advanced stage disease, are cured.  A paper recently published in the Journal of Clinical Oncology presented encouraging results for young women treated with ABVD chemotherapy, which is currently the standard approach in the United States.  This study reviewed the reproductive outcomes of a subset of female patients treated on clinical trials within the European Organisation for Research and Treatment of Cancer (EORTC), and found that women less than age 32 who were treated with non-alkylating chemotherapy (such as ABVD) had no increased risk of POF (overall incidence 3%, similar to women in the general population), whereas those older than 32 years had a moderately increased risk of POF (9%).  In contrast, women treated with alkylator-containing therapy, such as MOPP or BEACOPP, experienced a high rate of POF regardless of age, with an overall incidence of 60%.

Although this large cohort evaluation has shed light on the incidence and risk factors for POF in women with Hodgkin lymphoma, the data in women treated for non-Hodgkin lymphoma (NHL) are less clear. Continue reading “Fertility and Lymphoma”

Waldenstrom’s Macroglobulinemia Clinical Database Study

The purpose of this study at Weill Cornell Medical College is to learn about what might cause lymphoma, to learn about how lymphoma harms the body, and to learn about treatments for Waldenstrom’s Macroglobulinemia.

This study is open to people being treated for Waldenstrom’s Macroglobulinemia outside of NewYork-Presbyterian/Weill Cornell, but participation would require at least one visit at Weill Cornell.

Waldenstrom’s Macroglobulinemia is a rare type of lymphoma, a disease where one of the white blood cells, the lymphocytes, increases in number more than they should. The lymphocytes in Waldenstrom’s Macroglobulinemia also secrete a protein called IgM. Excess IgM can interfere with the circulation of blood. Investigators at Weill Cornell Medical College and other institutions are collecting information about lymphoma patients and their disease, as well studying their lymphoma cells in the laboratory.

Participants in this study give their permission for the investigators to collect their clinical information for research purposes. In addition, the researchers will store participants’ blood, urine, check swab, bone marrow and/or tumor tissue samples for research studies to be performed now and in the future. In some cases, participants may be asked by their physician to provide additional samples.

By studying the clinical course of lymphoma patients and the lymphoma cells in the laboratory, we hope to learn more about what causes lymphoma. We also hope that information from these studies will help identify new treatments for people with lymphoma.

To find out more about this study please contact June Greenberg, RN at (212) 746-2651 or email June at jdg2002@med.cornell.edu.

The principal investigator of this study is Dr. Peter Martin. Click here to read Dr. Martin’s clinical and research profile.

Weill Cornell Lymphoma and PTSD Study

By Regina Jacob, MD

Update: this study is closed to enrollment. 

Coping with Lymphoma to Enhance Adjustment and Reduce Stress in Survivors (CLEAR Stress) is a study being done here at the Weill Cornell Lymphoma Program that is looking at Post-traumatic Stress Disorder (PTSD) and Post-traumatic Growth in patients diagnosed with Lymphoma (Non-Hodgkin’s, Hodgkin’s, or Waldenstrom’s Macroglobulinemia). We are looking to see if we can find which patients are more likely to develop PTSD, which patients are more likely to develop Post-traumatic Growth, and we are also looking to see if there is a correlation between the two.

Participation consists of a one-time interview, which will be approximately 60-90 minutes and is given in survey form. This can be completed in-person, over the phone, via mail, or via internet-based surveys.

Click here for more details about the CLEAR Stress study.

Study Background

What do we know about Post-Traumatic Stress Disorder (PTSD) in Cancer?

In a survey study done at Weill Cornell Medical College in 2008, it was found that up to 30% of all Lymphoma Survivors suffered from at least moderate symptoms of PTSD. This is important because PTSD can influence a survivor’s overall quality of life—contributing to both anxiety and depression that last long term. PTSD in the cancer population is not the same as the PTSD seen in war veterans—the stress is not discrete and there are more choices given to the cancer patient with regards to treatment options. Therefore, the treatments that have successfully enabled war veterans diagnosed with PTSD to rejoin society, do not work as effectively in cancer patients. As a result, physicians, nurses, social workers, and families try to prevent a cancer patient from developing PTSD.

What is Post-traumatic Growth?

Some people like to think of it as the opposite of PTSD, but it is a little more than that:  it usually involves all the positive changes a person goes through after a stressful encounter. Among cancer survivors, up to 90% of all cancer survivors report some degree of post-traumatic growth. The most common being: stronger relationships with friends/family, a newfound appreciation for life, a stronger sense of self, and a stronger sense of spirituality.

What is the relationship between PTSD and Post-traumatic Growth?

Thus far, there is a very little data about the correlation between Post-traumatic Growth and PTSD. Most physicians and psychologists believe that patients who demonstrate more Post-traumatic growth will also demonstrate less PTSD (which is very desirable since the treatments available for PTSD are not as effective in cancer patients). Ideally, if health care professionals can understand which patients are at a higher risk for developing PTSD, then we might be able to prevent PTSD in the first place.

For more information about the CLEAR Stress study or if you are interested in participating, call Dr. Jacob at (646) 962-5027 or e-mail Dr. Jacob at rej2008@med.cornell.edu