Dear OncoLink "Ask The Experts,"
I have CTCL (cutaneous T-cell lymphoma), and have had it for about 5 years (diagnosed). In the beginning, I was treated with PUVA, as often as 3 times per week. Then, as the cancer came under control, it was reduced to 1 time every two months. The cancer has been in remission for about a year and 1/2. The doctor suggested that I just sun bathe and see if the cancer stays in remission. Is this a recognized treatment for CTCL once you have had a prolonged remission? Of potential treatments, which has the least risk of other cancers (melanomas) and re-occurrence of CTCL?
Dr. Alain Rook, Professor of Dermatology at the University of Pennsylvania, responds:
It would be helpful to know the original extent of involvement that the patient had at the commencement of therapy. Since PUVA was the only treatment used, I will assume no blood involvement.
With that said, once skin-only CTCL patients are in remission, we simply recommend a healthy life style, which to me means a low fat diet (better for the immune response), plenty of fruits and vegetables. Exposure to ultraviolet light would not be discouraged, but avoidance of sun burn is important. I do not recommend routine sun exposure for patients in remission, as some CTCL patients may have an increased risk of melanoma.
For patients with more advanced CTCL at the time of diagnosis (with extensive skin and blood involvement), I often keep them on maintenance interferon injections long after they achieve remission.