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Basic Facts About Lymphoma
July 11th, 2008 by SueFrankly Speaking About Lymphoma
Understanding Lymphoma:
BASIC FACTS ABOUT LYMPHOMA
What Is Cancer?
Your body is made of millions of cells that work together to perform structural and biological functions. As these cells age and wear out, they are replaced by just enough healthy new cells to keep your body working properly. Cancer occurs when a single cell becomes abnormal and grows or accumulates to form a mass of cells called a tumor. Tumors can become threatening when they obstruct bodily functions by growing large enough, or by growing in vital places in your body.
What Is Lymphoma?
Lymphoma is the term used for cancers of the lymphatic system. The lymphatic system is a part of your immune system that plays a major role in how your body fights infection. To understand lymphoma, you need to know a little about how the lymphatic system works.
The lymphatic system is made up of a type of white blood cell called lymphocytes. Lymphatics are thin tubes that connect the tissues of the body to the blood stream. The lymphatic system also includes collections of lymphocytes in tissues that are exposed to the outside world such as our sinuses, intestines, airways, and skin.
Lymphoma occurs when there is an error in the way a lymphocyte is produced, resulting in an abnormal cell population. These cells can accumulate because either (a) they can duplicate faster than normal lymphocytes, or (b) they live longer than normal lymphocytes. Like normal lymphocytes, these abnormal cells can grow in the lymph nodes or other lymphatic system organs. And because the lymphatic system connects most of the body, these abnormal cells can appear and accumulate throughout the body.
Lymph nodes are found in clusters around the neck, underarms, groin, and internally throughout the chest and abdomen. Lymphocytes are cells that fight infection by traveling from various organs, through the lymph system, and through the blood and bone marrow to the lymph nodes. Wheras this behavior is normal for lymphocytes, in lymphomas masses of the malignant cells accumulate in various sites around the body
Lymphoma can occur in children or adults and comes in two basic forms: Hodgkin's lymphoma (also called Hodgkin's disease) and non-Hodgkin's lymphoma. An estimated 66,100 new cases of Non-Hodgkin's lymphoma will be diagnosed in 2008, with an additional 8,200 cases of Hodgkin's lymphoma (National Cancer Institute's SEER Program, 2008). Incidence rates for non-Hodgkin's lymphoma have nearly doubled since the early 1970s. The rate of increase has appeared to slow down during the 1990s. Incidence rates of Hodgkin's lymphoma have declined somewhat since the 1970s, particularly among the elderly.
What Causes Lymphoma?
People diagnosed with lymphoma frequently wonder "why me?". There is most likely nothing you could have done to avoid developing lymphoma. Currently scientists speculate that most cancers, including lymphoma, are due to a combination of environmental factors such as chemical exposures or viral infections. A predisposition to develop some cancers may be hereditary. No specific factors have been demonstrated to strongly predispose a person to lymphoma. There is some evidence that suggests certain viruses or other infectious agents may contribute to the development of lymphoma. There are rare cases in which lymphoma occurs in several family members. Yet, the risk of lymphoma in relatives does not warrant additional screening or undue concern.
What Are the Symptoms?
The most common symptom of lymphoma is a painless swelling of the lymph node(s) in the neck, underarm, and/or groin. Other symptoms may include fever, night sweats, fatigue, weight loss, or itchy skin. Remember, these symptoms can be common with other types of infections such as the flu. It is important to see your doctor if any of the symptoms last longer than two weeks.
How Is Lymphoma Diagnosed?
The diagnosis of lymphoma requires a biopsy of a swollen lymph node or mass. If you have symptoms that indicate that you might have lymphoma, a doctor will conduct a physical exam to check for swollen lymph glands. The doctor may also look for swelling or fluid in your chest or abdomen that might be caused by swollen lymph nodes. If swollen lymph nodes are found, the doctor will need to perform a biopsy. There are different types of biopsies. For lymphoma patients, it is important to biopsy sufficient tissue to ensure an accurate diagnosis. In a core biopsy, a piece of tissue is removed from an area where cancer is suspected. This may not provide enough tissue so many doctors will recommend an open biopsy, in this case an entire swollen lymph node is removed. While a core biopsy can be done under local anesthesia, an open biopsy often requires a general anesthetic and may require a few stitches.
What is Staging?
Staging is the determination of the extent of lymphoma by analyzing which (and how many) lymph nodes are involved. Staging is a critical process that helps determine which treatment is most appropriate for you. The stage of the disease also affects the likelihood of remission or cure after treatment.
Doctors use other tests to help confirm the type and stage of lymphoma:
- Blood tests
- Imaging tests: x-rays, CT (or CAT) scan, MRI, PET
- Bone marrow examination
- Cerebrospinal fluid (CSF) examination
What Are the Goals of Treatment?
The goal of treatment may be cure, to achieve remission or a disease "response," or it may be to alleviate symptoms that cause pain or discomfort.
Some individuals with some types of lymphoma may be cured. They can enjoy a normal life expectancy with currently available treatment. Others with lymphoma may not be cured, but may enjoy prolonged remissions. A remission is a period of time where there is no or little evidence of the lymphoma. During the initial evaluation and staging of lymphoma, your doctor will acquire information to help estimate the likelihood that your lymphoma will respond to treatment and whether cure is a possibility. It is important to carefully discuss your goals of therapy with the doctor, including the difference between receiving standard therapy or participating in a clinical trial.
How Is Treatment Decided?
Treatment for Hodgkin's lymphoma and non-Hodgkin's lymphoma depends on the stage of the cancer, its location in the body, the extent of symptoms, and the general health and age of the patient. Treatment may include radiation therapy, chemotherapy, bone marrow or stem cell transplants, radioimmunotherapy or biologic therapy. Clinical trials (research studies) involving the use of new treatments may also be used (see Treatment for Lymphoma for more explanation).
Doctors consider several factors when they discuss with you the best therapy for your type and stage of lymphoma:
- Newly diagnosed versus recurrent disease---patients who have recurrent disease will require specialized therapy different from those who are newly diagnosed.
- Age---younger patients (those younger than age 60) generally have a better prognosis.
- Performance status---patients with a higher level of physical activity before diagnosis tend to tolerate and respond better to therapy.
- LDH Enzyme in the blood---people with lower levels of lactate dehydrogenase (LDH) may have a better prognosis. LDH is a substance found in the body, especially the liver, kidneys, muscles, heart. This substance can accumulate in these organs at higher levels when a patient has lymphoma.
- Extranodal disease---if disease is not found in organs outside the lymph nodes, the prognosis is generally better.
- Stage of disease---patients with Stage I or Stage II disease tend to have better prognosis than patients with Stage III or Stage IV disease. Each stage of disease requires a specific treatment approach.
Can Lymphoma Be Cured?
Some types of lymphoma, especially in the early stages, are curable. There is a great deal of promising research on lymphoma. Scientists are exploring new methods of treatment, new drugs and combinations of drugs, and clinical trials. One of the primary goals of the Lymphoma Research Foundation is to support an integrated, nationwide research strategy to increase the cure rates for this disease.
How Do I Get More Information?
For further information, please contact:
Lymphoma Research Foundation
8800 Venice Blvd., Suite 207
Los Angeles, CA 90034
(310) 204-7040 or (800) 500-9976
or
111 Broadway, 19th Floor
New York, NY 10006
(212) 349-2910 or (800) 235-6848
web: www.lymphoma.org
e-mail: Helpline@lymphoma.org
The Leukemia & Lymphoma Society
1311 Mamaroneck Avenue
White Plains, NY 10605
(800) 955-4572
web: www.leukemia-lymphoma.org
e-mail: infocenter@leukemia-lymphoma.org
National Cancer Institute
(800) 4-CANCER
web: www.cancer.gov
American Cancer Society
(800) ACS-2345
web: www.cancer.org
Updated June 23, 2008
http://www.thewellnesscommunity.org/education/lymphoma/basic_facts.php
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