Learning about Non-Hodgkin’s Lymphoma

You may have read headlines, or listened to news reports about how Maryland governor, Larry Hogan, is to begin chemo treatment for Non-Hodgkin’s lymphoma.   The treatment was set to begin on Monday, and indeed is underway, to battle Stage III lymphoma cancer.  Stage III is an aggressive yet treatable stage of this rather common cancer. Unfortunately, many of us are in the dark as to the details of this cancer, how it progresses, and how it is treated.  This is as good a time as any to learn about this lymphatic cancer.

To start, there are two types of lymphomas.  These are Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma, the cancer we will discuss here.  Although both types affect the lymphatic system, they differ in the way that they act, progress, and respond to treatment.  It is as if they are two totally different types of cancers, which they are.

Non-hodgkin’s lymphoma is one of the most common cancers in the U.S. and accounts for about 4 percent of all cancers.  There are about 20-200,000 cases of this cancer which occur yearly in the country, and typically affect people over the age of 60.  This cancer begins in the lymphocytes, a type of white blood cell within the lymphatic system, part of the body’s immune system the body’s disease fighting center. As mentioned, Non-Hodgkin’s is a common type of lymphoma, and there are several different types of Non-Hodgkin’s lymphoma that fall into the category. The most common types of non-Hodgkin’s lymphoma include diffuse large B-cell lymphoma and follicular lymphoma. B-cell lymphoma is the particular type that has affected the Maryland governor, said to be the most common of the Non-Hodgkin’s lymphomas.

We want to focus on B cell lymphoma, but it is important to note that Non-Hodgkin’s lymphoma can begin in either the B cells or T cells. B cells are the ones that fight infection by producing antibodies.  These antibodies attack antigens and foreign bodies. T cells on the other hand attack and kill off antigens directly themselves. Most cases of non-Hodgkin’s lymphoma are caused by B cells, as noted. Determining the origin of the lymphoma, whether B or T cell, can individualize the treatment of the cancer.

Although research has not yet found the cause of non- Hodgkin’s lymphoma, what we do know is that the cancer occurs when there is a buildup of abnormal lymphocytes.  Normally, these abnormal cells would undergo apoptosis, or cell death.  In non-Hodgkin’s lymphoma, however, these cells live on and continue to grow, divide and multiply.  This overabundance of abnormal lymphocytes cause one of the most noticeable symptoms, swollen lymph nodes.  These swollen nodes can be found in the neck, armpit, or groin.  Other typical symptoms include fatigue and weight loss.  As the disease spread, other symptoms can develop and organs outside the lymphatic system may be affected.  Part of the body like the tonsils, adenoids, spleen, thymus and bone marrow may be affected first, as they are directly related to the lymphatic system.   If the disease persists, the lymphoma can affect all other organs.

Risk factors for non-Hodgkin’s lymphoma include immune-suppressant medications, certain viral or bacterial infections like HIV, Epstein-Barr virus, or H. pylori, and certain environmental chemicals. Age is also a risk factor, as we see those above 60 are at higher risk for being diagnosed.  This is not to say it cannot appear at any age, but the risk is increased with increased age.  Oddly enough, many people who have no known risk factors for the disease, develop it anyway.  Similarly, many who have multiple risk factors will never end up developing lymphoma.  The key is to be diligent with noticing changes in your body and lymph nodes in particular.  If your see or feel swelling, monitor it and bring it to the attention of a doctor.