Lymphoma is a cancer that affects the lymphatic system. There are two main types of lymphoma: Non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma. Both Non-Hodgkin's and Hodgkin's lymphoma are derived from white blood cells called lymphocytes – which are part of the body's immune system – but they have different behaviors and responses to treatment. Non-Hodgkin's lymphoma is really a group of more than 65 different types of related cancers; each cancer having its own unique characteristics. Underneath the diagnosis of Non-Hodgkin’s lymphoma are some of the fastest, and slowest growing cancers known to medicine.
Almost all cases of NHL are derived from B lymphocytes (B cells). B lymphocytes mature into antibody-producing plasma cells that protect the body against infection. Approximately 10 to 15% of all cases of non-Hodgkin’s lymphoma are derived from T-lymphocytes. T-lymphocytes play an important role in fighting viruses, and helping to modulate the immune system to fight infection. Non-Hodgkin's lymphoma can arise in the bone marrow, lymph nodes, lymphatic organs such as the spleen, or in the lymphoid tissue found in the stomach or intestines. Abnormal lymphocytes can spread to any part of the body. While some NHLs can be localized to a small group of lymph nodes, the majority, –most have spread to other parts of the body by the time of diagnosis. The concept of stage in lymphoma is less important than it is other cancers, since blood cells are born with the intrinsic privilege to roam the body, fighting infection. As a result, stag is only one of several factors physicians look at as they evaluate any given persons disease.
Non-Hodgkin's lymphoma is relative rare compared to other cancers. It is estimated that there are about 70,000 cases in 2012, which accounts for about 4 percent of all cancers. More than 95 percent of cases occur in adults. The number of cases has been steadily increasing since the 1960s, though over the past 5 years, it seems this has plateaued.
Age is a strong risk factor for this disease, with most cases occurring in people in their 60s or older. Overall, the risk of non-Hodgkin's lymphoma is higher for men. However, certain types of non-Hodgkin's lymphoma are more common in women. In the United States, Caucasians are at higher risk than other ethnic groups. Worldwide, Non-Hodgkin's lymphoma is more common in developed countries, with the highest rates in the United States and Europe.
Obesity is likely a risk for non-Hodgkin's lymphoma. People exposed to significant radiation and those with weakened immune systems (due to organ transplants or genetic syndromes) have an increased risk to the disease. Infection with the human T-cell leukemia/lymphoma virus (HTLV-1), the Epstein-Barr virus, HIV, Hepatitis C and other, rarer infections may raise the risk as well. Some autoimmune diseases such as rheumatoid arthritis, lupus, and celiac sprue have been linked to an increased rate of Non-Hodgkin's lymphoma.
There are no recommended screening tests for Non-Hodgkin's lymphoma. The disease may cause many general symptoms, including: enlarged lymph nodes in the neck, groin or underarm; swelling in the abdomen; feeling full after a small amount of food; chest pain; shortness of breath; coughing; fever; weight loss; night sweats; and fatigue. These symptoms are more often a sign of some other condition. However, any chronic instances should be checked by a physician.
Lymphomas are usually divided into one of two types: the indolent or chronic slow growing lymphomas, or the more aggressive faster growing lymphomas. Some of the indolent forms of the disease may not require any treatment, and can be watched carefully by you and your physician. They may require treatment if they become symptomatic, or affect the normal functions of your body. Most aggressive types of lymphoma require treatment of some sort, usually chemotherapy. The standard treatment for most sub-types of Non-Hodgkin's lymphoma, depending on the disease and its behavior, is chemotherapy. Removal of lymphoma through a surgical approach is rarely if ever the best option, as the disease is typically systemic at diagnosis. Surgeons play a very important role in helping the oncologists obtain small pieces of the lymphoma. Once a small piece of the lymphoma has been obtained, it is reviewed by pathologists specializing in the diagnosis of lymphoma, called hematopathologists. In select cases, when the lymphoma is localized, radiation therapy can be a very safe and effective way to control the disease. In very select cases, peripheral blood stem cell transplants can be an important means to treat some forms of lymphoma. The important message is that there are many types of treatment of the many different kinds of lymphoma. The highly experienced team of lymphoma physicians at NYP is well versed in all the conventional options, as well as some of the newest treatments for these diseases.