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Non-Hodgkin's Lymphoma
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Non-Hodgkin's lymphoma is a cancer of the lymph system. Tumors develop in the body that stem from lymphocytes, which are a type of white blood cell. It is more common to have non-Hodgkin's lymphoma than it is to have Hodgkin's lymphoma. There are many types of non-Hodgkin's lymphoma, depending on the type of cell involved. The most common subtypes include follicular lymphoma and diffuse large B-cell lymphoma.
Signs and symptoms that indicate you might have non-Hodgkin's lymphoma include swollen glands in the armpit, neck or groin area, chest pain or difficulty breathing, abdominal pain, fever, night sweats, fatigue and weight loss.
Two types of cells are involved in the immune system and these are broken down into subtypes. The two main areas are B cells, which make antibodies to neutralize foreign invaders. Most types of non-Hodgkin's lymphoma are derived from B cells. T cells are another type of lymph cells. It isn't often that T cells cause non-Hodgkin's lymphoma. The type of lymphoma you have determines the type of treatment.
Non-Hodgkin's lymphoma occurs in other places besides the lymph glands. The disease can easily spread to the tonsils, lymphatic vessels, adenoids, thymus, spleen and bone marrow. It can sometimes involve tissues out of the lymph system.
No one knows what causes non-Hodgkin's lymphoma although there appears to be some risk factors. These include taking medications that suppress the immune system, having viruses or bacterial infections such as HIV, hepatitis C and Epstein Barr virus. Certain chemicals like insecticides and weed killers seem to promote the onset of non-Hodgkin's disease and those older than age 60 have a higher risk of developing the disease.
Doctors do certain tests and exams to diagnose non-Hodgkin's lymphoma. A physical exam can show enlargement of the lymph nodes. Blood tests can show abnormal cells in the bloodstream and tests, such as MRI and CT scans of the chest and abdomen, can show the presence of lymphatic tumors. Imaging tests can help stage the disease. A bone marrow test can show the precursor cells or the actual cells involved in lymphoma. Biopsies of the abnormal tissue can show non-Hodgkin's lymphoma.
Doctors use the bone marrow biopsy or other biopsies to tell what kind of non-Hodgkin's lymphoma you have. The doctors need to know if it is a B cell or T cell lymphoma and what the cells look like under the microscope. Specific genetic changes can occur in these cells and are checked for by the doctor and the doctors also look for specific antigens on the surface of these cancer cells. The cancer is staged based on the extent and grade of the cancer cells.
The treatment of non-Hodgkin's lymphoma depends on the stage and type of the cancer, as well as on how well you would tolerate the treatment. Some cases of the disease aren't treated at all because they are slow growing and aren't likely to be deadly. Instead of treating the cancer, the doctor will simply follow the cancer to see if it needs treatment at some time in the future.
The treatment of lymphoma of this type involves chemotherapy that kills the cancer cells. Radiation therapy is done to certain areas of cancer that need direct treatment with radiation. A stem cell transplant is done after all the cancer cells are gotten rid of through high dose chemotherapy or radiation. The stem cells grow new healthy cells to replace the diseased cells. There is also medication to increase the body's immune system so that it can fight the cancer. This includes the medication called rituximab or Rituxan. It is used to treat B cell lymphoma. Rituximab is a monoclonal antibody that attaches to the B cell, allowing the immune system to recognize it as foreign. There are also drugs that go directly to cancer cells and deliver radiation to these cells once they attach to the cancer.