Non-Hodgkin's Lymphoma

Non-Hodgkin's lymphoma is a cancer of the immune cells. Immune cells usually fight against infections and other related conditions. The lymphatic system includes: lymph vessels that connect lymph nodes. It contains lymph, which is fluid that contains white blood cells that fight infection. Lymph nodes are round masses of lymph tissue found in the neck, armpit, chest abdomen and groin. The spleen, thymus and tonsils are included in the lymphatic system. Non-Hodgkin's lymphoma can begin anywhere but most commonly begin in the lymph node.

Non-Hodgkin's lymphoma usually begins in a B cell, a type of lymphocyte. The abnormal B cell divides out of control, making more cancer cells. The cells invade the lymph nodes, the blood and the bone marrow primarily. They are not protective against cancer but just expend their energy in division.

Risk factors for non-Hodgkin's lymphoma include having a weakened immune system, suffering from certain infections, such a HIV infection, Epstein Barr viral infection, Helicobacter pylori infection (a gut disease), hepatitis C and human T-cell leukemia virus or HTLV1 virus. Some of these infections also contribute to leukemia. Non-Hodgkin's lymphoma tends to occur in people over the age of 60 but can happen when the individual is as young as 20. There may be a risk factor between obesity and non-Hodgkin's lymphoma. People who work with chemicals, such as herbicides, are at greater risk of developing the disease.

Symptoms of non-Hodgkin's lymphoma include unexplained weight loss and fatigue, swollen yet painless lymph nodes, fever and night sweats, chest pain or difficulty breathing and pain in the abdomen.

Doctors diagnose non-Hodgkin's lymphoma through a physical exam which can show an enlarged spleen and enlarged lymph nodes. A biopsy of the lymph nodes can be performed which can show the presence of cancer cells. Blood tests can show elevations in lymphocytes and a bone marrow biopsy can be abnormal, showing cancer cells in the bone marrow. A chest x-ray can show the presence of lymph nodes swollen in the chest cavity.

There are many types of non-Hodgkin's lymphoma. The most common type of the disease includes diffuse large B cell lymphoma and a condition called follicular lymphoma. They can be slow growing and indolent or can be aggressive (intermediate grade or high grade). The indolent lymphomas grow into more aggressive forms over time. The type of lymphoma determines the type of treatment you get and some cancers need specific forms of treatment.

Treatment of non-Hodgkin's lymphoma is highly specialized, with treatment including chemotherapy and specialized radiotherapy to specific areas. You usually have a specialist in hematology and oncology who manages your cancer treatment. There are specialists at certain locations that specialize in only one subtype of non-Hodgkin's lymphoma and it may pay to see a doctor who is a subspecialist. You will also meet with a registered dietician who will help you gain weight and eat right.

More recently, some people are treated with stem cell therapy for their non-Hodgkin's lymphoma. Stem cells are isolated out of the bone marrow and are allowed to multiply. When there are enough stem cells, the bone marrow is killed off and the stem cells are injected into the body so that they can find the bone marrow and begin making only healthy cells.

Staging is important in diagnosing non-Hodgkin's lymphoma. Different stages require different treatments. The type of non-Hodgkin's lymphoma defines the treatment as well. Aggressive tumors are treated differently from indolent tumors. Your age is related to the type of treatment you'll get as well as the type of health problems you otherwise have. There may need to be no specific treatment for indolent cancers if you are elderly. Biological therapy and chemotherapy are used primarily in aggressive tumors or in indolent tumors in young people.