Lymphoma is a type of cancer involving cells of the immune system, called lymphocytes. Just as cancer represents many different diseases, lymphoma represents many different cancers of lymphocytes-about 35 different subtypes, in fact.
Lymphoma is a group of cancers that affect the cells that play a role in the immune system, and primarily represents cells involved in the lymphatic system of the body.
The exact causes of lymphoma are not known. Several factors have been linked to an increased risk of developing lymphoma, but it is unclear what role they play in the actual development of lymphoma.
These risk factors include the following:
Age: – Generally the risk of NHL increases with advancing age. HL in the elderly is associated with a poorer prognosis than that observed in younger patients.
Infection with HIV
Infection with human T-lymphocytic virus type 1 (HTLV-1)
Infection with Epstein-Barr virus (EBV), one of the etiologic factors in mononucleosis
Infection with Helicobacter pylori, a bacterium that lives in the digestive tract
Infection with hepatitis B or hepatitis C virus
Medical conditions that compromise the immune system
Diseases requiring immune suppressive therapy, often used following organ transplant
Inherited immunodeficiency diseases (severe combined
immunodeficiency, ataxia telangiectasia, among a host of others)
Exposure to toxic chemicals
Farm work or an occupation with exposure to certain toxic chemicals such as pesticides, herbicides, or benzene and/or other solvents
Black hair dye, which for more than 20 years has been linked to higher rates of NHL
Genetics: Family history of lymphoma
The presence of these risk factors does not mean a person will actually develop lymphoma. In fact, most people with one or several of these risk factors do not develop lymphoma.
To identify which areas of the body are affected by lymphoma, the following tests are also commonly used: –
blood tests, including complete blood count (CBC)
blood chemistry, including tests of liver and kidney function
bone marrow biopsy or aspiration
lumbar puncture (spinal tap) to check for cancer spread to the central nervous system (brain and spinal cord)
computed tomography (CT) of the chest and abdomen or sometimes X-rays
magnetic resonance imaging (MRI)
bone scan or gallium scan (when a radioactive material is injected into the bloodstream to look for evidence of inflammation or bone tumors)
gallium scan to look for tumor or inflammatory cells
Positron emisson tomography (PET) scan to look for abnormal cells
These tests are important for determining the spread of the lymphoma within the body and in deciding which type of treatment should be used.
General health care providers rarely undertake the sole care of a cancer patient. The vast majority of cancer patients receive ongoing care from oncologists but may in fact be referred to more than one oncologist should there be any question about the disease. Patients are always encouraged to gain second opinions if the situation so warrants this approach.
Although medical treatments are fairly standardized, not all physicians behave similarly.
One may choose to speak with more than one oncologist to find the one with whom he or she feels most comfortable.
In addition to one’s primary care physician, family members or friends may offer information. Also, many communities, medical societies, and cancer centers offer telephone or Internet referral services.
Once one settles in with an oncologist, there is ample time to ask questions and discuss treatment regimens.
The doctor will present each type of treatment, discuss the pros and cons, and make recommendations based on published treatment guidelines and his or her own experience.
Treatment for lymphoma depends on the type and stage. Factors such as age, overall health, and whether one has already been treated for lymphoma before are included in the treatment decision-making process.
The decision of which treatment to pursue is made with the doctor (with input from other members of the care team) and family members, but the decision is ultimately the patient’s.
Be certain to understand exactly what will be done and why, and what can be expected from these choices.
As in many cancers, lymphoma is most likely to be cured if it is diagnosed early and treated promptly.
The most widely used therapies are combinations of chemotherapy and radiation therapy.
Biological therapy, which takes advantage of the body’s innate cancer-fighting ability, is used in some cases.
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