Lymphoma

Lymphoma is a type of cancer that afflicts the lymphatic system and directly affects one of the most critical units of the body:  The Immune System. The very system that is designed to protect our bodies is itself invaded by malignancy with the occurrence of lymphoma. The number of cases is on the rise, and researchers are working hard to find out why. It is most likely due to the deteriorating environment around us that increasingly exposes us to dangerous chemicals.

What is Lymphoma?

Lymphoma is a type of cancer that invades the body’s lymphatic system. The lymphatic system is a body wide network that is a major part of the immune system, and is responsible for transporting disease fighting elements throughout the body, as needed, to fight infectious invaders and protect us from disease. There is lymph tissue in most parts of the body, so lymphomas can originate almost anywhere. The malignancy associated with this type of cancer causes tumors (clumps of out-of-control cancerous cells) to form in the lymphocytes (white blood cells).

There are two major types of lymphoma: Hodgkin’s lymphoma (also known as Hodgkin’s disease), and Non-Hodgkin’s lymphoma, which is the much more common form. In 2004, 7,880 new cases of Hodgkin’s disease were diagnosed in the United States, while the number of new non-Hodgkin’s cases numbered 54,320.  There are more than 30 different subtypes of non-Hodgkin’s lymphoma, and this type of lymphoma is found about seven times more often than Hodgkin’s disease. Non-Hodgkin’s lymphoma is one of the most rapidly increasing types of any cancer in the United States, with the number of cases more than doubling since the 1970’s. The good news is that along with more cases, the survival rate has greatly increased too. Unfortunately, the types of treatments given for lymphoma have some very serious side effects that often accompany them.

How Does Lymphoma Develop?

A bit of background on the lymphatic system will help us to better understand this disease. This complex and critical system is crucial to the health of our entire body. The lymphatic system is composed of an interconnected collection of ducts or “tubules” that are designed to transport a milky fluid called “lymph” throughout the body. Lymph is the vehicle whereby cells responsible for fighting disease and repairs are moved around the body. Lymph is composed of lymphocytes, monocytes, and granulocytes, all of which fall under the heading of leukocytes. Periodically placed along this immune system highway are small, pea-shaped organs known as lymph nodes that are responsible for producing and storing lymphocytes. Concentrations of lymph nodes are found in certain parts of the body including the underarms, abdomen, neck, chest, and pelvic region. Other organs that are part of the lymphatic system include the spleen, thymus, adenoids, bone marrow, and tonsils.

Lymphoma occurs when the lymphocytes begin to grow abnormally in a cancerous manner. They become too numerous, and are not able to perform their function efficiently, which causes the immune system to be compromised. There are two main types of lymphocytes: T cells and B cells.  B cell lymphomas are more commonly found in adults, while T cell lymphomas are equally common in both children and adults. T cells, produced by the thymus, directly attack and destroy invaders, mainly of the viral variety. B cells typically fight off bacterial infections by indirectly producing plasma cells that in turn make antibodies to zap the bacterial antigens. About 85% of non-Hodgkin’s lymphomas occur in B cells, with the remaining 15% found in T cells.

Non-Hodgkin’s Lymphoma

In the early stages of non-Hodgkin’s lymphoma, there may be few, if any, discernable symptoms, which makes early diagnosis very difficult. The only one that may be recognizable is swollen lymph nodes that are usually not painful. These may occur in the armpit, groin area, or neck. Other symptoms that may occur as the disease develops include:

• Fever
• Night sweats
• Unexplained fatigue
• Abdominal pain, swelling, or a feeling of fullness in the area
• Unexplained weight loss
• Nausea
• Vomiting
• Indigestion

As the cancerous lymphocytes grow uncontrollably, the lymph nodes swell and may begin to put pressure on other parts of the body, affecting nerves and muscles. In advanced cases of non-Hodgkin’s disease, other signs that may appear include:

• Anemia:  This is the result of low red blood cell (RBC) counts because the swollen lymph nodes can crowd the bone marrow and keep it from doing its job sufficiently. One of the functions of bone marrow is the production of RBCs, which are responsible for maintaining proper iron levels in the blood.
• Excessive bleeding:  Bone marrow also creates “platelets,” which are an integral part of the blood clotting process. Without proper platelet levels because of swollen lymph nodes crowding bone marrow, patients may have trouble controlling bleeding.
• Systemic problems:  Sometimes malignant cells can be spread throughout the body via the lymph system and cause other organs such as the kidneys and liver to become dysfunctional and even fail.
• Bone pain
• Headaches
• Swelling and congestion in the upper chest
• Swelling in the face and neck
• Pain and/or pressure in the lower back

What Causes Non-Hodgkin’s Lymphoma?

The exact reason why lymphocytes begin to malfunction and become cancerous is not known for sure, but certain risk factors for non-Hodgkin’s lymphoma have been identified. The most common ones include:

• Chemical exposure:  People who have had abnormally high exposure to certain kinds of chemicals have a higher incidence of non-Hodgkin’s lymphoma than the general population. Some of the offending substances include weed killers and pesticides. Dark-colored hair dyes have also been implicated, especially before certain ingredients were eliminated in the 1980s, but the evidence is a bit sketchy.
• Excessive radiation:  This includes folks who have undergone extensive radiation therapy for the treatment of cancer. Survivors of the atomic bomb that was dropped on Hiroshima, Japan during World War II have also been found to have a higher than normal incidence of non-Hodgkin’s lymphoma.
• Immunosuppressive drugs:  People who have had organ transplants, such as the liver or kidneys, are typically given drugs to suppress the immune system so the body will not reject the organs. One of the side effects of these drugs is a greater risk for lymphoma.
• Infections:  Certain infections also increase risk for non-Hodgkin’s lymphoma. In Africa, people infected with the parasite that causes malaria or those who have been exposed to the Epstein-Barr syndrome are more susceptible to a specific type of non-Hodgkin’s lymphoma called Burkitt’s lymphoma. Exposure to a bacterium called Helicobacter pylori, which causes stomach ulcers and can lead to stomach cancer as well, has also been linked to increased risk for non-Hodgkin’s lymphoma. Certain other conditions that compromise the immune system, such as HIV/AIDS will also make it easier to get lymphoma.
• Age:  Non-Hodgkin’s lymphoma is most common amongst people in their 60s, but it can occur at any age.

Hodgkin’s Lymphoma (Hodgkin’s Disease)

This less common type of lymphoma is named after the British doctor who first discovered it in the 1830s. The death rate for Hodgkin’s disease in this country has dropped significantly, by about 60%, in the last 40 years, but it still takes the lives of about 1,300 Americans every year.

In many ways, Hodgkin’s disease and non-Hodgkin’s lymphoma are similar. Many of the same risk factors are thought to cause them both, and they share a lot of common symptoms. However, there are several distinct differences that separate these two conditions:

1. One of the hallmark signs of Hodgkin’s disease is that it consistently moves through the lymph system in an orderly way. It can begin in a lymph node anywhere in the body, and typically moves to the next adjacent lymph node, and continues its orderly journey if not treated. Very rarely, will “skipping” occur, where the disease skips over a section of lymph nodes as it advances.
2. Another distinctive feature of Hodgkin’s disease is the presence of certain types of cells taken from a biopsy that are visible under the microscope. They are referred to as Reed-Sternberg cells (named after the two doctors who originally discovered them), and they have very distinct features. They usually contain two or more nuclei, and are a positive identification of Hodgkin’s disease. Other cell variations examined under the microscope can help identify certain subtypes of Hodgkin’s disease.
3. In the early stages of Hodgkin’s disease, the symptoms, if there are any, are so similar to influenza, that they are often mistaken for it. If you have what you think is the “flu” and symptoms continue for more than two weeks, you should get checked out to eliminate the possibility of Hodgkin’s disease.

How is Lymphoma Treated?

Surgery is not usually appropriate for lymphoma, unless a specific organ such as the spleen, for example, has been attacked by the cancer. The most commonly used mainstream medical therapies for both Hodgkin’s and non-Hodgkin’s lymphomas are chemotherapy and radiation therapy. Sometimes they are used separately, and sometimes in conjunction with each other.

While the “cure” rate has improved over the years, these “treatments” can have some vicious side effects. The most commonly used chemo therapies include a combination of several drugs that are very hard on patients. Nausea, vomiting, hair loss, and a compromised immune system are typical side effects. Radiation is even worse, especially in young children. It can cause severe growth abnormalities. Both chemo and radiation can result in sterility as well as heart and lung damage, and the effects are only intensified when used simultaneously.

If you or a loved one is diagnosed with lymphoma, or any type of cancer for that matter, the decisions you face regarding treatment options can sometimes be just as critical as the original condition itself. Each case is different, so make it your responsibility to learn as much as you can about the specifics of your situation. Don’t take anyone’s word for it, including your doctors’, when it comes to your best options. If you do decide to use chemo or radiation, it is best to work with a naturopath or doctor who is knowledgeable about natural alternatives. There are excellent support regimens that can help your body to heal itself and protect you from some of the negative side effects of mainstream treatments as well.