Non-Hodgkin's lymphoma facts

• NHL is a cancer that originates in the lymphatic system.
• About 71,000 patients will be diagnosed with NHL in 2015, and approximately 19,500 patients will die of NHL in the U.S.
• There are several subtypes of NHL, each requiring different treatments.
• Non-Hodgkin's lymphoma symptoms and signs include
• swollen lymph nodes,
• weight loss,
• fever,
• night sweats.
• NHL is staged on a 1 to 4 scale with A (no associated symptoms like fever, weight loss, or night sweats) and B subtypes.
• Staging the cancer is important to determine treatment and predict the outcome of treatment.
• Depending on the stage and type of NHL, treatment can include chemotherapy, biological therapy, stem cell transplant, and/or radiation therapy.

What is non-Hodgkin's lymphoma?

Non-Hodgkin's lymphoma is a type of cancer that originates in the lymphatic system. It is estimated to be the sixth most common cancer in the United States. The lymphatic system is part of the body's immune system and helps fight infections and other diseases. In addition, the lymphatic system filters out bacteria, viruses, and other unwanted substances.

The lymphatic system consists of the following:

Lymph vessels: These vessels branch out throughout the body similar to blood vessels.

• Lymph: The lymph vessels carry a clear fluid called lymph. Lymph contains white blood cells including a type of white blood cell called lymphocytes (such as B cells and T cells).
• Lymph nodes: Lymph vessels are interconnected to small masses of lymph tissue called lymph nodes. Lymph nodes are found throughout the body. Collections of lymph nodes are found in the neck, underarms, chest, abdomen, and groin. Lymph nodes store white blood cells. When you are ill and the lymph nodes are active, they will swell and be easily palpable (a doctor can feel them during an examination).
• Additional parts of the lymphatic system: The tonsils, thymus, and spleen are additional components of the lymphatic system. Lymphatic tissue is also found in other parts of the body, including the stomach, skin, and small intestine.

Because lymphatic tissue is found in many parts of the body, non-Hodgkin's lymphoma can start almost anywhere.

Signs and symptoms of Hodgkin's lymphoma may include:

• Painless Swelling of lymph nodes in your neck, armpits or groin
• Persistent fatigue
• Fever
• Night sweats
• Unexplained weight loss
• Severe itching
• Increased sensitivity to the effects of alcohol or Pain in your lymph nodes after drinking alcohol

When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you.

Doctors aren't sure what causes Hodgkin's lymphoma. But it begins when an infection-fighting cell called a lymphocyte develops a genetic mutation. The mutation tells the cell to multiply rapidly, causing many diseased cells that continue multiplying.

The mutation causes a large number of oversized, abnormal lymphocytes to accumulate in the lymphatic system, where they crowd out healthy cells and cause the signs and symptoms of Hodgkin's lymphoma.

Various types of Hodgkin's lymphoma exist. Your diagnosis is based on the types of cells involved in your disease and their behavior. The type of lymphoma you are diagnosed with determines your treatment options.

Classical Hodgkin's lymphoma

Classical Hodgkin's lymphoma is the more common type of this disease. People diagnosed with this disease have large, abnormal cells called Reed-Sternberg cells in their lymph nodes.

Subtypes of classical Hodgkin's lymphoma include:

• Nodular sclerosis Hodgkin's lymphoma
• Mixed cellularity Hodgkin's lymphoma
• Lymphocyte-depleted Hodgkin's lymphoma
• Lymphocyte-rich Hodgkin's lymphoma

Nodular lymphocyte-predominant Hodgkin's lymphoma

This much rarer type of Hodgkin's lymphoma involves large, abnormal cells that are sometimes called popcorn cells because of their appearance. Treatment may be different from the classical type. People with this type of Hodgkin's lymphoma may have a better chance of a cure when the disease is diagnosed at an early stage.

Which lymphoma treatments are right for you depends on the type and stage of your disease, your overall health, and your preferences. The goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission.

Lymphoma treatments include:

• Active surveillance. Some forms of lymphoma are very slow growing. You and your doctor may decide to wait to treat your lymphoma when it causes signs and symptoms that interfere with your daily activities. Until then, you may undergo periodic tests to monitor your condition.
• Chemotherapy. Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. The drugs are usually administered through a vein, but can also be taken as a pill, depending on the specific drugs you receive.
• Radiation therapy. Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells.
• Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, involves using high doses of chemotherapy and radiation to suppress your bone marrow. Then healthy bone marrow stem cells from your body or from a donor are infused into your blood where they travel to your bones and rebuild your bone marrow.
• Other treatments. Other drugs used to treat lymphoma include targeted drugs that focus on specific abnormalities in your cancer cells. Immunotherapy drugs use your immune system to kill cancer cells. A specialized treatment called chimeric antigen receptor (CAR)-T cell therapy takes your body's germ-fighting T cells, engineers them to fight cancer and infuses them back into your body.

Factors that can increase the risk of Hodgkin's lymphoma include:

• Your age. Hodgkin's lymphoma is most often diagnosed in people between 15 and 30 years old and those over 55.
• A family history of lymphoma. Having a blood relative with Hodgkin's lymphoma or non-Hodgkin's lymphoma increases your risk of developing Hodgkin's lymphoma.
• Being male. Males are slightly more likely to develop Hodgkin's lymphoma than are females.
• Past Epstein-Barr infection. People who have had illnesses caused by the Epstein-Barr virus, such as infectious mononucleosis, are more likely to develop Hodgkin's lymphoma than are people who haven't had Epstein-Barr infections.