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Lymphoma - symptoms, treatments and therapies

LYMPHOMA, or LYMPHATIC CANCER - causes and treatment

This article about Lymphoma or Lymphatic cancer will give you a start to help you increase your personal odds of beating lymphatic cancer - the symptoms, the diagnosis and all the latest options on cancer treatments and cancer therapies. We will even cover the causes.

This article has been compiled by Chris Woollams from worldwide research and expert sources*

Read the whole article below or just select the part(s) that you are interested in from the list below and click onto that piece.

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Introduction

It´s all too easy to think of lymphoma as some sort of rare and minor cancer. Sadly, this is far from the case. It is true that numbers of new cases are less than a third of those of lung or breast cancer. Currently. But this cancer is growing at such a fast rate in our modern world that it is estimated to become the second or third largest cancer by 2025. Its causes include chemical pollutants from formaldehyde to benzene and herbicides and pesticides.

And it is not a single cancer, rather it is a group of 30-40 different but related cancers.

Lymphoma or lymphatic cancer is thus the term given to the group of cancers in the lymphatic system, occurring when some of the white immune cells, called lymphocytes, become abnormal and malignant.

Lymphoma is usually subdivided into two subgroups:

  • - non-Hodgkin lymphoma (Formerly Hodgkins Disease)
  • - Hodgkin lymphoma (Formerly Hodgkins Lymphoma)

Non-Hodgkins accounts for about 80 per cent of cases.

American web sites will often divide these two subgroups into further subtypes.

In 2014 research from Weill Cornell seemed to offer hope that a new treatment may be just around the corner. 

The scientists studied diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin lymphoma, and their ‘drug’ was shown to be able to completely eradicate the human lymphoma in mice after just five doses.

Apparently, a regulatory transcription factor, Bcl6, controls the DNA in order to ensure that aggressive lymphomas thrive. Weill Cornell researchers developed an inhibitor to stop Bc16 (online Cell Reports).

Bc16 is also know to be a controlling influence in breast cancer as well, but lymphoma was the urgent requirement. “We desperately need a new strategy to treat this lymphoma -- many patients are resistant to currently available treatments," said lead researcher Melnick.

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The Lymphatic System

Lymph is a colourless liquid which bathes the cells of your body, passing through the walls of the capillaries into the lymph system, then to at least one lymph node before passing into the blood stream. You have twice as much lymph as blood in your body and the lymph serves to take some nutrients to your cells while taking toxins and bacteria away from your cells. Lymph also carries triglycerides from fat digested in the intestine. It is also part of your immune system. The lymphatic system is made up of a series of vessels and glands, or lymph nodes, spread throughout your body. The biggest volume of lymph is in your thoracic duct which lies across your chest. Even your tonsils are part of the lymph system.

There is no heart to pump your lymph. At night when you sleep, your lymph flow slows. Gravity can move lymph, but the prime driver of lymph flow is your own action (or lack of it). Obviously actions that get the chest moving will create movement in the lymph. These include arm movements, stretching, laughter, press ups, swimming Tai Chi and so on.

The lymph contains infection-fighting white blood cells, Some are called lymphocytes. There are several forms, notably B-lymphocytes and T-lymphocytes. They develop in the bone marrow and some mature in the thymus.

In lymphoma, the lymphocytes start to multiply abnormally and collect in certain parts of the lymphatic system, such as the lymph nodes. You also become more vulnerable to infection as the lymphocytes become damaged.

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Lymphoma Symptoms

The most common symptom of lymphoma is a painless swelling in a lymph node, usually in the armpit, groin or neck. This is caused by the damaged lymphocytes collecting in that node. The swelling may also ache.
The converse is not necessarily true just because you have a swollen lymph node it doesnt mean you have lymphatic cancer; the lymph nodes can swell in response to any infection. Once the cancer starts to spread you may find you have symptoms of tiredness or fatigue, night sweats, fever, unexplained weight loss, a persistent cough or feeling of breathlessness and trouble getting rid of infections. Some people experience a persistant itching of the skin all over the body and even a sensitivity to alcohol! 

If the lymphoma is in your abdomen, you may even experience bloating or indigestion.

With Hodgkins lymphoma symptoms may also include nose bleeds, or blood spots under the skin.

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Hodgkins Lymphoma (formerly Hodgkins disease)

Named after the Doctor, Thomas Hodgkin, who first identified the disease in 1832, Hodgkins lymphoma is one of the most common cancers among younger people, although still relatively rare. It affects young adults aged between 15 and 35, and adults over the age of 55. More men than women are affected.
The disease, although aggressive, can be successfully treated in about 80 per cent of cases. 

It is defined by the presence of a large, abnormal B-lymphocyte cell. (This is called a Reed-Sternberg cell.) B-lymphocytes are produced in the body in response to invasion by a foreign body. This could typically be a virus or bacterium, but could include a toxin or a chemical.

Subtypes occur; typically M D Anderson Cancer Center in Texas detail:

Nodular Sclerosing Hodgkin´s Lymphoma: The affected lymph nodes have mixed areas of normal cells, Reed-Stemberg cells and prominent scar tissue. This is the most common type, making up 60% to 80% of all cases.
Lymphocyte-Rich Classical Hodgkin´s Lymphoma: A newly identified subtype and behaves like mixed cellular Hodgkin´s lymphoma.
Mixed Cellular Hodgkin´s Lymphoma: The affected lymph nodes contain many Reed-Stemberg cells in addition to several other cell types. Mixed cellular primarily affects older adults.
Lymphocyte Depletion Hodgkin´s Lymphoma: There are large numbers of Reed-Stemberg cells, but very few other cell types are found in the lymph nodes. It is the least common form of Hodgkin´s lymphoma and found in less than 5% of the cases. It is seen more often in elderly or in patients with AIDS.
Nodular Lymphocyte Predominance Hodgkin´s Lymphoma: This is not considered a classic Hodgkin´s lymphoma, because it lacks some of the features that identify Hodgkin´s lymphoma and also Non-Hodgkin´s lymphoma. Most of the lymphocytes found in the lymph nodes are normal. Abnormal cells, known as "popcorn cells" are a special type of B-cell found in the nodular variety. NLPHL accounts for about 5% or 6% of the cases of Hodgkin´s lymphomas. It affects more men than women. The average age of patients is in their mid-30s. This type of Hodgkin´s lymphoma is usually diagnosed at an early stage and the prognosis is excellent.

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Non-Hodgkins lymphoma

Non-Hodgkin´s lymphoma is then any type of lymphoma without the Reed-Sternberg cell. It is the most common form of lymphoma and is broadly categorised in two groups:
         * high-grade, or aggressive non-Hodgkins lymphoma, where the cancer         develops quickly and aggressively
        * low-grade, or indolent non-Hodgkins lymphoma, where the cancer         develops slowly and you may not have any symptoms for many years

This cancer is associated with ageing and the average age at diagnosis is around 65. 

High-grade non-Hodgkin´s lymphoma advances rapidly but can be quickly diagnosed and treated. On average about 60 per cent of cases achieve 5-year survival.

The low-grade disease is much harder to diagnose and may not cause symptoms until quite advanced. This makes it more difficult to cure although the symptoms can be successfully held at bay.

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Causes

There is little doubt that this is a cancer of the modern world.
Research has indicated that causes include:

Chemical Pollution: Chemical solvents such as acetone, benzene, toluene, xylene, turpentine, and various alcohols, not just ethyl alcohol have been linked to lymphoma. The Yale School of Public Health has produced a report on organic solvents and their links to non-Hodgkin lymphoma. UC Berkeley School of Public Health conducted a meta-study using data from 22 research studies and concluded that, "The finding of elevated relative risks in studies of both benzene exposure and refinery work provides further evidence that benzene exposure causes NHL. Benzene exposure, linked to both leukemia and lymphoma is the subject of both increasing American research and lawsuits! 

Tricyclic Anti-depressants:  People who take tricyclic antidepressants are at increased risk for a rare group of blood cancers known as non-Hodgkin lymphoma, according to study conducted by researchers from the Institute of Cancer Epidemiology at the Danish Cancer Society, and published in the journal Epidemiology.

"Our results indicate an increased risk of non-Hodgkin lymphoma specifically among long-term users of tricyclic antidepressant medications," the researchers wrote. "Given the high prevalence of antidepressant use, this finding warrants additional studies."

Dark Hair Dyes have been linked to lymphoma. A 2008 American study in the Journal of Epidemiology commented on this.

Formaldehyde has also been linked to Lymphoma, as was reported a few years ago in CANCERactives Cancer Watch.

Pesticides: Chemicals linked to herbicides, defoliation (agent Orange included) and pesticides have been linked to Lymphoma. Agricultural workers have higher risks of these cancers, and risks extend to communities drinking water originating in field run-offs.

Heavy metals and even EMFs have also been the subject of concern but nothing is proven as yet.

The fact is that the number of new cases of non-Hodgkin´s lymphoma in our modern world has been slowly but steadily rising by more than 4 per cent a year. This growth rate would make it almost the largest cancer in the UK by 2030.
The Epstein-Barr virus has been associated with a few lymphomas. People with HIV seem to be at a higher risk, as are people with the stomach bacterium Helicobacter pylori. 

Memorial Sloan-Kettering are looking at possible genetic factors in families.

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Treatments

There are many, many treatments available, possibly due to the fear that this cancer is on its way to being one of the biggest cancers in the Western World; and because there are so many slightly different types of this disease. So your treatment will be very individual to you.

For example, the MD Anderson cancer center in Texas lists possible treatments as:
         Monoclonal antibodies
         Cytokine therapy
         Vaccine therapy
         Liposomal drug delivery
         Anti-angiogenesis
         New drug screening programs
         Management of unusual or difficult cases

Memorial Sloan-Kettering is in Clinical Trials with

  1. Pralatrexate and Gemcitabine, plus folic acid and vitamin B-12
  2. Bendamustine HC1
  3. ABVD with or without Rituximab
  4. SGN-35

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Treatment of Non-Hodgkins Lymphoma

1 Radiotherapy may be used in confined areas like the neck or lymph nodes or over larger areas such as the chest or upper abdomen. It may be used in conjunction with chemotherapy, or on its own.
Radio-immunotherapy may use radio labeled monoclonal antibodies for some types of Lymphoma.

2 Common chemotherapy options include the drugs:

ABVD: This refers to a combination of the drugs Adriamycin, Bleomycin, Vinblastine, and Dacarbazine (DTIC). These are administered as injections and are usually repeated every 2 weeks.

CHOP: one of the most common chemotherapy regimens for treating Non-Hodgkin´s lymphoma. It employs 4 drugs in the regimen. Cyclophosphamide (brand names cytoxan, neosar); Adriamycin (doxorubicin, or hydroxydoxorubicin); Vincristine (Oncovin); and steroid tablets Prednisone (sometimes called Deltasone or Orasone). Note that this treatment may well cause fertility problems, and side-effects such as tingling in the hands and feet, nausea and hair loss. According to the American NCI, patients on this treatment are at a higher risk of developing secondary cancers in the brain, liver, kidney, bladder, skin and lung. The treatment usually involves 6 cycles each of 4 weeks.

R-CHOP: adds the monoclonal antibody rituximab; clinical trials are currently looking at whether it should be prescribed every 14 or 21 days for non-Hodgkins lymphoma.

For patients with advanced forms of the disease, samples of bone marrow may be taken and stored by refrigeration, while chemotherapy kills off all the white cells in the body. Thereafter the bone marrow is transplanted to grow new white (and hopefully, uninfected) cells.

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Diagnosis

Lymphoma may be diagnosed and confirmed in a number of ways:
Lymphangiogram: A dye, injected into the lymphatic vessels, enables the  lymph nodes and lymphatic vessels to be seen more clearly using X-rays.

Gallium (Radioisotope) Scan: Radioactive gallium is injected into a blood vessel and it circulates throughout the body and may collect in a tumour. The body is then scanned from several different angles and this test can be very useful with Hodgkin´s lymphoma.

Blood Tests: Can determine abnormal levels of red and white cells.

Bone Marrow Aspiration and Biopsy: Bone marrow is obtained inserting a long, thin needle into a large bone (for example, the hip) and collecting a small sample of marrow. The skin, tissue and surface of the bone are numbed with a local anesthetic first.

X-Ray: Taking pictures of the infected areas inside the body.

Biopsy: Taking a piece of tissue from an area of suspected cancer to examine the white cells under a microscope.

Computerised Tomography (CT) Scan:  A 3D X-ray picture is taken from different angles around the body. The pictures are then combined using a computer. There is concern that too many CT scans can actually cause cancer.

Magnetic Resonance Imaging (MRI): An MRI is similar to a CT scan but uses magnets and radio frequency waves instead of X-rays. Less used in Hodgkin´s lymphoma than CT scans, but useful in evaluation of the bones and brain.

Positron Emission Tomography (PET) Scan: PET images provide information about how tissues function.

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Staging

The stage describes the extent to which the tumor has spread in the body. It helps predict outcome and prognosis and can determine the treatment approach.
Stage I (early stage): One lymph node region is involved.
Stage II (locally advanced disease): The cancer is found in two or more lymph regions on one side of the diaphragm or the cancer is found in one lymph node region plus a nearby area or organ.
Stage III (advanced disease): The disease involves lymph nodes both above and below the diaphragm or one node area and one organ on opposite sides of the diaphragm.
Stage IV (widespread disease): The lymphoma is outside the lymph nodes and spleen and has spread to one or more organs such as bone, bone marrow, skin and even other organs.

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Alternative Therapies, Complementary treatments

Two reports covered previously in Cancer Watch may interest readers:

1 Fucoidan is a natural compound found in various forms of seaweed like kombu, limu, wakame andmozuku plus animals like the sea cucumber. Researchers from the Hashemite University in Jordan at the AACR Dead Sea International Conference on Advances in Cancer Research working on previous studies that the extract from common brown seaweed causes cancer cell death (apoptosis) and shrinks tumours, have found that fucoidan suppressed cancer cell growth and caused a significant increase in apoptosis, or cellular death, in lymphoma cancer cells while leaving healthy cells intact.

Some forms of B-cell lymphoma are especially resistant to standard treatment and thus new therapies are needed, said Professor Mohammad Irhimeh adding, in this study, we looked at a new treatment strategy using novel active compounds derived from a natural source seaweed. Clinical Trials are planned.

2 Vitamin D. Lymphoma patients with a vitamin D deficiency are twice as likely to die from their cancer as patients with normal blood levels (defined as 25 nanograms per litre) say scientists at the Mayo Clinic (American Society of Haematology Conference).

50 per cent of patients in the study (all recently diagnosed in the years from 2002 to 2008) had a blood vitamin D deficiency. Over the following three years this group were 50 per cent more likely to become worse and twice as likely to die as those having normal blood vitamin D levels.

Both fucoidan and vitamin D are available as supplements.

Other research has shown up natural compounds that might help. The Mayo clinic went as far as saying that 5 cups of Green Tea per day stopped lymphoma in its tracks. Less euphoric, but none-the-less relevant was research from the Tohoku School of Medicine. A 9-year study followed the consumption of green tea by 42,000 people. Looking at blood cancers and cancer in lymph nodes in particular, the researchers found there was a 40 per cent reduction for the former, and 50 per cent for the latter, in those people consuming 5 cups per day (American Journal of Epidemiology). Selenium (which has some ability to displace some heavy metals from cells, Indole 3 Carbinol which has been shown to displace and/or denature some chemical pollutants from the body, Chlorella which has research behind it showing it can help clean certain tissues and beneficial bacteria (probiotics), which have been shown in clinical research to help eliminate chemical pollutants and heavy metals from the body in conjunction with fibres like lignans, may each have a role to play in prevention or as part of an integrative programme.

If you are looking for supplements click on the tab at the top of the page and go to the Natural Selection shop where they have selected the best of the best and you can buy with confidence.

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Summary

It is clear that Lymphoma is almost a disease in its own right. Growing rapidly, caused by the pollution in the modern world, with up to 40 variations and many individual treatments. Great attention needs to be paid to this disease. It belies the usual blah from cancer and health bodies that getting cancer is your own fault. In this case, it most probably isnt. And by 2030 it could be the Western Worlds largest cancer! 

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