Non-Hodgkin's Lymphoma - Medical Malpractce Lawyers
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Non-Hodgkin's Lymphoma - Medical Malpractice
Non-Hodgkin's lymphoma is a large group of cancers representing the lymph tissue. It can occur at any age but is most common in older people. There are aggressive and slow growing lymphomas; there are lymphomas involving the B cells or the T cells of the lymph system. B cell lymphoma involves Burkitt lymphoma, small lymphocytic lymphoma, diffuse large cell lymphoma, follicular lymphoma and precursor B cell anaplastic lymphoma. Mantle cell lymphoma is a B cell lymphoma. T cell lymphomas include mycosis fungoides and anaplastic large cell lymphoma, among others. The prognosis of the various lymphomas depends on the type of lymphoma and on the stage of the disease.
There are about 65,540 cases of non-Hodgkin's lymphoma occurring in the US every year. Of these, 20,210 have died. The treatment of non Hodgkin's lymphoma has improved greatly over the last several years. Slightly more men have lymphoma than women.
The exact cause of non Hodgkin's lymphoma is unclear. It starts in B cells or T cells and spread to the lymph glands and bone marrow. It can develop in those people who have a reduced immune system such as with HIV or with transplant patients. The tumour can be slow growing, intermediate growing or fast growing, such as with Burkitt lymphoma. This is the "grade" of the cancer. Certain genetic markers can be on the cells, which further differentiate the type of cancer a person has.
The symptoms of non Hodgkin's lymphoma include fever and chills, night sweats, severe itching, unintentional weight loss and swollen glands in the neck, groin or arm pits. There may be swelling or pain in the abdomen, which can lead to constipation, nausea, vomiting and loss of appetite. The brain can be affected, which can lead to headache, seizures, personality changes or problems with concentration.
Doctors do several tests to check for the presence of non Hodgkin's lymphoma. They do a complete history and physical examination which can show swollen glands or a swollen abdomen. Chemistry tests are done to see the protein level of the body along with the function of the liver and kidneys. A bone marrow biopsy will show if the cells are in the bone marrow. A CBC can be done which can show the white blood cell count, which may be low. CT scans of the chest, abdomen and pelvis can show enlarged clusters of lymph nodes. A Gallium scan can be performed to identify swollen lymph nodes. Doctors can do a lymph node biopsy to find the cancer and identify its type. A PET scan can show areas of increased activity in the lymph nodes or elsewhere in the body.
The treatment of non Hodgkin's lymphoma depends primarily on the type of lymphoma, your overall health and age, the stage of the cancer at the time of diagnosis, the symptoms you have and the grade of the cancer. Radiation therapy can be done if the disease is well confined to a single area. Chemotherapy is the most commonly used form of treatment for non Hodgkin's lymphoma. Combination chemotherapy is very common. Rituxan is used to treat B cell non Hodgkin's lymphoma. Another good treatment is radio-immunotherapy. This involves putting together a radioactive molecule with an antibody directed at the tumour. The radio-molecule goes directly to the cancer and the radioactivity kills it.
Another treatment that is relatively new is called "stem cell therapy". This involves collecting and growing stem cells in the patient's bone marrow and then killing off the rest of the bone marrow and other lymph cells. The stem cells are put back in the body and then replace the missing cells in the body. It is sometimes risky to do but works when nothing else does.
The prognosis of non Hodgkin's lymphoma depends on the grade and stage of the disease. Low grade lymphoma may not be treated well with chemotherapy alone but, as it is low grade, it may take years before it gets any worse. Chemotherapy can cure most types of high grade lymphoma. If the chemotherapy doesn't work, the patient usually dies quickly.
Doctors define lymphoma as being Hodgkin's lymphoma or non-Hodgkin's lymphoma. Non-Hodgkin's lymphoma is considered more severe and there are many varieties of the condition. It is a disease that affects the lymph system, the bone marrow and the blood of the affected individual. It begins in the lymph nodes, which take toxins, bacteria, viruses and parasites out of the bloodstream and which are prone to getting cancer as a result. It is the lymphocytes that are affected by non-Hodgkin's lymphoma and the tumors often begin in the lymph nodes first. Lymphocytes are a part of the immune symptom. Non-Hodgkin's lymphoma has become more common than Hodgkin's lymphoma and the reasons for this are as yet unknown.
There are numerous types of non-Hodgkin's lymphoma and it all depends on which lymph cell is involved. Some lymph cells are responsible for making antibodies, while others are helper cells or cells that actually destroy the pathogen. When it comes to non-Hodgkin's lymphoma, the most common types are follicular lymphoma and a lymphoma known as B-cell lymphoma. B cells make antibodies for the body.
The symptoms of non-Hodgkin's lymphoma can be very generalized and you might not know you have it for quite some time. You may feel tired all the time and not have the energy you are used to having. You can have swollen glands in the groin area, the armpit or in the neck-the most common places for lymph glands. Coughing, chest pain, fever, difficulty breathing can all be related to secondary pneumonia or directly to involvement of the lymph nodes in the chest. Besides fatigue, you can have weight loss that you cannot predict and night sweats. You can get abdominal swelling or pain in the abdomen. If you find yourself with these symptoms, even if they are mild and persistent, see your doctor for a blood test or a lymph gland biopsy to show what kind of lymphoma you may have.
Doctors do not know the direct causes of non-Hodgkin's lymphoma. Toxic exposure at work or in the environment may play a role as can infection with various infectious agents that can alter the DNA structure of the lymphocytes. Cancer occurs when one blood cell begins to divide out of control and many more copies of the cell are made. Eventually, the lymphocytes spread all over the body to all of the lymph glands and to the bone marrow. When it affects the bone marrow, other types of blood cells, like other white blood cells, red blood cells and platelets do not get made and you get thrombocytopenia and anemia.
B cells or T cells of the lymphatic system can be affected by lymphoma. The B cells, as mentioned, produce antibodies to fight off infection and there are helper B cells that make the other B cells work better. T cells invade tissue and kill the foreigners in the body without need for antibodies. The treatment options available differ depending on the type of non-Hodgkin's lymphoma there is.
Risk factors for lymphoma include taking immunosuppressant medications for another disease. You can't fight off toxins or pathogens very well if you are immunosuppressed. Diseases like hepatitis C, HIV and chronic Epstein-Barre infections can contribute to getting non-Hodgkin's lymphoma. H. pylori infections contribute to getting non-Hodgkin's lymphoma and chemical exposure to pesticides can play a role in the disease. Most patients with non-Hodgkin's lymphoma are older than the age of 60.
When you have non-Hodgkin's lymphoma, you see a hematologist or an oncologist. They perform a complete physical and history, paying attention to the lymph nodes. An x-ray, CT scan or MRI scan of the neck, chest and abdomen can show areas of tumour along with fluid-filled areas. A PET scan can show areas of increased metabolic activity, typical of cancer. Bone marrow biopsies are commonly done to see if the bone marrow is affected.
Non-Hodgkin's lymphoma is often treated with chemotherapy or radiation. Some slow growing tumours are not treated at all but are watched to make sure they don't become more aggressive. In some cases, the person' stem cells are removed from their bone marrow, grown outside of the body and are then reimplanted into the body after chemotherapy kills the rest of the bone marrow and tumour cells.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here