DR. HOOK- Cell blocks: Lymphoma has many incarnations

Drama– what does it mean? When I moved to LA., I met one billion people who worked in the Hollywood "industry." I had never heard the expression "drama in one's life," though, girlfriend, I've definitely lived it in the past. (At least I hope it's in the past.)

I have a friend who doesn't like drama and prefers everything to be Prozac-coated. To him, drama is so '80s.  Others I know love a drama queen and salute others with a "sigh" and the drama queen salute: back of hand on the forehead. Tragedy!

I have another friend who never calls, never emails, and God forbid he would ever stop by. We've teased each other over the years to see who's been suffering more from each other's neglect. I called him a month ago but didn't hear back. A month later, I called again and said, "So, Mr. Man! Why didn't you call me back? I've been waiting!" His response: "I was in chemotherapy when you called." 

Ooooooh– low blow! But, unfortunately, this time he was serious. Ix-nay on the ama-dray.

Who expects a friend to have NHL? Currently I have two who do, plus my auntie. NHL does not stand for National Hockey League; it stands for Non-Hodgkin's Lymphoma. In cancer, a type of healthy cell becomes unhealthy and starts to reproduce faster than Mel Gibson.  

Remember the chocolate factory episode in I Love Lucy when the production line sped out of control, and Lucy and Ethel stuffed their mouths and dresses full of chocolate truffles? That's the definition of cancer. Malignant cells grow so out of control that they take over everything and destroy productivity.   

The lymphoid cells are immune cells, B-cells, T-cells, and NK-cells that are involved in fighting infection. The ones that predominantly live in lymphoid tissue (i.e. lymph nodes, which many people refer to as "glands" when they're sick) are referred to as lymphoma if they become malignant. 

The lymphatic system is pretty interesting because it has its own "roadways" to distribute immunity to the body.  Lymphoid cells live in the spleen and lymphatic system to combat bad things that can harm us. So, for example, if you have strep throat, often the lymph nodes in the front part of the neck become enlarged due to immune cells revving up to fight the bacteria.

Lymphomas are categorized as Hodgkin's Lymphoma or NHL There are over 20 different varieties of NHL depending on what B, T, or NK cells become malignant.  

Here is the irony: the more aggressive the lymphoma, the more likely it will respond to treatment– but if it doesn't respond to treatment, then prognosis is very poor, as in weeks to live. The more indolent the lymphoma, the less likely it will respond to treatment– but most likely the person will live for years.

Indolent Lymphomas consist of 35-40 percent of NHL  About 24,000 Americans are diagnosed with this disease every year. Follicular lymphoma is the most common of indolent lymphomas, though it can also present as an aggressive lymphoma.

Aggressive Lymphoma occurs in 50 percent of NHL—about 30,000 Americans annually. Diffuse large B-cell lymphoma is the #1 NHL Highly Aggressive Lymphoma occurs in 5 percent of NHL– 3,000 Americans a year. Burkitt's lymphoma grows so fast it practically doubles in size every day.

 Treatment and prognosis depend on the type of lymphoma, its stage upon diagnosis, and the person's age and overall health. Whether the lymphoma has spread outside the lymph nodes also has a huge impact.  

I wish for my family, friends, and patients who have NHL that they beat this awful disease. This isn't drama; This is reality.



As an indolent lymphoma survivor myself, the good news is that many consider lymphoma to be a "gateway" disease, which many study due to the fact that advances here can be translated into advances for other diseases. We have seen an explosion over the past few years of targeted therapies that have less harmful effects than traditional chemo (having experience with both types of therapy, I can attest to that), but which have great effect. If it can ever be said that there's a good time to get sick, now is that time as there's lots of good news and hope to spread around. Take care....Allan

Allan has a good point - there fortunately are many people working on lymphoma treatments and new FDA approved therapies come out each year.

Mike - Hodgkin's Survivor, The Lymphoma Blog http://www.lymphomainfo.net/blog