Non-Hodgkin's Lymphoma

The function of the immune system is to defend the body by fighting against infections and other diseases. Non-Hodgkin's Lymphoma is a cancer that begins in the cells of the immune system. The lymphatic system, which is part of the immune system includes lymph vessels, lymph, lymph nodes, tonsils, thymus and spleen. Lymphatic tissues exist throughout the body including the stomach, skin and small intestine.

Non-Hodgkin's Lymphoma usually starts in a lymph node. It begins when a lymphocyte (usually a B cell) becomes abnormal. The abnormal cell divides and makes copies of itself. These new cells further divide, thus producing more and more abnormal cells. The abnormal cells don't die when they should, nor do they protect the body from infections or other diseases. The buildup of extra cells often forms a mass of tissues which is known as a growth or tumor.

Non-Hodgkin's Lymphoma is classified according to the pace at which the cancer spreads. The cancer is graded as low, intermediate or high. Burkitt's tumor is an example of a high-grade lymphoma.

Causes
Although the causes of this cancer are unknown, they are likely to develop in people with compromised immune systems. The risk of lymphoma increases after an organ transplant or in person with HIV infection. This cancer affects adults to a larger extent. About half of all cases are in people aged 60 and above. Also, more males are affected than females.

Symptoms
The symptoms of non-Hodgkin's Lymphoma are defined by the type of cancer and part of the body it affects. Some of the common symptoms experienced include:

• Fever
• Severe itchiness
• Excessive sweating, especially while sleeping at night
• Swollen lymph nodes in the neck, underarms, groin, or other areas
• Unintentional weight loss

If the cancer affects the thymus gland or lymph nodes in the chest, symptoms include coughing or shortness of breath brought on by pressure the tumor places on the windpipe (trachea) or other airways. A person may experience a headache, have trouble concentrating or undergo personality changes, and also seizures if the cancer affects cells in the brain. Non-Hodgkin's Lymphoma in the digestive tract can cause nausea, vomiting, or abdominal pain. Anemia is a result of non-Hodgkin's Lymphoma of the bone marrow, as lymphoma cells replace red blood cells.

Tests
The first step in detection is usually a physical examination of the patient involving a thorough checkup of body areas with lymph nodes by the doctor to determine if they are swollen. Laboratory tests to diagnose non-Hodgkin's Lymphoma and the stage at which it exists include:

• Blood chemistry tests
• Bone marrow aspiration and biopsy
• CBC with white blood cell differential
• CT scans of the chest, abdomen and pelvis
• Lymph node biopsy: A biopsy involves removal of a small sample of the of the tissue thought to be cancerous under local anesthesia.
• PET (positron emission tomography) scan
• X-rays

Treatment
The treatment of any cancer depends on the stage it is at when first diagnosed and how rapidly it spreads. Low-grade lymphomas usually grow slowly and cause few symptoms but eventually become resistant to treatment, which is why doctors often postpone treatment until the cancer shows signs of spreading. When non-Hodgkin's Lymphoma is treated with chemotherapy, it usually involves many different types of drugs being administered at the same time. Some drugs such as chlorambucil (marketed as Leukeran) are administered orally; others such as cyclophosphamide (marketed as Cytoxan) are injected into a vein or muscle. Chemotherapy is usually given in cycles of a treatment period and followed by a rest period.

Another drug called rituximab (Rituxan) is often used to treat non-Hodgkin's lymphoma. Rituxan is a form of immunotherapy. It targets a molecule on the surface of B-cells.

Radiation therapy is also frequently used to damage cancer cells and stop their growth. Non-Hodgkin's Lymphoma patients with a poor prognosis may be treated with high-dose chemotherapy with or without radiation, followed by a bone marrow transplant.

Prognosis
Low-grade lymphomas progress slowly and sometimes take over 10 years to get to a stage where they are detected. However, low-grade non-Hodgkin's lymphoma can't be cured with chemotherapy alone. While chemotherapy often can shrink low-grade lymphomas, the cancer usually recurs within five years.
Usually, intermediate-grade and high-grade lymphomas respond well to chemotherapy. However, the cancers that do not respond to chemotherapy drugs are generally fatal within a year or two of diagnosis.

Cases of non-Hodgkin's Lymphoma have become fairly common and have been increasing in the United States since the 1950s. Hope for better solutions lie in research being zealously conducted to find out the cause of this rapid increase as well as appropriate cures.