FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

NON-HODGKIN'S LYMPHOMA NO LONGER A "DEATH SENTENCE"

Question: My neighbor and good friend has been diagnosed with non-Hodgkin's lymphoma. I understand that it is a type of cancer, but I don't know where it starts or anything about the how life threatening it is. Would you write about this disease, please?

Answer: Non-Hodgkin's lymphoma is a term that describes a group of similar cancers of the immune system. As the name suggests, this disease is related to, but subtly different from, another cancer of the immune system Hodgkin's disease.

Added together, both types of lymphoma rank as the sixth most common cancer in the United States. About 59,000 people develop this disease every year. Of the total number with lymphoma, 85 percent have the non-Hodgkin's variety, just like your neighbor. And the percentage of those with non-Hodgkin's lymphoma, particularly among the older population, is increasing.

Lymphomas usually begin with rather non-specific symptoms of fever, night sweats and weight loss. Often there are one or more noticeably enlarged, but not particularly tender, lymph nodes. In some individuals, the swollen lymph nodes are within the chest or abdomen, where the swelling isn't readily apparent. In others, it occurs in the neck or groin where it may be among the first noticeable signs of the disease.

When the doctor is suspicious of a possible lymphoma, he or she may first order a blood test. If the results heighten the suspicion, the removal of tissue from the affected lymph node for study under a microscope (a biopsy) is necessary to confirm the diagnosis. The specific type of lymphoma is then determined by other specialized tests performed on the tissue sample and the blood. Once the specific type of lymphoma is determined, a CT scan and/or MRI are done to determine the location of the involved lymph nodes, and if other organs are involved.

As a general principle, chemotherapy and radiation are used to treat lymphomas. The complicated series of testing I've mentioned is necessary because the specific type of Hodgkin's or non-Hodgkin's lymphoma, and its stage that is, which nodes and other tissues are involved determine the best type of treatment for that individual.

Treatment of lymphoma has become one of the success stories in the fight against cancer. Over the last 20 years the prognosis has changed from being uniformly bleak to one of considerable optimism. The specifics of each individual's disease determine his or her prognosis, so general statements are of little help for determining your neighbor's prognosis. Be assured, however, that most sufferers now have improved length and quality of life mean survival with low grade non-Hodgkin's lymphoma is 5 to 8 years while others may actually be cured of their disease.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.