Lymphoma shows up in two types

March 17, 2009

BY DAWN BAUMGARTNER VAUGHAN

dvaughan@heraldsun.com; 919-419-6563

DURHAM -- Lymphoma is a blood cancer that begins in the cells of the immune system.

According to the Lymphoma & Leukemia Society, about 74,340 Americans were diagnosed with lymphoma in 2008. The society describes lymphoma as resulting when a lymphocyte -- a type of white blood cell -- undergoes a malignant change and begins to multiply, eventually crowding out healthy cells and creating tumors that enlarge the lymph nodes or other parts of the immune system.

The National Cancer Institute breaks it down:

"There are two basic categories of lymphomas. One kind is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer."

David Turner's lymphoma -- diffuse large B-cell -- is the most common. Most lymphomas are non-Hodgkin, the fifth most common cancer among men and women in the U.S.

Not all lymphomas are treated the same. Turner has undergone three regimens of chemotherapy, and is now receiving radiation.

His first and second chemotherapy regimens were typical treatment for his kind of lymphoma. But it is behaving much more aggressively than normal, said his Duke University oncologist, Anne Beaven.

Why is Turner's cancer more aggressive than others? That's one of the things scientists are always trying to figure out, Beaven said. They don't know why.

The lymphoma responded well with Turner's first chemotherapy treatment, and he went into remission. But then it relapsed. His lymphoma is kind of clever, Beaven said. Each time it was given more chemo, it avoided it and found another way to grow.

"The problem with cancer of any sort or lymphoma is that if there is any one cancer cell left, it wants to grow back," Beaven said. Oncologists look for bigger groups of cancerous cells, but they can't see that one miniscule cancer cell, she said.

When it comes to lymphoma, there are no obvious risk factors like other classic cancers. With lymphomas, Beaven said, most of the time they don't know what causes them. There are some diseases that put patients more at risk for them, like AIDS. There is also an increased association with lymphoma in general and a lot of pesticides, like Agent Orange, she said.

But overall, researchers don't know what causes it. There's no screening test. Symptoms show up and they go from there.

To learn more about lymphoma, visit www.cancer.gov, www.leukemia-lymphoma.org or www.lymphoma.org.