Lymphoma Basics
What is "lymphoma"?
Lymphoma can be characterised as a cancer involving the immune system. Lymphocytes, which are where lymphoma is derived from, are a part of your immune system. They are part of your white blood cells. There are B lymphocytes and there are T lymphocytes. B lymphocytes function to make antibodies against disease and against infection, and T lymphocytes don't make antibodies but assist the B cells in fighting infection. When something goes wrong in these cells, in the B cells, or the T cells, usually where they are made in the lymph glands, in the lymph nodes, then that problem leads to overabundance production of B cells and/or T cells in that particular area. Both lymphomas, Non-Hodgkin's lymphoma and Hodgkin's lymphoma can present in the same manner. Hodgkin's lymphomas involve subtypes of lymphocytes that look different under the microscope. They have different characteristics but ultimately get treated the same way, although with different chemotherapeutic agents.
What is '"non-Hodgkin's lymphoma" (NHL)?
The best way to describe a lymphoma, in particular is as a cancer of the lymphatic system, or the lymphocytes, which are one particular type of white blood cell. There are non-Hodgkin's lymphomas and there the Hodgkin's lymphomas, and the non-Hodgkin's lymphomas make up the majority of the lymphoma diagnoses in the world. There doesn't seem to be a predilection to kids versus adults in non-Hodgkin's lymphoma. It tends to be seen all across the age groups, very few in young childhood, which make up the majority of the Hodgkin's cases. However, non-Hodgkin's lymphoma doesn't spare the sex. It's as common in males as it is in females. It's common across all age groups. The one wonderful thing about all the lymphomas in general is that they are curable, in addition to being treatable.
What is the "lymphatic system"?
If you remember back to high school and college biology, the lymphatic system is another one of those systems that run parallel to the venous and the blood system. Parallel to the blood and the veins and the arteries is the lymph and it's just another way of circulating immune system throughout your body. It's where the B cells and T cells are which help function to control disease and to control infection circulate through the body. It's a parallel system. So, if you usually have a problem with a blood vessel you don't have a problem with the lymph system, and if you have a problem with the lymph system it doesn't necessarily lead to a problem with the blood system. However, ultimately, the lymphomas and the diseases that that arise from the lymphatic system arise within the lymph nodes. Lymph nodes are, the best way to describe them, is that they are draining points along the lymphatic system where B cells and T cells are produced, or your immune system is produced and regulated, as well as where things go awry. Arid T cells and B cells are formed into malignant forms of themselves and that's from where these lymphomas arise.
What causes non-Hodgkin's lymphoma?
A lot of different cancers, specifically lymphomas, have particular genetic abnormalities associated with their tumours. There's a particular type of non-Hodgkin's lymphoma called mantle cell lymphoma, which has a specific genetic abnormality. There are specific types of leukaemias that have a specific genetic abnormality. It's theorised that that particular genetic defect leads to the production of the cancer. However, some people also believe that genetic mutation just happens to be a way to mark or to identify this particular cancer, and we're not a hundred percent sure how these mutations develop to begin with. We do know that the environment plays a large role. There are a large number of Russian patients who now live in the United States that lived in and around the Chernobyl area and the Kiev area, where they were exposed to significant fallout from the Chernobyl nuclear disaster. Those patients have had a higher degree of prevalence and incidence of non-Hodgkin's lymphomas as a result of certain exposures and radiation exposure. So, in the end what causes non-Hodgkin's lymphoma is possibly a genetic predisposition due to particular genetic abnormalities, as well as a strong environmental component.
Why has the incidence of non-Hodgkin's lymphoma increased so dramatically?
The answer to the question of why non-Hodgkin's lymphomas have increased in incidence over the past thirty years may go toward the ability to diagnose these cancers earlier, and because I see an increased incidence of lots of cancers across the board, and especially in younger patient populations. So, it's hard for me to single out one particular cancer from others as being in increased incidence. In my opinion, the most significant cause of cancers, and lymphoma in particular, is probably environmental impact and environmental exposures. Whether it is radiation exposure, toxin exposure, or pesticide exposure, the use of these products (although getting better in the United States) is still a significant problem and a significant health exposure across the world. I think the more we are exposed to toxic agents, the more likely we are to end up with other cancers in the future.
What is an "antibody"?
You might remember back to high school and college biology when you learned about the vaccines and you learned about why you get the measles vaccine and why you get now a chicken pox vaccine and all these vaccines that we get throughout childhood if we are believers in vaccines. Vaccines are exposing your body to a particular protein component of a disease and having your body, your B cells and T cells which are part of the immune system produce antibodies against or basically a product to block the protein that's abnormal or to block the disease. So by exposing your body to a nonlethal or nonpathogenic, nonharmful portion of a disease whether it be measles, mumps, rubella, chicken pox, yellow fever. You know there's tons of vaccines, your body goes ahead and makes antibodies or blocking products, a blocking protein to block or destroy the abnormal protein or pathogenic or harmful protein that may enter your body. Every year you may or may not get a flu vaccine. A flu vaccine has components or protein components of all the particular flu viruses that have been found across the world.
What is an "antigen"?
An antigen is a protein product that an antibody can be made against. To give you an example of what an antigen-antibody complex is: if you were exposed to the common cold last week then you have the antigen of the common cold circulating in your body. That antigen is a particular protein. The antigen has a three dimensional formation, the antigen looks a certain way. Your body, in an effort to fight that common cold, makes an antibody to block that particular antigen. When you get a vaccine for anything -- yellow fever, flu vaccine, measles, mumps -- you are injected. The vaccine is a harmless antigen of that particular harmful disease and then, in turn, your body makes an antibody, or a blocking protein, against that antigen.