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LYMPHOMA
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LYMPHOMA
The human immune system is a fascinating network which protects us from all
sorts of invading germs and parasites. It is composed of special bean-sized glands,
called "lymph nodes," which filter the blood and destroy foreign invaders. These lymph
nodes are connected to each other through an elaborate closed "circulation system"
which eventually returns the purified lymph fluid to the bloodstream.
Specific immune cells, called "lymphocytes," are contained within the lymph nodes, and also within the skin, tonsils, spleen, liver and intestines to quickly recognize and react to invading germs. Without this lymph system, we would soon die of overwhelming infection. A complex variety of cancers can arise within this system, called "lymphomas."
Like any cancer, lymphoma starts from just one cell. Some lymphomas are "indolent," which means the patient can live for many years without any treatment at all. Others are very "aggressive," and among the most deadly cancers known. Just as their are many types of lymphomas, many treatment strategies have been researched.
If a person develops lymphoma, it is critical to get prompt diagnosis and proper treatment; this can literally make the difference between life and death. Understanding your options will give you the peace-of-mind of knowing you've done everything possible to ensure a successful outcome for yourself or a loved one.
While there is ultimately just one type of RBC and platelet, there are normally several
main types, and many subtypes, of WBC's. The main types are lymphocytes, neutrophils, monocytes, eosinophils, and basophils. The number of each of these per milliliter of blood is counted in the laboratory during
the routine Complete Blood Count ("CBC") with "differential" . All of them participate in the immune system, and the lymphocyte is the crucial cell for identification of invading germs. The 2 main subtypes of
lymphocytes are called "T-cells" (for Thymus) and "B-cells" (for Bone). The "T-cells" are involved in stimulating (T-helper) and suppressing (T-Suppressor) the immune system, while "B-cells" form the surface coating ("antibodies") sprayed onto foreign invaders, to allow them to be engulfed ("phagocytized") by the
other WBC's. The system must stay in fine balance to function properly.
Now each of the body's cells has "surface proteins" (also called "immunoglobulins") coating their external membranes; these particular
proteins are unique for each individual (except identical twins). When foreign tissue, such as a transplanted
organ or some germ invades the body, it is quickly identified as foreign by it's
different surface proteins, a process performed by T-helper cells. These T-cells
then contact the nearby "B-cells", which receive information from the T-cells about
exactly what the invader's surface coat looks like. The "B-cells" then make an antibody
to attack this particular coat, leaving every other body cell alone. Once coated,
the invader in quickly destroyed by other roaming WBC's. To keep the process from getting
out of hand, "T-Suppressor" cells kick in and reduce the immune response. If this
system doesn't work well, "auto-immune" diseases like rheumatoid arthritis or Lupus
can develop. Similarly, a strong immune response will cause the rejection of a
transplanted organ, so "immunosuppressive" drugs will be needed to tone down the immune response. T-helper cells can recall
for many years what a germ looks like, and then quickly activate an immune response
if exposed to it again. This is the principle of vaccination. While T-helper cells
can live many years, other WBC's only live for 8 to 12 hours, so must continuously be replaced
to avoid infection. The "T" and "B" lymphocytes may be found circulating in the bloodstream,
stuck in the bone marrow, or living in clusters in "lymph nodes" . These lymph nodes, or "glands", are normally pea-sized filters which purify the
blood. Lymph nodes are connected to each other via lymph channels which can act as
conduits for spreading infection or cancer. Lymph nodes normally swell when working
on fighting an invading germ, since more WBC's are being produced in them. This is seen in
mumps and groin infections. They will also swell if invaded by cancer, whether it
starts inside migrates from outside of the lymph node. There are also areas of "lymphoid tissue" containing the germ fighting WBC's in the tonsils, spleen, liver and intestines.
Germs are usually quickly and effectively killed by the immune system, without us
ever being aware of them! Thus the immune system is a dynamic process which normally
saves our lives every day.
Lymphoma is actually a confusing myriad of diseases, the classification of which is still argued
about today. Normally, the production of new WBC's is under strict control of the
immune system, regulated by the "genes" inside of each cell. The genes determine whether more copies of the cell should be
made to fight a particular infection, via sensing a particular stimulation (such
as a piece of the germ) from the infecting agent. The common element in all lymphomas
is that an alteration occurs in the genes of a single cell, leading to it's uncontrolled division. That is, it makes millions of copies, or "clones" of itself. Any WBC that has been exposed to an invader undergoes a change in it's
genes ("rearrangement") which now will identify it. If it loses control of it's division
processes, it also fails to perform it's regular functioning, which compromises the
delicately balanced immune system. Ultimately, all cancers are diseases of the genetic
material ("DNA") within the genes of the affected cell. Cancers have different names depending upon
what type of cell is affected (i.e. lung, liver, prostate, myeloma) but the basic
process remains the same- uncontrolled production of abnormal cells. These cells
then have the capacity to spread to other body areas, which is the definition of "malignant". The actual process of spread is called "metastasis", and is what makes cancer so dangerous.
Lymphoma is divided into "B" and "T" cell types, and is simply when these cells, at some stage of their development, start dividing
out of control, lose their ability to fight infections, and shunt nutrients away
from normal cells. It is different from leukemia, another type of blood cancer, by
the fact that it develops in lymph nodes, although it may spread to any body area. In fact,
some chronic types of leukemia and lymphoma may be indistinguishable. Lymphoma may
be aggressive or indolent; their are lots of types. Hodgkin's and Non-Hodgkin's lymphoma is the first distinction.
The human immune system is a fascinating network which protects us from all
sorts of invading germs and parasites. It is composed of special bean-sized glands,
called "lymph nodes," which filter the blood and destroy foreign invaders. These lymph
nodes are connected to each other through an elaborate closed "circulation system"
which eventually returns the purified lymph fluid to the bloodstream.
Specific immune cells, called "lymphocytes," are contained within the lymph nodes, and also within the skin, tonsils, spleen, liver and intestines to quickly recognize and react to invading germs. Without this lymph system, we would soon die of overwhelming infection. A complex variety of cancers can arise within this system, called "lymphomas."
Like any cancer, lymphoma starts from just one cell. Some lymphomas are "indolent," which means the patient can live for many years without any treatment at all. Others are very "aggressive," and among the most deadly cancers known. Just as their are many types of lymphomas, many treatment strategies have been researched.
If a person develops lymphoma, it is critical to get prompt diagnosis and proper treatment; this can literally make the difference between life and death. Understanding your options will give you the peace-of-mind of knowing you've done everything possible to ensure a successful outcome for yourself or a loved one.
The Cancer Group Institute's material explains, in plain English, the bewildering types, definitions, risk factors, frequency, symptoms, evaluations, historical and latest effective treatments for lymphoma. We describe surgery, radiation, chemotherapy, and bone marrow transplant along with their expected side effects and results. While we don't promise cure, we tell you everything you must know to help you make the right choices today in dealing with a lymphoma problem.
