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The Non-Hodgkin’s Lymphoma information contained on this page
will focus more towards Gloria's condition. If you would like to research
more, you can go to the links at the bottom of this page.
Gloria's specific disease is called
Non-Hodgkin’s Lymphoma, B-cell, Small Lymphocytic, Low-grade, Stage IV.
The info here is a general idea of the disease, but there will be info in
here relating to her condition.
OVERVIEW
Lymphomas are cancers of the lymphatic system - the body's
blood-filtering tissues that help to fight infection and disease. Like other cancers, lymphomas, occur when cells
divide too much and too fast. Growth control is lost, and the lymphatic cells
may overcrowd, invade, and destroy lymphoid tissues and metastasize (spread)
to other organs.
There are two general types of lymphomas: Hodgkin's Disease (named after Dr.
Thomas Hodgkin, who first recognized it in 1832) and non-Hodgkin's lymphoma.
The lymphatic tissue in Hodgkin's disease contains specific cells -
Reed-Sternberg cells - that are not found in any other cancerous lymphomas or
cancers. These cells distinguish Hodgkin's disease (HD) from non-Hodgkin's
lymphomas (NHLs).
ANATOMY
The lymphatic system - the target of lymphomas - includes the lymph nodes and
other organs that make up the immune and blood-forming (hematopoietic)
elements of the body.
The lymph nodes are oval, pea-sized organs. They are found beneath the skin
along the route of large blood vessels, and they are grouped in areas such as
the neck, underarms, groin, abdomen (trunk), and pelvis (hips). The lymph
nodes are linked throughout the body by narrow tubes known as lymphatic
vessels. These vessels carry lymph, a colorless liquid that is collected from
the body's tissues; chyle, a milky fluid taken from food in the intestine
during digestion; lymphocytes, specialized white blood cells; and other blood
cells. The lymphatic fluids and lymphocytes ultimately are funneled back into
the bloodstream through a connection in the left upper chest.
Other organs that contain lymphatic tissue and so are affected by lymphoma
include the:
Spleen, a ductless gland that is located on the left side of the body under
the lower rib cage; it is makes lymphocytes and other infection-fighting
cells, stores healthy blood cells, and filters the blood);
Thymus gland, a gland located in front of the heart; it produces immature
T-cells that, when mature, are involved in immune system responses;
Bone marrow, the inner region of the
bones;
Adenoids, the lymphatic tissue in the post-nasal area; and
Tonsils, the rounded mass of lymphatic tissue at the back of the throat
Both Hodgkin's disease (HD) and
non-Hodgkin's lymphomas (NHLs) begin in lymphatic tissues and can invade
other organs. But NHLs are much less predictable than HD, and they are more
likely to spread to areas beyond the lymph nodes.
SYMPTOMS
The most common sign of both Hodgkin's disease (HD) and non-Hodgkin's
lymphoma (NHL) is a painless swelling in one or more of the lymph nodes of
the neck, collarbone region, armpits, or groin. But it is important to
remember that most lymph node swelling - especially in children - is caused
by an infection, not by lymphoma. Affected lymph nodes usually return to
normal size within a few weeks or months after an infection has cleared.
Physicians often observe swollen lymph nodes during this time to see if they
change in size following antibiotic treatment.
General Symptoms
As lymphomas progress and cancerous lymphocytes spread beyond the lymphatic
system, the body loses its ability to fight infections. The generalized symptoms
that develop may be confused with influenza, other infections, such as
infectious mononucleosis ("mono"), tuberculosis (TB), or other
cancers.
In particular, people with HD or NHL may
experience:
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fever
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drenching night sweats
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weight loss
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fatigue
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appetite loss
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red patches on the skin
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severely itchy skin, often affecting the legs/feet
The itching associated with Hodgkin's
disease is much more severe than that caused by dry skin. In some cases,
patients may actually scratch through the skin with their fingernails in
attempts to get some relief. The night sweats caused by HD or NHL may be so
extreme that they completely soak the individual's sheets and blankets.
Some oncologists refer to these
generalized symptoms as B symptoms. Unfortunately, B symptoms are related to
an increased cancer "burden" - more cancerous tissue - in many
patients and, therefore, indicate a worse prognosis, or outcome.
Small
lymphocytic/prolymphocytic lymphoma (B-SLL) represents only about 4% of adult
NHL. It usually occurs in adults with generalized lymph node disease
(lymphadenopathy). This disease manifests more often as B-cell chronic
lymphocytic leukemia (B-CLL) than as B-SLL. An increased rate of cell
division is associated with more aggressive disease and a shorter survival
time. The lymph node cells of SLL may transform into an aggressive, large
B-cell lymphoma in as many as 15% of patients. This is known as Richter's
syndrome. In addition, B-CLL/SLL may undergo a Hodgkin's-like transformation.
Staging
Once the physician has diagnosed
lymphoma, he or she will want to perform studies to establish the patient's
stage - that is, to find out how far the patient's cancer has spread. Staging
helps the physician to select appropriate treatment options and helps him/her
to arrive at a prognosis, or estimate of disease outlook and survival.
Clinical information is reviewed, including findings from the physical
examination, blood tests, and imaging studies. The imaging studies most often
employed are chest X-ray and computed tomographic (CT) scan of the chest,
abdomen, and pelvis.
As with many other cancers, NHL is
categorized on the basis of tumor burden. The Ann Arbor Staging System is the
most popular system for classifying NHL. The Ann Arbor Staging groups are as
follows:
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Stage
1:
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NHL is
limited to one lymph node group (e.g., neck, underarm, groin, etc.) above
or below the diaphragm, or NHL is in an organ or site other than the lymph
nodes (extranodal) but has not spread to other organs or lymph nodes.
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Stage
2:
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NHL is
limited to two lymph node groups on the same side of the diaphragm, or NHL
is limited to one extranodal organ and has spread to one or more lymph node
groups on the same side of the diaphragm.
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Stage
3:
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NHL is in two
lymph node groups, with/without partial involvement of an extranodal organ
or site above and below the diaphragm.
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Stage
4:
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NHL is
extensive (diffuse) in one organ or site, with/without NHL in distant lymph
nodes
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Treatment for Gloria’s type NHL
Nonlocalized, late-stage NHL
If the patient has nonlocalized, slow-growing, late stage (Stages 3 or 4)
NHL, the treatment plan is not so well defined. Because of the unhurried
growth of such tumors, chemotherapy and radiotherapy - which selectively destroy
rapidly-dividing cells - cannot eliminate all of the patient's cancer cells.
Therefore, these tumors usually are not "curable." In spite of
this, treatment options may include single agent chemotherapy, or combination chemotherapy,
or chemotherapy plus radiation therapy.
Relapse
The Indolent type lymphoma Gloria
has always relapses after treatment.
If I am not mistaken, the relapse usually comes before 18 months of
remission are up. The point of getting
her into remission is to basically “buy time”, because after we get her into
remission and the cancer reoccurs, we will be back to chemo or whatever, to
get it back into remission. I have
found a page that has a transcript you can read where doctors are explaining
this problem and treatments they use for relapsed lymphoma. You can go to this site by clicking here.
Links
This is a great site, just click on
“other cancers” on the left hand side, then click on “Lymphoma” and go from
there.
Cancerlifecenter
Here is where I got
most of the info posted here:
Onocologychannel
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