Non-Hodgkin's Lymphoma Quiz

Non-Hodgkin lymphoma (also known as non-Hodgkin's lymphoma or NHL) is a cancer that starts in the body's immune system in white blood cells called lymphocytes.

• NHL is a term that's used for several types of lymphoma which share some characteristics.
• There is another type of lymphoma, called Hodgkin lymphoma, which is treated differently.
• NHL most often affects adults, but children can get it too.
• NHL usually starts in lymph nodes or other lymph tissue, but it can sometimes affect the skin and other organs.

The lymphatic system is the part of the body that helps fight off disease and infection. The main areas in the body that make up the immune system are:

• Lymph nodes
• Spleen
• Bone marrow
• Thymus
• Adenoids and tonsils
• Digestive tract

Oncologists (doctors who specialize in treating cancer) are able to distinguish non-Hodgkin's from Hodgkin's lymphoma (formerly referred to as Hodgkin's disease) by examining the white blood cells of the patient. If the doctor does not detect what is known as a Reed-Sternberg cell, which are giant cells found in lymph fluid, the lymphoma is classified as non-Hodgkin's. If there are Reed-Sternberg cells present, it is classified as Hodgkin's lymphoma.

Hodgkin's lymphoma is recognized as one of the most treatable cancers, with over 90% of patients surviving more than five years. Non-Hodgkin's lymphoma, however, often arises in various parts of the body (organs and lymph nodes) and because of this, most cases of non-Hodgkin's lymphoma are diagnosed at an advanced stage and carry a worse prognosis.

Common symptoms of non-Hodgkin lymphoma include:

• Enlarged lymph nodes
• Chills
• Weight loss
• Fatigue
• Swollen abdomen
• Feeling full after only a small amount of food
• Chest pain or pressure
• Shortness of breath or cough
• Severe or frequent infections
• Easy bruising or bleeding

Depending on the type and stage (extent) of the lymphoma and other factors, treatment options for people with NHL might include:

• Chemotherapy
• Immunotherapy
• Targeted therapy drugs
• Radiation therapy
• High-dose chemotherapy and stem cell transplant
• Surgery
• Palliative and supportive care

Some types of non-Hodgkin lymphoma (NHL) are curable and some people with other types of NHL are able to treat their disease and keep it under control and live good quality lives with medical treatment.

Treatment is used to destroy all of the lymphoma cells to induce a complete remission. Complete remission means that all evidence of disease is eliminated. Patients who go into remission are sometimes cured of their disease. Some people never achieve complete remission but treatments keep the symptoms of the disease manageable.

Treatment teams for patients with non-Hodgkin lymphoma could include doctors such as:

• Medical oncologists or hematologists who treat lymphoma with chemotherapy, immunotherapy, and targeted therapy.
• Radiation oncologists who treat cancer with radiation therapy.
• Bone marrow transplant doctors who specialize in treating cancer or other diseases with bone marrow or stem cell transplants.

Non-Hodgkin lymphoma isn't infectious and isn't thought to be genetic, although your risk may be slightly increased if a parent or sibling has had lymphoma.

Non-Hodgkin lymphoma is caused by a change (mutation) in the DNA of a white blood cell called a lymphocyte. The cause of the mutation that triggers non-Hodgkin lymphoma is unknown.

Factors that can increase your risk of developing the condition include:

• Immune system problems
  • Human immunodeficiency virus (HIV)
  • Organ transplant
  • Rheumatoid arthritis
  • Lupus
  • Previous chemotherapy or radiation treatment
• Epstein Barr virus
• Helicobacter pylori infection

Life expectancy for cancers is often expressed in 5-year survival rates, which is the percent of patients still alive 5 years following diagnosis.

The overall 5-year relative survival rate for people with NHL is 72%. Survival rates can vary for different types and stages of lymphoma. Below are the 5-year relative survival rates for two common types of NHL, diffuse large B-cell lymphoma and follicular lymphoma.

The 5-year survival rate for non-Hodgkin lymphoma, diffuse large B-cell lymphoma:

• Localized (cancer is limited to one lymph node area, one lymphoid organ, or one organ outside the lymph system): 73%
• Regional (cancer reaches from one lymph node area to a nearby organ, is found in two or more lymph node areas on the same side of the diaphragm, or is considered bulky disease): 72%
• Distant (cancer has spread to distant parts of the body such as the lungs, liver, or bone marrow, or to lymph node areas above and below the diaphragm): 55%

• Localized is 96%
• Regional is 89%
• Distant is 85%

The average age for people diagnosed with non-Hodgkin's lymphoma is 60-years-old. Hodgkin's lymphoma, however, is most common in people aged 15- to 24-years-old as well as people over the age of 60.