Ask the doctors: Non-hodgkin lymphoma considered very treatable

Dear Doctors: My grandfather is 72 years old and has been diagnosed with non-Hodgkin lymphoma. I would like to know more about this type of cancer and what kind of treatment may be involved. Is it unusual for someone his age to get this kind of a diagnosis?

Dear Reader: Lymphoma is a type of cancer that originates in the lymphatic system, most often in the lymph nodes. These are small pea- or bean-sized tissues that, along with a network of vessels, ducts and other structures, make up the lymphatic system. They work together to circulate a specialized fluid known as lymph. You know when you have a scrape and there’s a layer of clear, watery fluid oozing from the wound? That’s lymph.

Just as the job of the circulatory system is to transport blood, the lymphatic system carries lymph throughout most of the tissues of the body. It carries away cellular waste and helps maintain optimal fluid balance in the tissues. The lymphatic system is also part of the immune system and plays an important role in fighting infection and disease.

When someone has lymphoma, it means that certain types of white blood cells found in lymph, known as lymphocytes, have begun to grow out of control. Their abnormal behavior leads to the formation of tumors. These not only interfere with the workings of the lymphatic system, but cancer cells from the tumors can spread to other parts of the body.

Lymphoma is divided into two types. One is non-Hodgkin lymphoma, which is your grandfather’s diagnosis. This type of cancer is more common in men than in women. Although it can occur at any age, most cases are diagnosed in people 60 and older. A family history of the disease increases someone’s risk. Certain chemicals and drugs, including insecticides and some types of chemotherapy, are also suspected to play a role.

The other type of lymphoma, known as Hodgkin lymphoma, is not as common. It involves a different subset of lymphocytes and is treated differently from non-Hodgkin lymphoma.

Both types of lymphoma have similar symptoms. These include fatigue; unexplained weight loss; enlarged lymph nodes in the neck, armpits or groin; night sweats; and itching that can become severe.

Non-Hodgkin lymphoma can progress at different rates. A slow-growing cancer that has few symptoms is known as indolent. With this diagnosis, a treatment approach known as “watchful waiting” is sometimes recommended. It’s just as it sounds – keeping a close eye on disease progress and not starting treatment unless symptoms begin to change.

When lymphoma spreads quickly and has signs and symptoms that can be severe, it is characterized as aggressive. Aggressive lymphoma requires immediate treatment. The approach depends on the stage at which the cancer is diagnosed, the patient’s medical history and their general health. Treatment can include chemotherapy, immunotherapy, radiation and targeted drug therapy. In some cases, stem cell or bone marrow transplants may be recommended. These are arduous treatments and can have serious side effects.

Still, although it depends on the type and stage of the cancer, with a five-year survival rate of 74%, non-Hodgkin lymphoma is considered very treatable.

Send your questions to askthedoctors@mednet.ucla.edu.