Battling a Rare Form of Non-Hodgkins Lymphoma
- Mia Gatanaga was diagnosed with primary mediastinal large B-cell, a rare form of non-Hodgkins lymphoma, in her senior year of high school after initially dismissing her symptoms as simply a ‘pulled muscle.’
- The 17-year-old, who is now in remission after four months of chemotherapy and more than 20 weeks of physical therapy, is set to attend college in the fall.
- If you live in the United States and are diagnosed with non-Hodgkin lymphoma, there’s a good chance it’s the B-cell variety. About 85% of all lymphomas diagnosed in North America are B-cell lymphomas.
The teen, who played as a defensive specialist on her high school varsity volleyball team, said she felt pain when breathing in, but she wrongly assumed it was due to pulling a muscle from a game or an intense workout.Read More
As soon as Mia visited her pediatrician, she was urgently transferred by ambulance to Lucile Packard Children’s Hospital Stanford, about an hour from her home. She stayed in the hospital for four months to undergo treatment for a tumor that was putting pressure on her lung.
Mia’s mom, Frances, recounted the moment her daughter was diagnosed with cancer, explaining, “Just like that, on October 13 we disappeared from our normal lives.”
“Mia never returned to school the next day, or me to my job. Mia’s dad and I just followed the ambulance to Palo Alto,” she continued. “I remember calling Mia’s brother, Brandon, who was attending college at UC Davis, letting him know we were on our way to Stanford.”
Dr. Lianna Marks, Mia’s oncologist, reassured the teen’s family that the type of cancer she was diagnosed with “responds very well to chemotherapy.”
“A tumor can get quite large and compress the lungs and heart. Patients can be quite sick,” Dr. Marks added. She explained that although surgery wasn’t needed to remove the tumor, Mia did have to undergo intensive chemotherapy and she is now in remission.
As Mia received treatment, she continued school remotely. It wasn’t until March 2022, the latter part of her senior year, that she was able to return to class in person.
Dr. Marks says both Mia and her mom’s positive outlook helped the teen throughout her cancer battle.
“Mia handled everything with grace, and her attitude throughout treatment helped her get through. Patients are going through something horrible, and the positive energy was really beneficial to her. It made caring for her very rewarding,” Dr. Marks explained.
Mia’s strength and determination paid off as she continued more than 20 weeks of physical therapy and can now lift 80 pounds and jog or walk easily, a huge accomplishment as after treatment she had trouble standing from a sitting position on the floor.
Now, she’s ready for college and is set to attend California Polytechnic State University in San Luis Obispo and study physical therapy.
“My big dream is to return to Stanford someday and work there as a pediatric physical therapist to help children regain physical and mental strength after an experience like I went through,” Mia said.
When doctors diagnose people with non-Hodgkin lymphoma, they’re not talking about a single cancer, but many. “Non-Hodgkin lymphoma is a big category,” Dr. Julie Vose, chief of hematology/oncology at the University of Nebraska Medical Center, tells SurvivorNet.
All non-Hodgkin lymphomas start in white blood cells called lymphocytes, which are part of your body’s immune system. From there, doctors separate these cancers into types based on the specific kind of lymphocytes they grow from: B cells or T cells. Knowing whether you have a B-cell or a T-cell lymphoma is important, because it will determine what kind of treatment you get.
What Are B-Cell Lymphomas?
B cells make proteins called antibodies that protect your body against bacteria, viruses, and other germs. Germs have a protein called an antigen on their surface, to which the antibody attaches. That signals your immune system to attack the invading organism.
If you live in the United States and are diagnosed with non-Hodgkin lymphoma, there’s a good chance it’s the B-cell variety. About 85% of all lymphomas diagnosed in North America are B-cell lymphomas. And in the United States, these cancers affect white people more often than African Americans or Asian people.
T-cell lymphomas are more common in other parts of the world, such as Asia. That may have to do with causes that are unique to those regions, Dr. Vose says.
Doctors further divide B-cell lymphomas into a few subtypes:
Diffuse large B-cell lymphoma is the most common type. One out of every three people diagnosed with lymphoma in the United States has this type. If you have diffuse large B-cell lymphoma, the first sign might have been a swollen gland in your neck, armpit, or belly. This is a fast-growing cancer, but it is treatable. In many people, it’s curable.
Follicular lymphoma is the second most common type of lymphoma, and it usually starts later in life. Although it’s not as curable as diffuse large B-cell lymphoma, it grows slowly. “Patients often have symptoms for months or years before they’re diagnosed,” Dr. Vose says. Some people with this cancer don’t need to start treatment right away. People who do go on treatment have a good likelihood of going into remission.
Chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) are variations on the same type of cancer. They both affect a cell called a small lymphocyte. The difference is, CLL cells are in the blood and bone marrow, while SLL cells are in the lymph nodes and spleen. Both cancers grow so slowly that many people live for decades with them.
Mantle cell lymphoma is a relatively rare cancer. It can be challenging to treat, because it grows quickly and it doesn’t respond as well to cancer drugs as some of the other lymphomas. But researchers are working on new therapies that will hopefully improve survival for people who are diagnosed with this cancer.
Marginal zone lymphomas start in cells that look small under the microscope. This is a group of cancers that tend to grow slowly.
There are other types of B-cell lymphomas, including Burkitt lymphoma and hairy cell leukemia, but they are rare.
What Is Primary Mediastinal Large B-Cell Lymphoma?
Another type of B-cell lymphoma is primary mediastinal large B-cell lymphoma (PMBCL), the type Mia was diagnosed with. According to MacMillan Cancer Support primary mediastinal large B-cell lymphoma is a form of non-Hodgkin lymphoma (NHL), sometimes known as primary thymic mediastinal lymphoma.
“The abnormal B-cells (lymphoma cells) usually develop in a part of the lymphatic system called the thymus gland. They then build up in lymph nodes behind the breastbone and between the lungs. This area is called the mediastinum,” the charity explains, noting that abnormal cells can be found in the windpipe, heart, thymus, large blood vessels, and lymph nodes.
Symptoms of primary mediastinal large B-cell lymphoma can cause:
- a cough
- aching in the chest
- a hoarse voice
- swelling in the neck, arm or face
- headaches that worsen when bending forward
Contributing: SurvivorNet Staff