Woman, 22, Believed Her Struggles at the Gym Stemmed From Slacking Off, But After Shortness of Breath, a Rash & Groin Pain, She’s Diagnosed With Stage 3 Hodgkin Lymphoma

She explains she continued to experience a string of unusual symptoms that didn’t stand out immediately, but over time, she started to piece together.

“I was having night sweats. When I turned 20, I went through a big shift in the way my body felt, to the point where I was telling people you go through a second puberty, which you don’t,” Denham explained.

Then she noticed a rash on her leg and a lump in her groin; she figured it was time to see her doctor. After undergoing some tests, her results revealed that her symptoms were not a coincidence; they stemmed from cancer.

“He said it’s Hodgkin’s Lymphoma and it’s stage 3. I only thought it would be stage 1 because I didn’t think I felt unwell enough,” Denham said.

Hodgkin lymphoma, a cancer that begins in B lymphocytes—white blood cells that help the body fight infection.

Her treatment began shortly after, which included six cycles of chemotherapy and immunotherapy, a cutting-edge treatment that reengineers the body’s own immune cells to fight cancer from within.

As she continues treatment, she hopes others learning of her story recognize odd symptoms early and get checked, so in the case of cancer, it can be caught and treated early.

Understanding the Types of Lymphomas

Hodgkin Lymphoma and non-Hodgkin lymphoma are the two main types of lymphoma, and their classification depends on the type of white blood cells and the presence (or absence) of Reed-Sternberg cells.

They are both cancers of the lymphatic system, which includes lymph nodes, spleen, bone marrow, and other immune tissues. They’re symptoms can overlap, including swollen lymph nodes, fatigue, fever, night sweats, and unexplained weight loss. However, the way they are treated may vary.

WATCH: Dr. Jason Westin explains symptoms associated with lymphoma

If doctors are unable to detect the Reed-Sternberg cell (a giant cell derived from B lymphocytes), then the lymphoma is categorized as Non-Hodgkin lymphoma. However, if Reed-Sternberg cells are present, the lymphoma is diagnosed as Hodgkin Lymphoma.

WATCH: The type of lymphoma you have matters.

Lymphoma treatment largely depends on the nature of your specific diagnosis. For non-Hodgkin lymphoma patients, their cancer is more likely to spread randomly and be discovered in different groups of lymph nodes in the body. Hodgkin lymphoma cancers, on the other hand, are more likely to grow consistently from one group of lymph nodes directly to another.

B-Cell vs. T-Cell Lymphoma

Doctors classify non-Hodgkin lymphoma based on the type of lymphocytes affected:

B-cell lymphomas account for nearly 85% of non-Hodgkin lymphoma cases. These cancers originate in cells responsible for producing antibodies that identify and fight infections.
T-cell lymphomas, making up 15% of cases, arise in T-cells, which directly attack harmful invaders like bacteria and viruses.
Identifying whether the lymphoma is B-cell or T-cell helps guide treatment options tailored to the disease’s behavior and progression.

Types of B-Cell Lymphoma

• Diffuse large B-cell lymphoma
• Follicular lymphoma
• Small lymphocytic lymphoma (SLL) / Chronic lymphocytic leukemia (CLL)
• Mantle cell lymphoma
• Marginal zone lymphomas
• Burkitt lymphoma

Types of T-Cell Lymphoma

• T-lymphoblastic lymphoma/leukemia
• Peripheral T-cell lymphomas
• Cutaneous T-cell lymphoma
• Aggressive vs. Indolent (slow-growing) Lymphomas

One of the key distinctions doctors make when diagnosing non-Hodgkin lymphoma is how rapidly the cancer grows and spreads.

Indolent (slow-growing) lymphomas tend to develop over time and may not require immediate aggressive treatment.
Aggressive lymphomas spread quickly and need intensive treatment to prevent further progression.
Dr. Jennifer Crombie, medical oncologist at Dana-Farber Cancer Institute, explains that understanding whether the lymphoma is indolent or aggressive is essential, as they require very different treatment approaches.

What Treatment for Non-Hodgkin Lymphoma Looks Like?

Lymphoma treatment largely depends on the nature of your specific diagnosis. For non-Hodgkin lymphoma patients, their cancer is more likely to spread randomly and be discovered in different groups of lymph nodes in the body. Hodgkin lymphoma cancers, on the other hand, are more likely to grow consistently from one group of lymph nodes directly to another.

WATCH: Non-Hodgkin lymphoma treatment options

“There are some lymphomas that are very treatable but not curable,” Dr. Lawrence Piro told SurvivorNet.

Dr. Lawrence Piro is the President and CEO of The Angeles Clinic and Research Institute in Los Angeles, a Cedars-Sinai affiliate. He adds that some lymphomas progress quickly if left untreated.

Non-Hodgkin lymphoma treatment depends on the type, stage, and how fast it grows. People with aggressive non-Hodgkin lymphoma can expect to get a chemotherapy combination called R-CHOP, which is a drug cocktail consisting of chemotherapy drugs plus an antibody drug and a steroid to treat diffuse large B-cell non-Hodgkin lymphoma.

R-CHOP stands for:

• R: Rituximab (Rituxan) is a monoclonal antibody that attaches to a specific protein called CD20, which sits on the surface of B cells. It targets cancerous cells and destroys them.
• C: Cyclophosphamide is a type of chemotherapy drug
• D: Doxorubicin hydrochloride (hydroxydaunomycin) is a type of chemotherapy drug
• V: Vincristine sulfate (Oncovin) is a type of chemotherapy drug
• P: Prednisone is a steroid that lowers inflammation

Patients receiving R-CHOP receive the drug in six cycles that are three weeks apart.

“R-CHOP is a cocktail of drugs. There are five different drugs in that recipe,” Dr. Jennifer Crombie, medical oncologist at Dana-Farber Cancer Institute, tells SurvivorNet.

WATCH: Understanding R-CHOP treatment.

R-CHOP side effects can include:

• Tiredness and weakness
• Hair loss
• Mouth sores
• Bruising and bleeding
• Increased risk of infection
• Appetite loss and weight loss
• Changes in bowel movements

Immunotherapy and targeted therapy are also treatment options for non-Hodgkin lymphoma patients.

Rituximab (Rituxan) was the first immunotherapy drug approved to treat some forms of non-Hodgkin lymphoma. “Rituximab is the immunotherapy that has been approved the longest, and we have the most experience with lymphoma,” Dr. Chong tells SurvivorNet.

Rituxan has side effects, including fever, chills, swelling under the skin, itching, and mild shortness of breath.

Brentuximab vedotin (Adcetris) is a relatively new targeted treatment for non-Hodgkin lymphoma and Hodgkin lymphoma. This drug is an antibody-drug conjugate that combines an antibody (a type of protein that recognizes foreign substances in the body) with a drug that treats cancer. It uses a particular protein to deliver medicine directly to the cancer cell.

Non-Hodgkin lymphoma can also be treated with radiation, which aims beams of intense energy at the cancer to stop cancer cells from growing and dividing.

Questions for Your Doctor

If you are dealing with a lymphoma diagnosis, it’s important to ask your doctor a series of questions so you will have an idea of what your next steps will look like. To help you during this difficult time, SurvivorNet has some questions to kickstart your conversation with your physician.

• What type of lymphoma do I have?
• What does my pathology report say about my diagnosis?
• Should I get a second opinion before I explore possible treatment options?
• Based on my diagnosis, what do you anticipate my treatment path?
• What common side effects should I expect when I begin treatment?
• Will I be able to continue working and performing normal daily activities during treatment?
• Where can I get help working with the insurance company regarding treatment costs?
• Who do you recommend I get mental health help from during my treatment?

Learn more about SurvivorNet's rigorous medical review process.

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