Treating Non-Hodgkin Lymphoma
- Zoe Plastiras, 23, was diagnosed with Stage 2 non-Hodgkin lymphoma just three months after doctors found a “grapefruit-sized” tumor on her heart.
- The tumor was first discovered when Plastiras was eight months pregnant and experiencing symptoms of breathlessness and cough, something she likened to her pregnancy.
- Now that her daughter Ophelia has been born, Plastiras is set to start chemotherapy this month.
- Treatment paths for non-Hodgkin lymphoma can vary depending on what type of non-Hodgkin lymphoma you have.
The tumor measured 11.7 centimeters by 6 centimeters by 9 centimeters was found when Plastiras was 32 weeks pregnant.
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Followup procedures, like needle biopsies and a surgical biopsy, weren’t done until after Plastira’s daughter Ophelia was born three months ago.
It was then doctors confirmed she had Stage 2 non-Hodgkin lymphoma.
“I will forever be grateful for my daughter as I believe they would never have found this mass if it wasn't for her pushing everything in my body around. She has essentially saved my life,” Plastiras said.
Plastiras, who admits to feeling “more positive and informed” after more doctors appointments, will begin treatment in just a few days.
Noting that it took her three months to get a diagnosis and treatment plan, the new mom explained, “That uncertainty has been a rollercoaster of horrible up and down feelings but now I feel ready for treatment. I have so much support and people to help out with my baby when I need them. So I'm 100% ready to beat this."
Plastiras, who will undergo six chemo treatments every three weeks for four months, will get a CT scan to check if the mass has reduced in size. After completion of her chemotherapy treatments, a PET scan will reveal whether she is cancer free.
Now she is urging others to get checked if they noticed something different within their bodies, “even if it is small.”
Why Sneaky Lymphoma Symptoms Make Cancer Diagnosis Difficult
Lymphoma is a cancer that often creeps in silently, without symptoms. And even when people do have signs, they don't necessarily point directly to cancer. For example, swollen glands are much more likely to be from an upper respiratory infection than lymphoma.
The sneaky nature of symptoms, coupled with a lack of screening for lymphoma, leads many people to be diagnosed at an advanced stage 3 or 4. By that point, the cancer may have already spread throughout their body. Yet even at a late stage, the outlook isn't as dire as many people might assume.
Related: 6 Symptoms of Lymphoma & How to Spot Them
"The one thing that I always reassure people about when they are diagnosed with advanced-stage lymphoma is that, unlike other cancers, where the advanced stage is a death sentence, that's certainly not the case for lymphoma," Dr. Elise Chong, medical oncologist at Penn Medicine, told SurvivorNet in a previous interview.
For example, the 5-year relative survival rate for early-stage follicular lymphoma is 96%. Once the disease has spread, the 5-year survival rate is 85% still good odds.
"We have many treatments with which people can either be cured with advanced-stage lymphoma or have very good remissions," added Dr. Chong. "So it doesn't change how treatable someone is, even when they do have advanced-stage lymphoma."
Symptoms of non-Hodgkin Lymphoma
Plastiras decided to seek medical advice when she began experiencing breathlessness and a cough.
Both symptoms are in line with the most common signs of the disease, which include:
- Fever
- Swollen lymph nodes in the neck, armpits, or groin
- Chest pain
- Abdominal pain
- Coughing
- Trouble breathing
- Constant fatigue
- Night sweats
- Sudden and unexplained weight loss
Individuals who suddenly experience any of these symptoms should consider scheduling an appointment with a doctor.
Non-Hodgkin Lymphoma: Symptoms & Diagnosis
Non-Hodgkin Lymphoma: It's More Than Just One Type
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.
Learning The Different Types of Non-Hodgkin Lymphoma
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, hairy cell leukemia, and Grey Zone Lymphomathe type Erinn Shaw was diagnosed withbut they are rare.
Related: Finding Lymphoma Early: Do you Know the Symptoms and Risks?
According to a case report in the Journal of Hematology, “Gray zone lymphoma (GZL) is an uncommon neoplasm with intermediate features of both classic Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL). It was identified in the World Health Organization (WHO) classification as its own neoplasm in 2008.”
What Are T-Cell Lymphomas?
The other category of non-Hodgkin lymphoma are the T-cell lymphomas. T cells either destroy germs themselves, or boost the activity of other immune cells. These types of lymphomas are much less common than B-cell cancers, affecting only about 15% of people with non-Hodgkin lymphoma.
T-cell lymphoma comes in different types, and all of them are pretty rare.
T-lymphoblastic lymphoma/leukemia affects mostly teens and young adults. It grows quickly, but is very curable.
Peripheral T-cell lymphomas are a group of cancers that develop in mature T cells. Depending on the type, they can affect a variety of organs, including the skin, lungs, and intestines. Some of these cancers grow faster than others.
Next Steps
Once your doctor has identified which type of non-Hodgkin lymphoma you have, you'll talk about treatments. Which therapy your doctor recommends will depend on your cancer type, where it is in your body, and how aggressive it is. Make sure you understand why your doctor has suggested a particular treatment and how it might help you before moving forward.
Contributing: SurvivorNet Staff
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