The lymphatic system is part of your immune system.
It helps your body fight infection.
It also helps maintain fluid balance in different parts of your body.
There are 2 main catagories of lymphoma: Hodgkin lymphoma and non-Hodgkin lymphoma.
Hodgkin lymphoma is different from other types of lymphoma. The other types of lymphoma are grouped together and called non-Hodgkin lymphomas.
Gargi Upadhyaya, MD is here to explain the different types of lymphoma and what your diagnoses and treatment options may be.
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How to Better Understand Lymphoma
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Learn more about Dr. Upadhyaya
Gargi Upadhyaya, MD, FACP
Specializing in hematology and medical oncology, Dr. Upadhyaya is board certified in internal medicine. She received her medical degree from Government Medical College, Surat, India. Her residency and hematology and oncology fellowships were completed at Los Angeles County USC Medical Center and City of Hope National Medical Center. She also served as a research fellow in the Hematology and Oncology Division of the Internal Medicine Department of the University of Michigan Medical Center. Dr. Upadhyaya has published articles in the Journal of Clinical Investigation, Blood, and Leukemia and is an active member of the American Society of Clinical Oncology (ASCO).Learn more about Dr. Upadhyaya
Transcription:
How to Better Understand Lymphoma
Melanie Cole (Host): If you’ve been diagnosed with lymphoma or looking for a second opinion, you and your family may be facing a lot of difficult questions. City of Hope’s lymphoma specialists can walk you through the treatment process, address your concerns and create a personalized plan designed to give you the best possible results. My guest today is Dr. Gargi Upadhyaya. She specializes in hematology and medical oncology at City of Hope. Welcome to the show, doctor. Tell us about lymphoma. People hear these words, about non-Hodgkin’s and Hodgkin’s. They don’t know what all of these are. Tell us about lymphoma and the different types.
Dr. Gargi Upadhyaya (Guest): The different types of lymphoma are divided into Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Hodgkin’s lymphoma is one of the diseases that occurs at two extremes at life. They can occur at a younger age and then at the older age between 50-60 years old. It is a very treatable and curable disease. Non-Hodgkin’s lymphoma are different types of lymphomas. They occur usually at a later age in life and are divided into high-grade and low-grade lymphomas. Hodgkin’s lymphoma is treated with chemotherapy every two weeks and we get a very good response. People are cured of that lymphoma. They go through treatment with not much difficulty. The non-Hodgkin’s lymphoma, the low-grade lymphomas, do respond very well to treatment; however, they are not cured. Having said that, non-Hodgkin’s lymphomas that are low-grade, even though they are not cured, they are very treatable and are not life-threatening. High-grade lymphomas are a little bit of difficulty to respond; however, people who respond to therapy live a very long and fruitful and happy life. If the patients do not respond to chemotherapy, we, at City of Hope, have secondary options of going through bone marrow transplants. City of Hope is known to be one of the best places in the world for bone marrow transplants.
Melanie: People hear lymphoma and because breast cancer, prostate cancer, these things are detectable, they are at one place but lymphoma is more of a systemic. It can be running through your blood stream. So, that scares people just a little bit more. How is lymphoma detected? Are there any symptoms or red flags that you would have sent up? Is there any screening available?
Dr. Upadgyaya: There’s no screening for lymphoma; however, there are symptoms that we all can look for and look out for. Number one is weight loss. If you lose more than 10% of your body weight without trying in a short amount of time, by saying short amount of time it would be 4-6 weeks or you have unexpected fevers, night sweats, which are drenching that you have to either change your sheets or shirt or clothes at night because of sweating or you have reoccurring infections meaning you have sinus infections and, two weeks later, you end up having a urinary tract infection. Any of those things that happen, you would get suspicious and you would go to see your doctor. Also, if you have any glands that are growing and you don’t have any symptoms, you still need to go see your doctor. Usually, you would see glands in the neck or in the armpit area that would be suspect that something is going on in your body.
Melanie: Do you ever remove those glands? Is it possible to have these glands removed and, thereby, stop the spread or is this usually a type of cancer that spreads pretty rapidly?
Dr. Upadgyaya: The treatment is not removal but we do remove one gland. That’s called an “excisional biopsy of the lymph node” to establish the diagnosis. Once diagnosis is confirmed, then chemotherapy is the mainstay of treatment. We do not treat lymphoma with surgery. When we start chemotherapy, the medication goes through the blood stream and helps kill the cancer cells and get the rapid response. Therefore, we do not need to have a surgical approach.
Melanie: So, doctor, is there a genetic component? What puts someone at risk and are there any preventive measures that they can do to protect themselves from lymphoma?
Dr. Upadgyaya: It is known to run in families but there are no genetic tests for lymphoma. Like breast cancer, we do not have the BRCA-1 or two genes or any other gene telling us that you are at high risk. However, if your family members--mother or father--have been diagnosed with lymphoma at a younger age, it would be a good idea to you have yourself checked out and have a regular physical exam once a year. Look out for enlarged nodes. If you notice that you have trouble swallowing or you have trouble breathing, get medical attention right away and do not delay it.
Melanie: Would something show up on a routine blood test?
Dr. Upadgyaya: There is no blood test. There is the suspicion on a blood test to tell us whether a person has lymphoma if their white count is low or they are anemic but that does not confirm it. We have to confirm it with further testing and a biopsy.
Melanie: And, doctor, tell us what’s exciting. What are you doing at City of Hope for lymphoma patients?
Dr. Upadgyaya: There are lots of new treatments that are coming out at this point. There is immunotherapy where patients are responding with minimal side effects and also we have maintenance therapy which prevents the risk for reoccurrence. That is after a person has responded completely to therapy, they can be treated with maintenance therapy and the risk of reoccurrence decreases. People who don’t respond well and about 20-30% are patients with lymphoma who either reoccur or do not respond .In the first line therapy, we have bone marrow transplants and we treat with high dose chemotherapy followed by autologous bone marrow transplant.
Melanie: In just the last few minutes, and its great information, tell patients why they should come to City of Hope for their lymphoma care.
Dr. Upadgyaya: It is one of the nation’s largest clinical hospitals for bone marrow transplants. We have expert doctors like Dr. Forman and Dr. Alexandra Levine who are would renowned in the treatment of lymphoma. They would get the best of care with the best nursing staff and the best facility ever.
Melanie: Thank you so much, doctor, for being with us today. You’re listening to City of Hope Radio. For more information you can go to CityofHope.org. That’s CityofHope.org. This is Melanie Cole. Thanks so much for listening.
How to Better Understand Lymphoma
Melanie Cole (Host): If you’ve been diagnosed with lymphoma or looking for a second opinion, you and your family may be facing a lot of difficult questions. City of Hope’s lymphoma specialists can walk you through the treatment process, address your concerns and create a personalized plan designed to give you the best possible results. My guest today is Dr. Gargi Upadhyaya. She specializes in hematology and medical oncology at City of Hope. Welcome to the show, doctor. Tell us about lymphoma. People hear these words, about non-Hodgkin’s and Hodgkin’s. They don’t know what all of these are. Tell us about lymphoma and the different types.
Dr. Gargi Upadhyaya (Guest): The different types of lymphoma are divided into Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Hodgkin’s lymphoma is one of the diseases that occurs at two extremes at life. They can occur at a younger age and then at the older age between 50-60 years old. It is a very treatable and curable disease. Non-Hodgkin’s lymphoma are different types of lymphomas. They occur usually at a later age in life and are divided into high-grade and low-grade lymphomas. Hodgkin’s lymphoma is treated with chemotherapy every two weeks and we get a very good response. People are cured of that lymphoma. They go through treatment with not much difficulty. The non-Hodgkin’s lymphoma, the low-grade lymphomas, do respond very well to treatment; however, they are not cured. Having said that, non-Hodgkin’s lymphomas that are low-grade, even though they are not cured, they are very treatable and are not life-threatening. High-grade lymphomas are a little bit of difficulty to respond; however, people who respond to therapy live a very long and fruitful and happy life. If the patients do not respond to chemotherapy, we, at City of Hope, have secondary options of going through bone marrow transplants. City of Hope is known to be one of the best places in the world for bone marrow transplants.
Melanie: People hear lymphoma and because breast cancer, prostate cancer, these things are detectable, they are at one place but lymphoma is more of a systemic. It can be running through your blood stream. So, that scares people just a little bit more. How is lymphoma detected? Are there any symptoms or red flags that you would have sent up? Is there any screening available?
Dr. Upadgyaya: There’s no screening for lymphoma; however, there are symptoms that we all can look for and look out for. Number one is weight loss. If you lose more than 10% of your body weight without trying in a short amount of time, by saying short amount of time it would be 4-6 weeks or you have unexpected fevers, night sweats, which are drenching that you have to either change your sheets or shirt or clothes at night because of sweating or you have reoccurring infections meaning you have sinus infections and, two weeks later, you end up having a urinary tract infection. Any of those things that happen, you would get suspicious and you would go to see your doctor. Also, if you have any glands that are growing and you don’t have any symptoms, you still need to go see your doctor. Usually, you would see glands in the neck or in the armpit area that would be suspect that something is going on in your body.
Melanie: Do you ever remove those glands? Is it possible to have these glands removed and, thereby, stop the spread or is this usually a type of cancer that spreads pretty rapidly?
Dr. Upadgyaya: The treatment is not removal but we do remove one gland. That’s called an “excisional biopsy of the lymph node” to establish the diagnosis. Once diagnosis is confirmed, then chemotherapy is the mainstay of treatment. We do not treat lymphoma with surgery. When we start chemotherapy, the medication goes through the blood stream and helps kill the cancer cells and get the rapid response. Therefore, we do not need to have a surgical approach.
Melanie: So, doctor, is there a genetic component? What puts someone at risk and are there any preventive measures that they can do to protect themselves from lymphoma?
Dr. Upadgyaya: It is known to run in families but there are no genetic tests for lymphoma. Like breast cancer, we do not have the BRCA-1 or two genes or any other gene telling us that you are at high risk. However, if your family members--mother or father--have been diagnosed with lymphoma at a younger age, it would be a good idea to you have yourself checked out and have a regular physical exam once a year. Look out for enlarged nodes. If you notice that you have trouble swallowing or you have trouble breathing, get medical attention right away and do not delay it.
Melanie: Would something show up on a routine blood test?
Dr. Upadgyaya: There is no blood test. There is the suspicion on a blood test to tell us whether a person has lymphoma if their white count is low or they are anemic but that does not confirm it. We have to confirm it with further testing and a biopsy.
Melanie: And, doctor, tell us what’s exciting. What are you doing at City of Hope for lymphoma patients?
Dr. Upadgyaya: There are lots of new treatments that are coming out at this point. There is immunotherapy where patients are responding with minimal side effects and also we have maintenance therapy which prevents the risk for reoccurrence. That is after a person has responded completely to therapy, they can be treated with maintenance therapy and the risk of reoccurrence decreases. People who don’t respond well and about 20-30% are patients with lymphoma who either reoccur or do not respond .In the first line therapy, we have bone marrow transplants and we treat with high dose chemotherapy followed by autologous bone marrow transplant.
Melanie: In just the last few minutes, and its great information, tell patients why they should come to City of Hope for their lymphoma care.
Dr. Upadgyaya: It is one of the nation’s largest clinical hospitals for bone marrow transplants. We have expert doctors like Dr. Forman and Dr. Alexandra Levine who are would renowned in the treatment of lymphoma. They would get the best of care with the best nursing staff and the best facility ever.
Melanie: Thank you so much, doctor, for being with us today. You’re listening to City of Hope Radio. For more information you can go to CityofHope.org. That’s CityofHope.org. This is Melanie Cole. Thanks so much for listening.