Microscopes and Hodgkin's Lymphoma - Understanding the Pathophysiology of a Common Cancer

First off What is Lymphoma?

We have to first define what lymphoma is before discussing Hodgkin's disease. Lymphoma is a cancer that develops from cells in the body known as "lymphocytes." Lympocytes are a subcategory of white blood cells. There are two different types of lymphocytes: B-cells and T-cells. Almost all lymphomas, including Hodgkin's disease, stem from B-cells.

In Hodgkin's lymphoma a B-cell, for unknown reasons, becomes cancerous. The cell then makes many many clones of itself. These cells bundle together to form a solid tumor known as a lymphoma. There are several hypotheses for why these cells become cancerous in Hodgkin's. One belief is that infection with Epstein-Barr virus (EBV, the same virus that causes infectious mononucleosis) can cause the cells to turn malignant in genetically susceptible people. Other theories are that certain genetic translocations may be the underlying factor. As of yet, no particular theory has significant supporting data to call it the "cause." In fact, there may be multiple unrelated causes.

Types

There are different subcategories of Hodgkin's lymphoma. They are based on several microscopic characteristics, and are important in determining prognosis. The features the pathologist is looking for are the number of Reed-Sternberg cells, as well as the number of lymphocytes present in the biospy specimen. A Reed-Sternberg cell is a funny shaped cell with two nuclei that looks like owl's eyes.

The first subcategory, and most common type, is nodular sclerosing Hodgkin's lymphoma. In this type there are very few Reed-Sternberg cells with a moderate number of lymphocytes. It commonly occurs in younger individuals, and with treatment, the prognosis is excellent.

The second subcategory is mixed cellularity Hodgkin's lymphoma. This type has many Reed-Sternberg cells and a moderate number of lymphocytes when viewed under the microscope. It has an intermediate prognosis.

The third subcategory is lymphocyte predominant Hodgkin's. It has very few Reed-Sternberg cells and many lymphocytes. It occurs most commonly in males less than 35 years of age. It is also one of the few types that is not associated with Epstein-Barr virus infection.

Multiple Myeloma, a Blood Plasma Cancer, and the Arkansas Treatment

Within the last 20 years, the Arkansas Treatment has been developed for patients suffering from Multiple Myeloma. An acquaintance of the author's, who was treated with this chemotherapy regimen several years before his own diagnosis, had to travel to Arkansas to receive the treatment. After being diagnosed in June, 2008 with multiple myeloma, the author was able to receive this chemotherapy regimen locally near his home in the Upstate of South Carolina.

This treatment uses several different drugs during chemotherapy, followed by an autologous stem cell transplant. The full treatment actually calls for a tandem stem cell transplant (two in succession.) Whereas years ago, the only treatment for multiple myeloma was the drug that directly targets the cancerous cells (and then also targets lots of good cells as well), the several drugs used in this treatment all target the abilities of the cancerous cells to reproduce and encourage the body's normal disease fighting cells to eliminate them.

This treatment uses thalidomide as the main, cancer-fighting, oral drug, plus a cocktail of chemotherapy drugs which include bortezomib, cyclophosphamide, etoposide, cisplatin, doxorubicin, and dexamethasone. A variety of other drugs such as antibiotics, to help the body's impaired immune system, anti-nausea drugs, and pain killers (steroids) are administered concurrently.

With the older treatments directly targeting the cancerous cells, the life expectancies of multiple myeloma patients were on the order of two to four years following diagnosis. Since those drugs adversely affected many good body cells as well as the cancerous cells, the patients' bodies took a major hit every time the drug was administered. A high dose of that same drug (or similar ones) is part of the stem cell transplant procedure. Following the administration of the high dose drug, the author's white blood cell count was near zero. Fortunately, the stem cell transplant immediately followed the administration of the high dose, so his body was able to recover from the high dose by creating new stem cells and new good blood cells.

Newer treatments such as the Arkansas Treatment use drugs that target the cancerous cells indirectly. They attempt to turn OFF the ON switch that tells the cancerous cells to reproduce ad infinitum. They attempt to block blood supplies which allow the cancerous cells to flourish. They attempt to block signals sent from the cancerous cells to normal body disease-fighting cells that says, in effect, "I am a normal cell -- leave me alone." They attempt to encourage the body's disease-fighting cells to go after those cancerous cells and do their jobs -- that is, to eliminate them as unwanted cells in the body. Obviously, this is a layman's explanation of the tasks requested of the drugs in this treatment regimen, but you get the idea.

Since these drugs are not directly expected to kill the cancerous cells, they are much less harmful to the good cells of the body. This does not mean they are harmless to normal body cells. They still are quite potent chemicals that should not be used lightly. But they appear to each work well to perform the jobs requested of them. Life expectancies of patients receiving the Arkansas treatment are listed as ten plus years, and climbing.

Major side effects occur with this treatment regimen, but they appear to be worth the inconveniences. In the author's case, the two major side effects are deterioration of the heart muscle, and peripheral neuropathy. The author's heart efficiency deteriorated sufficiently over the course of treatment that he was prevented from receiving the second stem cell transplant. Having read lots of information on the internet prior to and during treatments, he somehow missed the possibility that the chemo drugs could adversely affect the heart muscle. The efficiency of his left ventricle went from normal values above 50% all the way down to 26%. At this low level, he was treated for congestive heart failure. The cardiologist said, however, that in many cases, the heart can recover from chemo-induced levels like this. This, in fact, has happened in the author's case. His heart's efficiency has risen once again to near-normal levels.

After the heart's efficiency problems were diagnosed, the author searched for and found several articles that did indeed warn that some of the chemo drugs used in this regimen can adversely affect the heart muscle. One of the drugs, in particular, was listed as prone to causing heart problems. When he asked one of the chemo nurses which of the medications could adversely affect the heart, she answered, "Oh, they probably all do."

The peripheral neuropathy is a major nuisance, but it does not appear to be a life-threatening problem. The author's fingers and toes all tingle and feel somewhat numb most of the time. The cancer drugs, and even the cancer maintenance drugs, appeared to cause these problems. After the main cancer medications were stopped, the tingling and numbness receded a little, but not completely. There were days following the chemo treatments when the author's hands hurt -- especially when holding or touching cold items. Today, they are tingly but that sensation can be ignored most of the time.

The author's body is currently "as clean of the cancerous cells as possible," according to his oncologist. This doctor also commented during that visit that many don't appreciate the gravity of that statement. "Years ago, half of the people who contracted multiple myeloma died within 3 years of diagnosis." Those numbers are greatly extended now due to chemo regimens like the Arkansas Treatment.

Dennis Dinger is a survivor of multiple myeloma. Diagnosed in June, 2008, he received five cycles of the Arkansas Treatment: four of chemotherapy, plus the fifth -- the high dose and the autologous stem cell transplant. His book, My Bout with Multiple Myeloma, chronicles his battle - to include the year prior to diagnosis, the treatments, and the recuperation period following all treatments. Throughout 2010, the cancer was in complete remission. For more details on the book, click on Multiple Myeloma.

In this book, he includes descriptions of most of the procedures to which he was subject, he gives helpful hints and suggestions to others who may have to deal with this or other cancers. The book was written for those who have been similarly diagnosed, as well as for their family members and friends who may be called upon to support their loved ones through similar battles.

Dennis Dinger is a Christian who is a Professor Emeritus of Ceramic and Materials Engineering at Clemson University.

Since his cancer diagnosis and treatments, he has been spending his days studying and writing Christian books. His most recent book attempts to bridge the chasm between technology and Christianity. It is entitled Global Climate Change, the Bible, & Science. His other Christian books are The Coming of the Lord Draweth Nigh, a study of prophecy and the Revelation, The Tribulation to Come, a study of the Revelation of John, and Absolute Truth for a Relative World.

Products We Use That Help Eliminate Side Effects

I would like to start by saying this is in no way meant to solicit you to buy the products we used for our little Emma. I am writing this to give you insight into what we did and what worked for all the side effects we were told would be part of her treatments.

Here is our story. On July 2, 2010, my wife took Emma (who was 4 ½ at the time) to a doctor's appointment because she looked a bit pale and we noticed a few spots on her neck that were not normal. Our doctor called a pediatrician and they advised us to get blood work done as soon as we could. This happened at our local hospital at 4pm and by 6pm we were back at the hospital where we were told that she had high risk B-cell ALL (an extremely high white blood count). Our lives changed in an instant as you are all aware. By 9pm, my wife and daughter were on their way to BC Childrens Hospital to start her treatments immediately.

For work, my wife and I operate a home based business as Independent Herbalife Distributors (an International company in the Health and Wellness industry). I am telling you all this to show a few things. This disease has no prejudice as it will afflict anyone; young, old, healthy or ailing. Emma has never had any major ailments and very few simple colds ever since she was born. We started her on natural children's supplements, and she voluntarily started having a morning shake every day. This turned out to be a good thing because while she was in the hospital, she did not want to eat "real" food but we were able to keep her strength up with the good nutrition in the shakes. Of course we made sure with the doctors that what we were giving her was not conflicting with any of the medication she was getting.

Secondly we were able to keep working as our business is done on the internet, over the phone and other simple methods, which meant we did not have to take time off our "jobs" or leave them altogether to be with Emma during this time. We have heard about so many others that had financial hardships and job issues because of this. After speaking with other parents of children at the hospital and clinic, as well as others from our church that had children with the same affliction, we made the decision to have all Emma's treatments done where the care is the best, at BC Childrens Hospital. This meant that we needed to move off the island which was a tough but necessary move. Again we were able to do this with very little disruption to our business (which means our income as well), while always being available for Emma.

So here is what we have been doing for Emma over the past 9 months - I cannot believe it has been that long already - and what has been happening. Every morning she has a Herbalife meal replacement shake made from ½ cup water and 1 cup milk. As lack of appetite is one of the side effects, we needed to make sure she was getting the appropriate nutrition for the day and as these provide it, we were glad that she would still have them. Another good thing is that while she is on steroids, she does not gain as much weight due to cravings caused by them. This shake has also given her a lot of energy which the doctors are very impressed about. Another side effect is nausea and constipation. For this, she is having Herbal Aloe Concentrate - which comes in regular or Mango flavor which she goes between depending on her tastes which changes when she has chemo treatments. This is a liquid that you drink which protects and heals your insides as well as prevent other internal issues. During one hospital visit, she was getting a high dose of Methotrexate and they decided to give her a stool softener and against our better judgment, we agreed. She developed blisters and burns on her bum due to this so bad that they prescribed Morphine for the pain. We increased the doses of Aloe, applied Vaseline and kept her clean, and within three days it was all cleared up. The doctors and nurses continue to be amazed at Emma's lack of side effects and at how well she handles her procedures. She is active and normally has a smile on her face, however she has the odd days where she gets tired and moody due to the drugs.

My suggestion for all that are either going through treatments or have someone they love going through, that they find themselves these products: A healthy meal replacement shake that tastes good and has a good amount of nutrients for the day. You need to keep your strength up and proper nutrition is key to this. A liquid Aloe product that you can take as it will settle your stomach and help prevent nausea and constipation. The aloe will also help with mouth sores that can accompany the chemo tablets you take at home. We are willing to answer any questions concerning what has worked for us as well as any other nutritional questions you might have, just send me a message at mbarts2009@gmail.com and my wife and I will get back to you.

With a degree in Business Marketing, a background in senior level management, I have learned a lot about people and what it takes for a business to succeed in different markets. Through all my experiences, I have done extensive customer service work, performed a lot of individual and group training as well as a large amount of different types of marketing. I would like to share my thoughts, ideas and comments to give you something to think about.

Some Lymphoma Symptoms

Lymphoma is a kind of cancer that affects the patient's lymphatic cells. These are part of the immune system. Naturally, it is a serious medical condition. Someone that has this cancer may show lymphoma symptoms. Do keep in mind, however, that a person could have this malignancy without displaying any of the symptoms mentioned here. Also, what you read on this page isn't a complete list -- nor is it, of course, intended to be used in place of advice from a doctor.

Anemia

The condition known as anemia may develop as one of the lymphoma symptoms. While anemia can refer to multiple situations, in many cases it is an instance of fewer than normal red blood cells in the individual's blood. This can medically occur in multiple ways: whether by a lack of sufficient production of them, by their destruction in high amounts, or by a the loss of a significantly high amount of blood. These, at least, are the three main ways in which it can occur.

Aside from lymphoma, other medical causes of anemia are also possible. For instance, it may be due do a deficiency in vitamin B12. In this case, the condition is labeled as the pernicious form.

Shortness of breath

A person who has lymphoma may also experience breathlessness as a symptom. This is far from the only medical cause, however. Congestive heart failure is another possible reason. It can also occur in instances of chronic obstructive pulmonary disease, which is where chronic bronchitis and emphysema are present at once. Asthma is also a reason behind shortness of breath. Pneumonia and many other medical reasons can also be behind it. There are various diagnostic methods that can be used to look for or rule out possible causes, with a chest X-ray being one of the possibilities. There may be particular treatment methods that are aimed at this cause, if it is found.

New T-Cell Therapy May Be a Powerful Cancer Fighter

Researchers have been working hard to find a way to use the body's own t-cell's to fight cancer and destroy it. Clinical trials have been conducted and some people who were participants have gone into complete remission using this exciting and novel new approach. This is known as "gene therapy" and researchers have been working furiously for years trying to find ways to utilize the body's own cells to be reprogrammed to fight and destroy cancer cells.

A clinical trial held at The University of Pennsylvania involved providing this treatment to participants who suffered from leukemia. One participant in particular, a man who had suffered from leukemia participated in the trial and it turned his life around for the better. Chemotherapy was no longer effective for his disease. A few weeks after this treatment, he was in complete remission with no trace of cancer to be found. It is now a year later and he is still completely cancer free. There were an additional two patients who participated in this trial. One had another complete remission of the leukemia and the third participant had a partial remission result. These results are extremely promising and plans are being made for further gene therapy trials.

The Procedure: This trial involved the removal of billions of a person's T-cells. T- cells are one of the white cells in the human body whose function is to fight and destroy viruses and tumors. Once these t-cells are removed they are genetically reprogrammed with new genes. These new genes actually teach the t-cells to seek out and destroy cancer in the human body. They are then reinjected back into the patient.

The doctors who are part of the trial are not stating yet that this is a cure. They say the treatment is still experimental and has only involved a few patients. This trial has been written about in The New England Journal of Medicine and Science Translational Medicine. Many researchers are very excited about it and feel it is a significant achievement in the field of gene therapy to fight cancer.

This procedure basically was able to use a person's own immune system to kill cancer cells. Researchers are now trying to determine if other types of cancer might also be responsive to this gene therapy.

The doctors leading this study and trial said they were also stunned by the results of complete remission. Although this is still experimental at this point, researchers hope to replicate this study again and see how it responds to other types of cancer.

Tumor Destruction by T-cells: Scientists are trying to determine how to make these modified t-cells destroy tumors. This particular research study done at The University of Pennsylvania appears to have been able to accomplish this by leaving a population of "memory" t-cells" within the body that will be able to remultiply when needed, as they will recognize the development of cancerous cells.

This gene therapy concept of genetically modifying the body's t-cells really began in the 1980s with research conducted in Israel. Over the years much research has continued to occur in this area and it appears that scientists are making great progress. Researchers are hopeful that one day soon, these "cancer killer" t-cells" will effectively destroy cancer and be available as a therapy option for people suffering from this dreadful disease.

Potential Dangers of T-Cell Therapy: Although this research is incredibly promising there are certain dangers still inherent to it. A person may become vunerable to infection because the treatment will destroy both healthy and cancerous cells simultaneously, in this leukemia case wiping out a patient's entire B-cell population. Doctors are providing these patients with precautions such as periodic infusions of immune building substances to prevent infections from occurring.

Another danger could be the overwhelming number of cancer cells that can die off all at once. This can overwhelm the liver and kidneys and lead to "tumor lyses", a potentially deadly reaction. Doctors are working on this problem by providing drugs which will help protect the kidneys while this process is occurring.

Additionally there may be other reactions which may be life threatening because everybody is unique and the modified t-cells can target cancer cells anywhere in the body. Therefore if there is cancer in the lungs, the lungs may become overwhelmed and the patient can develop breathing problems which can be dangerous. Additionally side effect reactions that occur from this treatment include high fevers and inflammation.

The Future: Researchers are very excited about the future of genetically modified t-cell therapy in treating and even destroying cancer. Although it may be years away, the hope is to perfect the therapy and make it available to anyone who may benefit from it. Many hurdles still exist including how this treatment could be massed produced by the pharmaceutical industry. Until that time, researchers continue to work hard and are grateful for the astonishing results of complete remission they have already achieved in several patients suffering from leukemia.

The Issels Medical Center in Santa Barbara, California is a world renowned alternative cancer treatment center. The Issels Treatment is an Integrative Immunotherapy program with a 50 year history. Founded in 1951 by a pioneer in integrative cancer medicine, Dr. Josef Issels, MD., a German oncologist, The Issels Medical Center in Santa Barbara, California treats patients with all natural non toxic therapies for a variety of health conditions including cancer.

Researchers May Have Found the Leukemia Cause

A new study may shed light into why leukemia, one of the deadliest cancers, develops in the first place.

Although leukemia is one of the best studied cancers, the cause of some types is still poorly understood, but experts in the US say a new method may make it possible for healthcare experts to discover why the disease forms.

Specialists at the Abramson Cancer Center of the University of Pennsylvania said that a newly-found mutation in acute myeloid leukemia patients could account for half of the remaining cases of adult acute leukemia which have no known origin.

Senior author Dr Craig Thompson, director of the facility, said the molecular biology of leukemia has been studied for the last 20 years and experts thought they had found most of the common genes for it.

"Now we're able to point to a distinct type of mutation for half of the remaining leukemia's for which we didn't know the cause and between one-quarter and one-third of leukemia's in older patients.

Every year more than 7,000 people are diagnosed with leukemia in the UK, or around 19 people every day, making it the tenth most common cancer, with more than 4,200 new cases diagnosed in 2006 alone.

The new findings, published this week in Cancer Cell, suggest that acute myeloid leukemia (AML) patients have increased levels of a molecule called 2HG.

AML is a quick-moving, deadly cancer that starts in the bone marrow and soon moves into the blood, and the specialists found that increased amounts of 2HG stem from a mutation in one of two related metabolic enzymes, IDH1 or IDH2.

People Who Died of Mesothelioma

Mesothelioma is a rare form of cancer typically caused by asbestos exposure. Asbestos becomes trapped in the mesothelium, which is the lining of such vital internal organs as the lung, stomach, and heart. It can become cancerous over time, when it is known as mesothelioma. Numerous celebrities and other notable people have died from this disease.

Steve McQueen, a famous American actor principally from the 1960s and 1970s was diagnosed with peritoneal mesothelioma in December 1979. The peritoneum is the lining of the stomach. His mesothelioma was at such an advanced stage that U.S. doctors declined to offer McQueen surgery or chemotherapy due to the risk involved. As a result, Mr. McQueen sought treatment in Mexico.

Despite the risks involved in the procedure, McQueen underwent surgery in Juarez, Mexico to remove a large tumor in his abdomen. McQueen died of a heart attack the day following the surgery on November 7, 1980. McQueen attributed his asbestos exposure to the removing of asbestos lagging from pipes aboard a ship while in the Marines.

In 2006, film and television actor Paul Gleason died of pleural mesothelioma, which affects the lining of the lungs. Gleason played a supporting role in several blockbuster movies from the 1980s including Trading Places, The Breakfast Club, and Die Hard. Gleason believed he got mesothelioma from asbestos exposure while working on building sites when he was young.

More recently, Merlin Olsen, a Professional Football Hall of Fame defensive lineman, actor, and television football commentator died of pleural mesothelioma on March 11, 2010. Olsen was diagnosed in 2009 in the later stages of the disease. He underwent three courses of chemotherapy before his passing.

Olsen filed a lawsuit in December 2009 against NBC Studios, NBC Universal, and 20th Century Fox claiming they exposed him to asbestos, which caused his mesothelioma. Olsen also named Sherwin Williams and Lennox Industries in the suit, as he had worked at a job involving drywall when he was young.