Black people are less likely than White people to develop non-Hodgkin lymphoma, but studies such as this one show that they have poorer outcomes. Existing racial and socioeconomic disparities among patients with non-Hodgkin lymphoma continue to lead to obstacles with access to newly available treatment options, explained Mary Jo Lechowicz, MD, in a presentation during the American Society of Hematology 2021 Annual Meeting. “African American patients have the worst median overall survival compared with…White patients,” said Dr. Lechowicz.
Although systemic racism and bias in medicine are the main reasons we see differences in outcomes for Black people—and tackling these issues is critical to achieving equity—awareness and education may also help narrow the gap by promoting earlier detection and prevention.
What is non-Hodgkin lymphoma?
Non-Hodgkin lymphoma (also known as NHL or just lymphoma) is a type of cancer that begins in infection-fighting white blood cells called lymphocytes. Lymphocytes are part of the lymphatic system, a network of organs (including lymph nodes) and vessels that filter body fluids of toxins and transports infection-fighting cells throughout the body.
Lymphocytes are tasked with distinguishing normal healthy cells from potentially dangerous invaders. But in patients who develop NHL, lymphocytes become abnormal themselves, multiplying out of control and collecting in lymph nodes and other tissues.
According to the American Cancer Society, non-Hodgkin lymphoma is one of the most common cancers in the United States, accounting for about 4% of all cancers. The health organization estimates that in 2022, about 80,470 will be diagnosed with NHL (including both adults and children) and 20,250 will die from this cancer (11,700 males and 8,550 females).
There are many different types of non-Hodgkin lymphoma, and they are categorized by how the cells look under a microscope and how they behave. Most types of NHL are either B-cell lymphoma or T-cell lymphoma. According to the American Cancer Society, B-cell lymphomas make up most (about 85%) of the non-Hodgkin’s lymphomas in the U.S. B-cell and T-cell lymphomas can further be divided into one of two categories based on how quickly the cancer cells are growing: aggressive (fast-growing) or indolent (slow-growing).
How do you know if you have non-Hodgkin lymphoma?
Signs and symptoms of non-Hodgkin’s lymphoma may include:
- Swollen lymph nodes in your neck, armpits, or groin (a main symptom that leads to an NHL diagnosis)
- Fever
- Night sweats
- Unexplained weight loss
- Persistent fatigue (feeling very tired)
What are the risk factors for developing non-Hodgkin lymphoma?
NHL can occur at any age. In fact, it is one of the more common cancers among children, teens, and young adults. Still, the risk of developing NHL increases throughout life, and more than half of patients are 65 or older at the time of diagnosis. The aging of the American population is likely to lead to an increase in NHL cases during the coming years. In the U.S., Whites more likely than Blacks and Asian Americans to develop NHL. Worldwide, NHL is more common in developed countries, with the U.S. and Europe having some of the highest rates. Some types of lymphoma are linked to certain infections that are more common in some parts of the world.
The exact cause of NHL is not known, but there are risk factors that may increase the likelihood of developing the disease. Factors affecting people’s risk of developing NHL have been studied extensively. Some of these factors are immune disorders, certain medicines, infections, lifestyle, family history, and occupational factors. For example, the risk of developing lymphoma and other cancers may be higher for butchers, car repair workers, gasoline station workers, agricultural and chemical workers, radiation-exposed groups such as uranium mine workers, nuclear industry workers, nuclear test site workers and “downwinders” (residents of cancer “hot spots” or other contaminated areas), according to this study.
How can I reduce my risk of developing non-Hodgkin lymphoma?
In 2008-2009, The President’s Cancer Panel issued “Reducing Environmental Cancer Risk: What We Can Do  “ with recommendations that can be taken to reduce cancer risk related to environmental contaminants, excess radiation, and other harmful exposures. Additionally, viral infections (particularly HIV) can lead to lymphoma. Avoidance of infection and high-risk practices is advisable. It is also recommended that you eat a healthy, nutritious diet, remain physically active, and exercise regularly.
What should I do if I suspect I might have non-Hodgkin lymphoma?
First of all, please keep in mind that the signs and symptoms of NHL are also associated with a number of other less serious diseases. Even if you have all the symptoms listed above, you may not have lymphoma or cancer. Nevertheless, if you have signs or symptoms that suggest the possibility of NHL, you should be seen by your doctor as soon as possible. If the doctor suspects lymphoma, additional tests, and possibly a tissue biopsy, may be ordered to make a diagnosis. Â You may also be referred to a blood cancer specialist called a hematologist-oncologist, which is the type of doctor who treats lymphoma.
What treatments are available for non-Hodgkin lymphoma?
Several NHL treatments are available. Which treatment or combination of treatments is best for the patient will depend on the particulars of their lymphoma, such as the types of cells involved and how fast the lymphoma is growing (whether it is indolent or aggressive). A doctor also considers the patient’s overall health and preferences. If a person’s lymphoma appears to be slow-growing (indolent) and does not cause symptoms, treatment might not be needed right away. Instead, a doctor may recommend regular checkups every few months to monitor the patient’s condition and whether the cancer is advancing. If a patient’s NHL is fast-growing (aggressive) or causes symptoms, a doctor may recommend treatment right away. Options may include chemotherapy, immunotherapy, targeted drug therapy, bone marrow transplant, and radiation.
Taking part in a clinical trial may be the best therapy for some NHL patients, according to the Leukemia & Lymphoma Society. Clinical trials are underway to develop treatments that increase the remission and/or cure rate of the disease. Click here to read more about clinical trials.
