Follicular lymphoma
Follicular lymphoma is a slow-growing cancer that affects the B-cell lymphocytes in the body. It typically begins in the lymph nodes but can often spread to other areas of the body including the bones, bone marrow and internal organs such as the spleen and the liver. It is classified as a Non-Hodgkin’s lymphoma and accounts for approximately twenty to thirty percent of all NHL cases.
Most patients who are diagnosed with follicular lymphoma show no symptoms until the disease has reached the latter stages. When symptoms do occur, they include swollen lymph nodes in the neck, groin or armpit areas that are not painful. Other symptoms include fatigue, night sweats, unexplained weight loss and fever. If follicular lymphoma is suspected, a physician will typically perform a biopsy on the affect lymph nodes as well as a CT or PET scan, chest x-ray and other diagnostic tests such as blood tests to determine a diagnosis.
Stage I follicular lymphoma typically includes only one group of lymph nodes that are affected. Stage II of the disease is when it spreads to two lymph node groups or more than one section of organ tissue or to nearby tissues or organs. Stage III includes lymph node groups that are located on both sides of the diaphragm. Stage IV is the most critical stage and involves the disease spreading to multiple internal organs. These can include the blood stream, bone marrow and the liver.
Follicular lymphoma is also divided into three different grades. These are based on the ratio of the sizes of the B-cells that are affected by the cancer. In grade 1 follicular lymphoma, the cancer is made up of only smaller cells. During grade 2, the cancers is made up of a mixture of both small and large cells and in grade 3, mostly larger cells are affected. This is also typically the most aggressive grade of the cancer.
Prognosis for follicular lymphoma is typically positive even in the latter stages of the cancer. There is currently a seventy percent survival rate at the ten-year mark of the disease. Treatment for the cancer is typically based on the stage or the severity of the disease. Follicular lymphomas have shown to be very sensitive to chemotherapy and radiation and treatment for the cancer has been highly effective in most patients.
Treatment methods may include radiation treatment, particularly in the earliest stages of the cancer. Radiation is typically performed for stages I and II. Chemotherapy is also used, normally in the latter stages of the disease as well as monoclonal antibodies like Zevalin or Rituximab. Many patients respond to combined treatment regiments like those that use both chemotherapy and monoclonal antibodies. Steroids are also typically prescribed in order to lower the risk of internal swelling during treatment. Patients who experience relapsed or recurring bouts of follicular lymphoma are typically treated with stem cell transplants.
If a patient is diagnosed with the disease but shows no symptoms, treatment is typically held until symptoms do occur. This “wait and watch” treatment method shows the same survival rate for patients as other methods that include treating the patient before symptoms are evident. When a patient begins to experience symptoms, the proper treatment is given. Clinical trials are also being held for follicular lymphoma. Patients who need more advanced treatment or who have follicular lymphoma that is not responding to other forms of treatment are typically encouraged to consider clinical studies that include newer treatment methods that have not yet been introduced to the average consumer.
The actual treatment method for each patient will depend on a number of factors including the stage of the disease, the overall general health of the patient and the preference of the doctor. Other factors that may be considered are the location of the patient and the specific facility where he or she will receive treatment.
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