Albert Malcolm, MD, Medical Oncologist, Discusses Lymphoma Video Transcript

I’m Dr. Albert Malcolm. I’m a medical oncologist and I’ve worked in Middletown for over 20 years.

What is Lymphoma?

Lymphoma is a cancer of the cells of the lymph system. The lymph system is what we think of as the lymph nodes or the glands that swell up when we have infections. They protect us from infections getting into the blood stream. There are different types of lymph cells. There are B cells which make antibodies and help us with vaccines and protect us from infections. There are the T cells which are part of the lymph system which help orchestrate and sometimes help directly kill bacteria or tumor cells.

Symptoms of Lymphoma

Lymphoma generally presents as swollen lymph glands that are usually not tender. They enlarge over time, sometimes rapidly if it’s a higher grade lymphoma; very slowly if it’s a low grade lymphoma. Many times people have a feeling of fatigue or tiredness. Sometimes changes in sense of taste and appetite and then weight loss will go along with it. They can get more frequent infections but that’s not usually a common presenting sign. It’s overall a change in how they feel. Fatigue is a very common symptom in people who develop lymphoma.

Treatment of Lymphoma

Lymphomas are a complex grouping of diseases that span from T and B cell lymphomas which are different from each other. Those would be non-Hodgkin’s lymphomas and then the classic Hodgkin’s disease that we’ve all heard about over the years. The treatments are now based on what sub-type of lymphoma it is and the aggression of the lymphoma. Low grade lymphomas tend to be treated with less aggressive treatment and are generally not curable. Whereas the intermediate and higher grade lymphomas carry a chance of cure but also progress faster.

Early Detection

Early detection of almost all diseases is advantageous to the individual. We would say they have less bulk of the disease therefore they would tolerate the treatments better. They are usually more fit, they have better energy, better protein status and better immune function when they are found earlier rather than later. It doesn’t matter as much in low-grade lymphomas but it absolutely important in intermediate and high-grade.

Risk Factors

There are some conditions that are inherited that can increase the risk of lymphomas. Having certain autoimmune diseases and treatments for that can increase the risk of lymphomas. Also, people who are on immunosuppressive drugs, in other words to control their immune systems so that they don’t reject organs or have autoimmune diseases such a lupus or psoriasis can be predisposed to develop lymphomas. This has been known for a long period of time and of course if you watch the TV commercials for many of the psoriasis drugs they have in there a warning that they can predispose to lymphoma.

Lymph Node Enlargement

If one has enlarged lymph nodes and they are tender, generally we would want to wait until we are sure that they are not caused by infection. That’s a normal response in the body. However, if lymph nodes stay enlarged over a period of many weeks or months, they should be investigated for the possibility of lymphoma although some can be lymph nodes that don’t go back to normal after infections but particularly if they are not tender and have been there quite a period of time, more than a few weeks, then they need to be evaluated for the possibility of developing one of these lymphomas.

Care at Atrium

The cancer program at Atrium Medical Center has been approved by the American College of Surgeons with commendation. It takes a lot of work to achieve that and proof of ongoing improvement and quality care that’s delivered in the institution. It’s a part of reaffirming that we do what we need to do to give our community the highest level of care available.

We work closely with Atrium Medical Center to help provide comprehensive cancer care for our patients. We have the availability of radiation therapy, robot-assisted surgery and skilled professionals.

Clinical Trials

Lymphoma has standard treatments available however when available one should consider inclusion in a clinical trial because it gives the opportunity to have either newer treatments or standardization of treatment that’s regulated very closely now.