Something I’ve always wondered is why there’s two different types of lymphoma, one apparently discovered by a guy named Hodgkin’s. You never hear anyone talk about Steve’s prostate cancer and non-Steve’s prostate cancer. Why the difference?
Also, it seems to me that non-Hodgkin’s is a lot more common than Hodgkin’s, when you’d think the named one would be more common. Or is that confirmation bias?
Back in 1832 John Hodgkin described an abnormal growth of lymphocytes that had distinct characteristics, behaved in a distinct way, and progressed in a predictable fashion. That’s Hodgkin’s lymphoma.
Other abnormal growths of lymphocytes with different characteristics that behave in different ways are called non-Hodgkins. It’s a catchall term, and there are different subtypes that have different names.
If you have lung cancer, your doctor will be very interested in finding out whether it’s small cell or non-small cell lung cancer, and there are at least five distinct types of prostate cancer.
Gross oversimplification (details mostly from UpToDate.com) follows:
Lymphomas arise from lymphocytes, a type of white blood cell. Lymphocytes themselves can be broadly divided into either T cell or B cell lymphocytes, each of which can be further divided into other various cell subtypes.
Hodgkin’s Lymphoma, or HL arises from germinal center or post-germinal center B cells and it also has a unique cellular composition, containing a minority of neoplastic cells (Reed-Sternberg cells and their variants) in an inflammatory background. It is separated from the other B cell lymphomas based on its unique clinicopathologic features.
Non-Hodgkin’s Lymphoma, or NHL arise from T cells or B cells.
Despite both arising from lymphocytes, the epidemiology, presentation, treatment, and prognosis tend to be very, very different between these two types, so it’s important to quickly determine whether a lymphoma is HL or NHL, then determine just which subtype/variant of those two categories are, and start with the specific interventions best for that specific type.
And while HL occurs less often than NHL by far, it got named not due to its prevalence, but due to its discoverer recognizing that it was different from the general class of lymphomas.
Meanwhile, >95% of prostate cancers are adenocarcinoma. The rest tend to be neuroendocrine, intraductal, or urothelial prostate carcinomas. It’s important to know these differences too, to guide treatment and biopsy will generally help differentiate which is which.
And perhaps urothelial prostate carcinoma was originally called Steve’s prostate carcinoma, but it apparently just never caught on.
Hopefully some kind oncologist or pathologist will stop by to provide a better summary than this simple old country doc can . . .
There’s also Burkitt’s lymphoma, which most people have never heard of.
Dr. Denis Burkitt was a missionary doctor who is actually better known for publicizing the link between colon cancer and dietary fiber; however, he also identified the cancer that bears his name. In Africa, it’s almost unknown in areas where the temperature drops below 50 or 60 degrees.
Possible hijack - what’s your opinion of UpToDate.com? I’ve used occasionally as layman, when close family members had medical problems and I wanted to do some research. It seems like a great resource to me, but I’ve never heard a medical professional mention the site. Is it as complete and up to date as it seems?
Uptodate.com - haven’t visited that site since I left hospital pharmacy. We subscribed to it, and used it all the time.
More cancers named after people: Wilms’ tumor, Ewing’s sarcoma, and Letterer-Siwe disease, all of them rare cancers that usually strike children.
Some are just named after what they look like. A friend of mine is dealing with a terrible gastric cancer known as signet-ring cell carcinoma.
Saying “Non-Hodgkin Lymphoma” is almost as indistinct as saying “cancer” as there are dozens of types that fit the broad description, and most of them have non-catchy names like DLBCL, SLL, MCL, etc.
Short answer: When diseases have that type of name, it usually means the disease is the same, but the cause is not, which would affect the treatment strategy.
In my case, I have Non-Artreritic Ischemic Optic Neuropathy. I had a biopsy to see if it was Arteritic (Giant-cell arteritis), because if it were, it could have been treated. But the resulting blindness was the same.
But it’s interesting how, in the media or in casual conversation, lymphoma’s almost always qualified as “H” or “non-H”, even though (superficially speaking) they have similar symptoms, treatment plans, and five-year survival percentages. As opposed to something like lung cancer, which is rarely described as small cell or non-small cell to anyone except between the doctor & patient. Cultural habits are weird, I guess.
Pretty much. It’s not perfect but the average physician finds it very, very useful.
What this thread really needs is a hematopathologist capable of expressing him/herself in a clearly understandable fashion. This is a rare breed in my experience, so for starters here’s a mostly helpful explanation of the difference between Hodgkin and non-Hodgkin lymphomas in relatively straightforward fashion:
The great majority of Hodgkin lymphomas (HL) are characterized by a particular type of large malignant cell, the Reed-Sternberg cell. Except that there’s another subtype of Hodgkin lymphoma (“non-classic” Hodgkins) that doesn’t have these cells and overlaps with B-cell non-Hodgkin lymphomas on a molecular level but still is classified as a kind of Hodgkin lymphoma. If this doesn’t make sense to you, I sympathize.
It’s convenient to separate Hodgkin and non-Hodgkin lymphomas, since they differ (broadly speaking) as to clinical characteristics and prognoses. But there are numerous exceptions (for instance, while HLs in general respond well to therapy and are often curable, some HLs are aggressive and hard to treat based on type, age of patient and stage).
The explosion of new information about subtypes on a genomic/molecular level is rapidly making existing knowledge (including time-honored classification systems) obsolete and frustrates pathologists and clinicians.
It’s all to the good if effective, individualized treatment is the result.
My BFF’s mother died from this. Horrible, horrible disease, and she had no symptoms until it was too late to do anything about it.
There’s also hairy-cell leukemia, which is extremely rare; I was never personally involved in treating a case. It’s called that because the leukemic cells have hair-like tentacles.
In recent months, I’ve had $8,000 in genetic and genomic testing, and it was all worth it because the results indicated that I would not need or benefit from chemotherapy. That was the best news I had since my diagnosis, and the oncologist, who walked into the room to tell me with a big smile on his face, said that even 5 years ago, “We would have made you sick when it wasn’t necessary.”
I realize that side effect treatment is much better than it was even a few years ago, and hair grows back, nausea goes away,etc. However, I was more concerned about long-term effects; my brother and his wife had a friend (who has since died from something else) who had to have a full mouth extraction several years after her own lymphoma (see footnote) was declared cured, and I have a distant relative who had to have a heart transplant.
Footnote: This woman was very happy to find out she had cancer. You’re probably wondering why anyone would be happy to find that out. Here’s why. In her case, she was having difficultly walking, and the preliminary diagnosis was ALS. Another test revealed that she had lymphoma that was pressing on her spinal cord, and treating it also improved her mobility although she did have some trouble for the rest of her life, probably from scar tissue.