Lymphoma matters - Your blood tests Insight into pathology Clinical trials update
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lymphoma ISSUE 116 SPRING 2020 matters Your blood tests Insight into pathology Clinical trials update
Owen talks
about his
experience
of angioimmunoblastic Understanding
T-cell lymphoma blood tests
07 Join our Bridges of
London event 12 22
29
26 Kathleen's experience
of Burkitt lymphoma
Clinical trials
update from
the NCRI
32
Join our Kenya trek
Contents 18
Lymphoma Action is the UK’s only 04 Latest
news
Medical opinion
Research into
charity dedicated to lymphoma, the News and follicular lymphoma
fifth most common cancer in the UK,
developments
20 Personal
and the most common among people
08
aged 15 to 24. We’ve been providing
in-depth, expert information and Ask the story
wide-ranging support for over 30 years, expert Dwayne shares his
helping thousands of people affected
by lymphoma. Our work drives Insight into experience of skin
improvements in the diagnosis, pathology lymphoma
treatment and aftercare of
lymphoma. We’re here for you.
Views expressed in this publication are those of the
contributors. Lymphoma Action does not necessarily
16 Fundraising
Our calendar
34 Support
groups
agree with or endorse their comments.
of events Kevin explains
© Lymphoma Action 2020.
For further information about permitted use
the benefits of
of our materials, please refer to our website. attending a group
Editor: Anne Hook
Cover: Georgia, who features in our revised
Young person's guide to lymphoma (see page 6)
To make a comment, to sign up,
or to unsubscribe to the magazine,
email publications@lymphoma- If you would like to make a donation
action.org.uk or telephone 01296 619400. towards our work please visit lymphoma-
action.org.uk/Donate or call 01296 619419.
Lymphoma Action
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Helpline (freephone) 0808 808 5555
Lymphoma Action is a registered charity in England and Wales (1068395) and in Scotland
(SC045850). A company limited by guarantee registered in England and Wales (03518755).
To keep up-to-date with latest news visit lymphoma-action.org.uk/News
WELCOME
Working in
collaboration
I hope you enjoy this latest edition of Lymphoma Matters.
As well as our medical writers, Lymphoma Matters
only comes together because of the stories and time
given by our supporters, by healthcare professionals
and by those willing to share their experiences
(and their photos!) – thank you.
Ropinder Gill,
So much of what we do is in collaboration with others, whether
Chief Executive
it’s getting behind the One Cancer Voice manifesto with other
charities, working as part of the Blood Cancer Alliance to make
Have your say in the change we need for the future, or being an active member
the Lymphoma of the global Lymphoma Coalition. There is real strength in
Coalition 2020 numbers when it comes to influencing decisions that will
Global Patient impact those affected by lymphoma.
Survey And being collaborative is one of our five new values. Building
See page 5. on the brand refresh, we have been looking at what we do and
how we work. We have developed new values and created a
long-term strategy that reflects our ambitions for the future.
We hope this resonates with you, and appreciate your ongoing
support as we aim to reach even more people affected by
lymphoma.
You can read about our strategy, how our work impacts
people and about those at the heart of it all online at
lymphoma-action.org.uk/AboutUs
Our new values
Focused We are dedicated to the needs of those
We hope you like this affected by lymphoma.
edition of Lymphoma Matters.
You can sign up to regularly Empowering We build confidence to make change happen.
receive our magazine at
lymphoma-action.org.uk/SignUp Trusted We use our expertise to deliver quality services.
Innovative We look to a better future for people
affected by lymphoma.
Collaborative We are inclusive and value
our partnerships.
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters Spring 2020 03
NEWS
136,000 people in the UK
are living with chronic cancer
A recent study from or slow its progression, 3 in 4 people with chronic
Macmillan Cancer relieve symptoms, and cancer are not getting
Support and Public improve quality of life. the support they
Health England’s National Some types of lymphoma need – whether that
Cancer Registration and fall into this category, is emotional, physical
Analysis Service (NCRAS) with treatment aiming to or financial. Living with
has found that there are control the lymphoma and chronic cancer can be
136,000 people in the UK send it into partial remission – challenging, but with
living with chronic cancer. with several different the right support and
treatments over the course treatment, people with
Chronic cancer is cancer of living with the condition. chronic cancer should
that is treatable, but not be able to live their lives
curable, where treatment Worryingly, the research as fully as possible.
aims to control the cancer showed that more than
One Cancer Voice: A manifesto in cancer research
for people living with cancer • Preventing people from
developing cancer.
In November, in manifesto makes
collaboration with 28 recommendations covering With 1 in 2 people in the UK
charities, we launched six key areas: diagnosed with cancer at
some point in their lifetime,
a manifesto for people living
with cancer calling on the •• Putting the right staff in place
Diagnosing cancer earlier
this could improve millions
of lives and touch every
Government to improve
prevention, diagnosis,
treatment and care.
• Ensuring people living with
cancer have access to the
family in the country.
appropriate treatment and
As the population living psychological support
with cancer grows, we
must ensure that people
• Supporting people living
with cancer beyond their
are not just surviving treatment
longer, but living well
too. The #OneCancerVoice
• Preserving the UK’s
status as a world-leader
04 Lymphoma Matters Spring 2020
Latest news lymphoma-action.org.uk/News
NEWS
Best Volunteer
Fundraisers of
Share your experiences
the Year!
in the Lymphoma We are delighted for Marguerite Russell and David
Coalition 2020 Global Cooke on their well-deserved win at the Institute
of Fundraising East Anglia Regional Awards in
Patient Survey – November 2019.
hurry, the survey closes
Their efforts, as part of the Norfolk Lymphoma
on 11 March 2020! Action Fundraising Group, have raised over
Every 2 years, the Lymphoma £183,000 for us since the group was set up in 2003.
Coalition – a non-profit network
David and Marguerite both have experiences
of patient organisations across
with lymphoma that drive them to work tirelessly
the world of which we are a
to help others affected by the condition. David
member – conducts a global
received a diagnosis of non-Hodgkin lymphoma
survey of patients with lymphoma
in 2001, and Marguerite’s sister passed away
and CLL and their family,
from lymphoma in 2009.
friends and caregivers.
The 2020 survey is your ‘We cannot thank Marguerite, David and the rest
opportunity to share what your of the Norfolk Lymphoma Action Fundraising
lymphoma experience has been Group enough for their hard work and dedication’,
like. Whether the diagnosis was said Carly Benton, Lymphoma Action Volunteering
recent or many years ago, we Development Manager. ‘We are so pleased that
want to hear from you! they have been given the recognition they
thoroughly deserve.’
The survey data will be used
locally and globally to: If you'd like to learn more about volunteering with
•• improve support services
advocate for change
us, go to lymphoma-action.org.uk/Volunteering
• provide relevant facts and
statistics.
Please complete the survey
online by 11 March 2020
at lymphomacoalition.org/
gps2020 Marguerite
with her
award
LymphomaAction LymphomaAction www.lymphoma-action.org.uk
Lymphoma Matters Spring 2020 05
NEWS
New information
now available
Written by medical writers, approved by experts
and reviewed by people affected by lymphoma,
our health information is updated every 3 years. Georg
ia M,
diagn
osed
We have recently revised at 24
three of our books:
•• Hodgkin lymphoma
Autologous stem cell
transplant (using your We have also revised our webpages on:
•
own stem cells)
Young person’s guide to •• marginal zone lymphomas (MALT, nodal and splenic)
common chemotherapy regimens for lymphoma
lymphoma, which includes
quotes from young people
affected by lymphoma,
•• lymphoma during pregnancy
what happens if lymphoma relapses.
like Georgia who is
featured on our Autolo
stem
gous
cell
transpla
nt
magazine cover.
Autol
Order your free copy online at ogous
lymphoma-action.org.uk/
Did you know? stem
cell tr
anspla
Shop or download from our You can download A tran
splant
using
nt
yo ur ow
n stem
website at lymphoma-action. PDFs of our health cells
Hodgkin
org.uk/Books information under lymphoma
What
the left-hand side Havin
is a st
g a stem
em ce
ll tran
cell tr
splant
?
After anspla
menu of each page –
Hodgkin
a stem nt
cell tr
anspla
nt
or, if you are looking
on a phone or lymphoma
tablet, at the
bottom of the page.
lymphoma
ing Hodgkin
Understand
and staging
Tests, scans
tment
Having trea
treatment
Coping with
r yoursel f
Looking afte
You can find a list of all of our our downloadable PDFs
at lymphoma-action.org.uk/Books
06 Lymphoma Matters Spring 2020
Book your place at lymphoma-action.org.uk/Bridges LN O N FUNDRAISING
Join our fabulous D
FAMILY EVENT O
Bridges of LN O N
London Walk – Sunday 7 June
Suitable for all ages and abilities, our Bridges of London walk is back. This walk
is all about you – its Your Walk, Your Way – and will take place on Sunday 7 June.
Walking from Vauxhall Park to Tower Adults £10, family (2 adults + 2 children)
Bridge by criss-crossing over 11 bridges £25, young people aged 4 to 16 £5,
is one of the best ways to see the children under 3 free.
capital. You will have plenty of time to
take in all the sights and you may want All we ask is that you try to raise £100 in
to stop and enjoy lunch by the Thames. sponsorship and we will support you in
your fundraising. All adult walkers receive
As this event is arranged completely a T-shirt and medal. Children also receive
by us, all the money you raise goes a medal. Small T-shirts are available to
towards supporting people affected by purchase in advance for £6.50.
lymphoma. It will be rewarding, fun,
absolutely achievable, and we would love Book your place on this fun event at
to welcome you to Team Lymphoma. lymphoma-action.org.uk/Bridges
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters Spring 2020 07
PERSONAL
ASK THE
STORIES
EXPERT
ask the
expert
Insight into
pathology
Consultant Haematopathologist
Bridget Wilkins answers your
questions on pathology
A pathologist is a
doctor who looks at Chronic lymphocytic Sometimes a lymphoma is
laboratory samples under leukaemia is a classic diagnosed coincidentally
a microscope and does example of a lymphoma that when surgery is being
specialised tests on them shows up in the blood. When undertaken to treat
the same disease stays put another condition, such as
to help make a diagnosis. in lymph nodes (we don't a suspected cancer in the
yet know why it does this), lung, breast or bowel. Those
Does the diagnosis of it’s called ‘small lymphocytic patients will not usually
lymphoma always rely on lymphoma’ – and that would need any additional biopsies.
a biopsy? need a biopsy for diagnosis.
It's very unusual for a patient’s Hairy cell leukaemia and When the diagnosis is known
first diagnosis of lymphoma splenic marginal zone and disease becomes more
not to require a biopsy, but lymphoma are another two extensive, or relapses after
there are some lymphomas examples of lymphomas that treatment, a biopsy is often
that ‘leak’ a lot of cells into have a lot of cells in the blood not needed for confirmation,
the blood and those can be stream and may not need a as imaging studies (MRI, PET
diagnosed from blood tests. biopsy for diagnosis. and CT scans, for example)
08 Lymphoma Matters Spring 2020
Find out more about tests, diagnosis and staging at lymphoma-action.org.uk/Tests ASK THE
EXPERT
It is very unusual for a patient's
first diagnosis of lymphoma not
to require a biopsy.
Preparing
tissue samples is
a complex process
that takes
can be sufficient. In the future, quickly onto the right care time.
‘liquid biopsy’ techniques such pathways.
as single cell and cell-free
tumour DNA testing may From a pathologist’s point of often the next quickest and
become commonplace in view, thinking about making easiest procedure to do. Most
these circumstances. a diagnosis of lymphoma, lymphomas can be diagnosed
I want the patient to have fully from these samples
How is it decided what undergone a biopsy procedure as long as they are of good
type of biopsy is required? that’s the least invasive, but quality.
It’s often a matter of what is which provides plenty of
practical in a particular place tissue for me to make a full However, there is often no
or at a particular time. It also diagnosis without having to left-over tissue for research
depends to some extent ask for a further sample. from needle biopsy cores, and
on how likely a diagnosis some lymphomas are very
Fine-needle aspiration can difficult to diagnose without
of lymphoma seems in any
usually be done very quickly being able to examine larger
particular patient. There
and the patient doesn’t amounts of tissue. So,
are many infectious and
need a general anaesthetic. sometimes a whole lymph
inflammatory causes of lymph
Aspirates are good samples node must be taken out;
node enlargement that initially
for seeing whether there this requires the patient to
mimic lymphoma but will
is, or is not, lymphoma, but have a general anaesthetic
resolve on their own over time.
they often don’t allow us and undergo a (usually small)
We want to sample those in
to tell exactly what type of surgical procedure.
the least invasive way possible
lymphoma is present. For that,
– usually by a fine-needle
a needle biopsy (to obtain a In general, we need
aspirate, with local anaesthetic
small solid core of tissue) is more tissue to diagnose
– to obtain a relatively small
number of cells to assess, for
reassurance. This approach is
also very efficient for detecting In general, pathologists need more tissue to
cancers other than lymphoma diagnose lymphomas than many other types of cancer.
and getting those patients
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters Spring 2020 09
ASK THE Read more 'Ask the expert' questions on our news section, lymphoma-action.org.uk/News
EXPERT
lymphomas than many other like Burkitt lymphoma, is When samples are sent from a
types of cancer because, suspected, every effort will smaller local hospital to one of
in addition to looking at be made to fast-track every the large regional lymphoma
‘standard’ histological step in the laboratory to laboratories, results can take
sections under a microscope, get the result ready and an extra 2 to 3 days while the
we need to do additional back to your oncologist or material is in transit. We all
tests such as immunostaining haematologist within 48 work hard to keep this to a
and molecular tests to reach hours. Unfortunately, we can’t minimum but it is a necessary
a full diagnosis. do this for every sample. price to pay for access to the
more extensive resources
Do you look at the The reason why things and expertise at the regional
sample alone or view normally take longer is centres.
scan images and because the tissue sample
blood tests as well? first needs to ‘fix’ in its As a pathologist, once the
Whenever we can access formalin preservative. It then sections are stained and
them, we look at all these needs to be processed into ready (thanks to my excellent
different tests together, a wax block, then have biomedical scientist colleagues
to inform the microscope sections in the lab, who are the experts
assessment we We need to cut and stained, at doing all of that), I then
make of the tissue make sure that and have extra typically need an hour or two
sample. When all the different tests done such to assess all the slides and
we aren’t able pieces of the as immunostains information to formulate my
jigsaw and molecular report. A complicated diagnosis
to do this, we do
puzzle fit. tests. Formalin may take half a day or even
our best to discuss
the results with the fixing takes up to 24 more. For speed, I like to write
haematologists, radiologists hours, depending on the my own reports directly onto
and other clinicians involved size of the tissue sample. the hospital computer system
in the patient’s care, to put For tiny pieces it can be as but, in some hospitals, reports
the full picture together little as 8 hours. Processing are dictated and then typed
while we are assessing the into one or more wax blocks up before being approved and
tissue. When even that isn't takes another 24 hours and authorised. You can see how
possible, we join the team of getting the various stains the time needed for all of
doctors, nurses, scientists and done typically takes another this adds up.
therapists who come together 24 to 48 hours. Adding
at MDT meetings to make molecular tests may add a Are biopsies ever
sure that all the different further week because they sent elsewhere (other
pieces of the jigsaw puzzle fit are not done in the same lab. treatment centres or
together as they should, so They are expensive too, so oversees, for example)?
that the diagnosis is correct. they're batched to keep the Yes. In the NHS in England,
costs manageable. However, biopsy specimens known or
Why does it take about we rarely wait for molecular suspected to have lymphoma
2 weeks to get the biopsy tests before making our are all sent to be assessed by
results? diagnosis – the results of experts based in large regional
You can rest assured that if those tests refine rather than pathology centres. Apart
a very aggressive lymphoma, determine our assessment. from the specialist knowledge
10 Lymphoma Matters Spring 2020ASK THE
EXPERT
In the NHS in England, biopsy specimens meeting by a member of
known or suspected to have lymphoma are the pathology team. This
all sent to be assessed by experts based in may be the pathologist who
has actually reported on the
large regional pathology centres. sample, or a colleague with
whom they have discussed
of the pathologists at these happens to work. Sometimes the findings in preparation
centres, the larger size of there is particular expertise for the MDT meeting. In
these laboratories means in one country (for example, general, for diagnosing
that they have access to a Hodgkin lymphoma in lymphomas, we work in
wider range of immunostains Germany) because there has teams of three or more
and genetic tests than is been a long history of clinical pathologists, so that we
available at smaller hospitals. trials being based there. can report samples with a
Similar, although less formal, minimum of delay, quality-
referral arrangements also Another reason why biopsy assure one another’s work
operate throughout the samples are sometimes sent and occasionally take a
NHS in Scotland, Wales and elsewhere, including overseas, holiday! Most pathologists
Northern Ireland. is for research as part of a find the MDT meetings are
clinical trial. This is something some of the most rewarding
If a lymph node sample is you should expect, as the parts of their work; we love
difficult to interpret for some patient, to be asked to give being able to ‘see’ the patient
reason, and particularly if it your consent for (or, if you through the discussion
seems to show something wish, to withhold consent) that takes place among the
rare that the local or regional as part of the discussions different clinicians who are
pathologist may not have around your consenting to present and we value being
seen many times, it may be take part in the trial. part of the clinical team.
sent for assessment by an
individual with very specific Do you discuss the With thanks to Bridget Wilkins,
expertise in diagnosing a results at MDT meetings? Consultant Haematopathologist,
Yes. Every lymphoma St Thomas' Hospital, London
particular type of lymphoma. and Royal Hampshire County
Some expertise of this sort diagnosis is discussed at the Hospital, Winchester for
is only available overseas, multidisciplinary team (MDT) answering these questions.
for example in the USA
or Hong Kong, because Every lymphoma diagnosis isFind
discussed at ??????????
the
out more
that’s where the individual MDT meeting by a member of the pathology team.
highly specialist pathologist
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters Spring 2020 11PERSONAL
EXPERIENCE
I REALLY DIDN’T
WANT THIS TO
BE LYMPHOMA
Owen talks about his diagnosis of angioimmunoblastic
T-cell lymphoma and his family history of lymphoma
I have been married to excluding some possible increasingly worried, and I
Yvonne for 27 years and causes, the ENT consultant found it difficult not knowing
wanted to continue to what the problem was.
we have two sons; one
monitor me, as my lymph
is 21 and at university nodes were still a bit Even with all this medical
and the other is 24 and swollen. focus on my lymph nodes,
has recently started strangely, I did not think I
working as a nurse. I am After a couple of MRI had lymphoma. Both my
scans showed no change, a elder brother and dad died
an IT Project Manager. needle biopsy was arranged. of non-Hodgkin lymphoma;
On the first day of a break The needle biopsy wasn’t my brother in 1999 and my
with my family I developed, conclusive, so I had two dad in 2001. So I thought
what felt like, a bad throat lymph nodes removed from I knew the symptoms
infection. The lymph nodes my neck under general of lymphoma, and my
in my neck became very anaesthetic in early January symptoms were different.
enlarged, and I thought 2018. In the days after the Having said that, I was
I must have picked up a lymph node removal my neck also certain that of all
strange infection on a was getting bigger and bigger. the things I did not want
business trip. I was given I thought I had developed an it to be, number one
intravenous antibiotics. infection in the wound, but was lymphoma.
it was the remaining lymph
Once home, I was referred nodes in my neck continuing After a difficult month of
to an ENT consultant. After to swell. I was getting waiting and worrying, in
12 Lymphoma Matters Spring 2020Read more about angioimmunoblastic T-cell lymphoma at lymphoma-action.org.uk/AITL PERSONAL
EXPERIENCE
February 2018 I was diagnosed with angioimmunoblastic T-cell
lymphoma, a type of high-grade non-Hodgkin lymphoma, and the
same lymphoma my dad had.
More tests followed including a PET scan, bone marrow tests
and more blood tests. I was told that I would be treated with
six cycles of CHOP chemotherapy, and then if I was in remission, We wanted to
I would be given a stem cell transplant.
be open about
We wanted to be open about it, and wanted our sons to the diagnosis.
know first. We went to see each of them in turn. They knew
I had been unwell for a while, and had been off work, so knew
it was something serious. But I was impressed by how caring
and mature they were, and was reassured that they were as
OK as they could be with the news. My mum would also have
to go through the non-Hodgkin lymphoma experience of
an immediate family member for a third time; maybe that’s
unique. Yvonne, my sons and my mum were amazingly
resilient, and this helped me.
I now felt able to let others know, and found telling family
and friends very helpful as everyone was very supportive.
Small gifts and regular phone calls made me realise they My family were
cared – perhaps more than I had known before. Although
amazingly
I had already been off work for several weeks, I was now
able to give them a clearer picture of what my diagnosis
resilient, and
would mean work-wise. this helped.
I began treatment at the end of February 2018 with CHOP
chemotherapy. At the beginning of the second cycle I lost most of
my hair. I woke up one morning with loads of it on the pillow, and
Did you
then had a shower and lost most of the rest, so decided to shave off
what was left. It was a bit weird and I was self-conscious for a few
days, but people were quite positive about my new look, so I began know?
to feel OK about it. Angioimmunoblastic
T-cell lymphoma is
The six chemotherapy treatments were in 3-week cycles. By the often fast-growing.
end of the second cycle I knew the pattern: Most people are
diagnosed at an
advanced stage and
Week 1 – low appetite and feeling sick, and sometimes being sick are treated with
Week 2 – feeling better than week 1 but aching back and hips chemotherapy.
Week 3 – feeling normal(ish). People who respond
well to chemotherapy
and who are fit
By the end of the second cycle I could see a bit of improvement. My enough might go on
lymph node swelling was reducing, and I was tolerating the chemo. to have a stem cell
transplant.
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters
Lymphoma Winter
Matters 2018/19
Spring 2020 19
13PERSONAL
EXPERIENCE
My brother and dad had lots the chemotherapy had been it, and knew it would be
of trouble with infections successful. Although I was physically challenging. My
during treatment, so I was apprehensive about having eldest son is a nurse, and
worried about picking up the stem cell transplant, I was during his degree course
infections. I was careful about even more worried that the he spent time in a stem
hand hygiene and avoiding chemotherapy hadn’t fully cell transplant unit, so we
anyone who was unwell. done its job. had some idea of what was
involved.
I had another The days leading up
PET scan and I was in no to the PET scan I had LEAM chemotherapy,
was told the doubt the were difficult. We which is a high-dose
chemotherapy transplant was decided to go chemotherapy called
was working. the right course away as a family ‘conditioning’ every day for 6
It was positive of action. for a short break, days, and then my stem cells
news, and given and hoped it was were given back to me. I felt
my family history, I a chance to relax. progressively worse as the
felt very emotional. But it was days of treatment went by. I
a mistake, and all it did developed mucositis (ulcers
I had my last dose of in my mouth, throat and
was spread the anxiety
chemotherapy the day the digestive tract) which made
between us.
2018 World Cup started. I am eating difficult, and I also
a big football fan and being I eventually had the PET scan, had very bad diarrhoea.
able to watch every game and it was the best news; the Over the next 3 weeks I
was certainly a plus. I made chemotherapy had worked. I lost a stone and a half.
the most of it and really had my stem cells harvested
enjoyed watching them all! in late July 2018 in readiness As expected, my blood counts
for the stem cell transplant dropped, and I found the
My treatment plan had the next month. days when I was neutropenic
always been to have an frightening. I was again worried
autologous stem cell By the time of the transplant about picking up an infection.
transplant using my own I was feeling better and I was in hospital for almost 3
stem cells. A PET scan stronger. I was in no doubt weeks feeling progressively
scheduled for about 6 that the transplant was the worse, but suddenly my blood
weeks after the last dose of right course of action, but counts began to recover, and I
chemotherapy would tell if I was very anxious about began to feel a little better.
14 Lymphoma Matters Spring 2020Find out more about working and lymphoma at lymphoma-action.org.uk/Work PERSONAL
EXPERIENCE
Work were really helpful and we realised that the old normal
was not going to be the new normal. At least not for now.
I was allowed home fairly January 2019, and initially I’m not sure this is the forever
soon after that, even though worked from home. It was normal, it’s normal for now.
Owen
my blood counts were still good to be getting back to
low. To be honest, I didn’t normal, and I was keen to do
feel ready to go home. I was so as quickly as possible. I
Owen’s family
still nervous about picking thought it would bring closure history of lymphoma
up infections and was still to my lymphoma experience. For most types of lymphoma,
struggling with diarrhoea. The By the end of March, I was there are no clear causes.
mucositis had all but gone, back to working 5 days a Lymphoma is not inherited – it
and I was eating again, but week, commuting to London is not passed from parent to
my sense of taste was weird. I occasionally. child. However, your risk of
couldn’t taste anything sweet developing lymphoma is slightly
and lots of savoury things By early May I realised I was higher if you have a close relative
tasted very different. struggling. I felt very tired, still (parent, brother or sister, or
had some digestive problems, child) who has had lymphoma.
My energy levels were low, and also could not achieve This increased risk is usually
but I tried to get outside and the closure to my lymphoma not linked to a particular gene.
walk a bit, even in the early experience I wanted. I spoke Research suggests the increased
days at home. I began to feel to a psychological nurse who risk may be caused by inheriting
better, but it was slow, and helped me to think about my several polymorphisms (variants
not every day was better life after lymphoma. I needed of a gene that can affect the
than the last. There were to adjust my work life balance. way the gene works) that all
times I felt like I was going contribute a small increase in
backwards and my energy Work were really helpful and I risk. These polymorphisms
levels weren’t getting higher. think between us we realised are often in genes of the
But I was getting better and I that the old normal was not immune system.
just needed to be patient. going to be the new normal.
At least not for now. I am Owen is currently
I began a phased return to now working less, and Yvonne participating in a genetic
work at the beginning of and I are enjoying this new project and it is hoped
phase of life together, that that such studies will
at the beginning we thought help understanding
gous
Autolo l
stem
cel
we might not have. Whilst in the future.
lant
transp
gous t
Autolo ll transplan
m ce
ste n stem
cells
A trans
ur ow
plant
using
yo
We have recently revised our book, Autologous
nt?
stem cell transplant. Download or order a free
transpla
m cell
What
Havin
is a ste
g a ste
a ste
m cell
m cell
transpla
transpla
nt
nt
copy at lymphoma-action.org.uk/Books
After
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters Spring 2020 15Find out more at lymphoma-action.org.uk/GetInvolved
FUNDRAISING
MARCH APRIL
Quiz month Easter fun
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this is quiz month! egg-static it’s Easter!
Download our pack of top tips on holding a Help get the country treasure hunting by
quiz, including six rounds of quiz questions holding Easter Egg Hunts. Our Egg Hunt
from lymphoma-action.org.uk/Quiz pack includes pictures of eggs, which you can
cut out and hide in your garden or perhaps
Alternatively, get your local pub
even at work around your office! Children
involved and join the world’s biggest
will also enjoy our LEAP for lymphoma
pub quiz across the UK from 8-12
where we are encouraging them to be
March 2020. There is no charge to
sponsored to bunny leap for lymphoma.
take part, but it is a great way
to raise money for Lymphoma To get your Egg Hunt pack or your
Action. PubAid will supply LEAP for lymphoma pack –
you with the quizzes and including bunny ears! –
promotional material. visit lymphoma-action.
Go to worldsbiggestquiz. org.uk/Easter
pubaid.com for more details.
MAY JUNE
All about Bridges and teddies
food Join in with our Bridges of
London walk on Sunday 7 June –
May is all about food. Get full details on page 7.
your friends and family together
As it’s June, why not hold a teddy bears
and hold a Lunch for lymphoma.
picnic? This is a lovely way to involve
You can host a lunch at home and charge children and is very easy to organise
a small ticket price, then hold a raffle on with your family, school
the day. BBQs, picnics and evening dinner or nursery. Just ask
parties count too! Alternatively you could children to bring
ask a local restaurant to support you with a their favourite
set menu, where you can add a little extra teddy and provide
on the ticket price and raise some additional some snacks and
funds. For lots of ideas and some great games. For your
recipes go to our website and download fundraising pack,
your free Lunch for lymphoma pack: please visit
lymphoma-action.org.uk/Lunch lymphoma-action.
org.uk/Teddies
16 Lymphoma Matters Spring 2020Find out more about legacies at lymphoma-action.org.uk/Legacy
FUNDRAISING
The Lymphoma Action
Spring Prize Draw is a great
opportunity for you to
make a difference to our
frontline services! Caroline received a diagnosis of stage 4
follicular lymphoma just as she turned
Caroline reached out 40. She has now been in remission for 13
to our support services years, and knows from personal experience
after receiving her own just how important our services are in
lymphoma diagnosis: helping people feel informed, encouraged and
'When I contacted supported during their treatment and beyond.
Lymphoma Action they
were so supportive, and Help us to keep our front line services running
Caroline they were the first people by taking part in our Lymphoma Action Spring
that I had a conversation Prize Draw. Every ticket bought helps us to
with where I wasn’t completely terrified. continue our work in making sure that no one
The Buddy that they found for me was the first faces lymphoma alone. To find out more, call
person who gave me hope and now I want to the Fundraising Team on 01296 619419 or email
do the same for others in a similar position.' fundraising@lymphoma-action.org.uk
IT'S
Spring is the perfect time
to sow periwinkle seeds.
Ours are only £1.50 a packet
and are sure to brighten up
your garden. The Madagascar
periwinkle (Catharanthus
roseus) is used to produce
two chemotherapy drugs –
vinblastine and vincristine.
Once your seeds have grown we ONLY
would love to see your photos, so £1.50
please share them on social media
at #LymphomaMatters.
Periwinkle seeds and pin badges are perfect for
wedding favours at lymphoma-action.org.uk/Shop
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters Spring 2020 17MEDICAL
OPINION
FOLLICULAR
LYMPHOMA
Stock photo
A journey from prognostic factors
to risk-adapted therapies
Professor Stefano
Luminari, Professor
of Oncology at the In this case, the subject is is to choose your transport
University of Modena risk-adapted therapy for and plan your route.
and Reggio Emilia in follicular lymphoma. The
question to ask is: is follicular In terms of response-adapted
Italy, gave a fascinating lymphoma suitable for risk- treatment in follicular
talk at the 49th Annual adapted therapy? lymphoma, this means
Trials Meeting. He deciding how to define ‘high
The results of previous trials risk’ and how to measure
compared his research
suggest that it is: follicular response to treatment.
into follicular lymphoma lymphoma is a heterogeneous
with a holiday in his (diverse, composed of different Several scoring systems, such
home town of Modena. parts) condition and several as FLIPI and PRIMA-PI, use
factors have been identified clinical features, blood tests
Choose your destination that influence treatment and bone marrow biopsy
When you’re going on outcomes. There does seem to results to classify follicular
holiday, you choose your be a clear difference between lymphoma as low or high
destination carefully and people who are at high risk risk. However, they all define
make sure the planning, of relapse or progression and high risk slightly differently. In
expense and time involved those who have a longer-lasting addition, other factors such as
is going to be worthwhile. response to initial therapy. genetic profiling, quantitative
Similarly, when addressing measures of the amount
a scientific question, you Select your means of of lymphoma in the body,
need to choose your area of transport and PET/CT scan results are
research carefully. The next step in your journey also important in identifying
18 Lymphoma Matters Spring 2020Read more about follicular lymphoma at lymphoma-action.org.uk/FL MEDICAL
OPINION
people with high risk The PETReA study is testing results and the full results of
lymphoma. Similarly, response whether response to initial the study are not yet available.
to treatment can be assessed treatment for follicular
in a variety of ways, including lymphoma, assessed by PET/ Ask if the journey was
PET/CT scanning. CT scan, can be used to worth it
determine who would benefit After any trip, you probably
The FOLL12 study selected from maintenance therapy reflect on whether it was
a score known as FLIPI2 to and what maintenance worthwhile, if you would go
define high risk follicular regimen to use. This study back and what you would do
lymphoma, and PET scanning is open to recruitment and differently if you went again.
and ‘minimal residual results are not yet available.
disease’ (MRD; no evidence In research terms, FOLL12
of follicular lymphoma in It is now time to go has certainly provided some
the bone marrow) to assess on your journey! valuable results. Unpublished
response to initial treatment. data have confirmed that
Together, these measures The FOLL12 study opened FLIPI2 and PET scan results
are a strong predictor in July 2012. Interim results after four cycles of treatment
of outcomes in follicular were presented at the are independent predictors
lymphoma. The FOLL12 study International Conference of response to treatment in
aimed to find out if they on Malignant Lymphoma in follicular lymphoma. However,
can be used to determine June 2019. Surprisingly, these there remains a need for better
whether or not maintenance results showed that ways of identifying
therapy is necessary for outcomes in the people with high risk
people who respond well to response-adapted We need better disease in order
initial therapy for advanced, arm of the study ways to identify to improve the
high risk follicular lymphoma. were not as effectiveness of
people with high
This approach is known as favourable as treatment.
outcomes in the risk disease.
response-adapted treatment.
standard treatment In conclusion,
Prepare for your trip and arm, in which treatment of follicular
check the forecast everyone received the lymphoma should be based
It’s always wise to research same maintenance therapy on the specific needs of
where you’re going so you regardless of their response each individual. Most people
have an idea of what you to initial treatment. This have low risk disease and it is
might expect when you get suggests that a complete important that treatments do
there. Of course, however response to initial treatment, not do more harm than good.
prepared you are, you might assessed by PET and MRD,
meet unexpected surprises is not sufficient to omit With thanks to Professor Stefano
Luminari, Professor of Oncology,
along the way. maintenance treatment. University of Modena and
However, it’s important to Reggio Emilia, Italy for
To this end, the researchers note that these are interim reviewing this article.
asked: has anyone tried a
response-adapted approach De-intensifying treatment regimens in people
to advanced follicular with low risk follicular lymphoma would be a
lymphoma treatment before? valuable area for future research.
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters Spring 2020 19PERSONAL
EXPERIENCE
MY
CANCER
WITH THE
STUPID NAME
Dwayne talks about his diagnosis
of mycosis fungoides
I had no idea of
As part of the creative want to get them checked the impact that trip
writing section of my out as it could be alopecia to the barbers
university degree, I was (spot baldness, often on the would have.
scalp).’ I decided to see my
asked to write about GP who checked me over and
something that had told me it was probably just
impacted on my life. That an allergic reaction to a kitten
wasn’t difficult for me… we had recently taken on. we went back, but I told her she
didn’t need to come into the
Five years ago I was 25, living Over the next 3 or 4 weeks, consultation with me. I wouldn’t
a family life with a partner the patches of hair got worse be long and it would be nothing
and her daughter and I and it looked like a UFO had to worry about. Little did I know!
had a full-time job. come down and made crop
circles on the top of my head. I was diagnosed with stage 1
I desperately needed a My doctor referred me to mycosis fungoides or MF for
haircut, so headed to my a specialist at the hospital short. It was explained to me
barbers. At the time I had who took a biopsy from my that it is a type of lymphoma
no idea of the impact of shoulder and told me to come that affects the skin. Because it
something he said to me: back in a couple of weeks' was early stage and not affecting
‘You have really thin patches time for the results. My my health, no treatment was
of hair, Dwayne. You might partner came with me when necessary at diagnosis.
20 Lymphoma Matters Spring 2020Find out more about cutaneous (skin) lymphoma at lymphoma-action.org.uk/SkinLymphoma PERSONAL
EXPERIENCE
I kept going back to the hospital for check-ups and reviews and
over time I had about seven or eight biopsies. It came to the
point when I was told that they wanted to do five sessions of
radiotherapy over 5 days. This was when it really hit me.
They said they would need to make a metal plate for the
bottom of my back. I joked: ‘Like Robocop?’ But sadly it was
far less cool than that; it was a metal plate in the shape of
the top of my bum and back. They needed to make a
metal plate to protect me
I found the five sessions of radiotherapy OK; they involved during radiotherapy.
a fair amount of waiting around, and then me lying down while
I pictured 'Robocop' but
a large machine zapped me through a hole in the plate that
was made for me. in reality it was far
less cool.
The patches went down and, whether it was
coincidence or part of the treatment, my hair
grew back, which was massive for me.
Since then, I have only needed to go for regular check-ups. If you would
like to talk to
For quite a while, I was able to put it to the back of my mind, someone about
but over time I have realised that emotionally it has affected how lymphoma has
me far more than I really acknowledge. If I feel unwell at any affected you, why
point – and recently when I had back pain – my first thought not call our Helpline,
Dwayne
is about my lymphoma, and I feel it will available Monday to
always feel present in some way. Friday, 10am to 3pm,
on 0808 808 5555.
DID YOU KNOW?
Cutaneous (skin) lymphoma
Skin lymphomas start in the skin. They are
often difficult to diagnose as they can resemble
other more common skin conditions. Skin
lymphomas differ from other types of
low-grade non-Hodgkin lymphoma because
treatments are often topical (applied to the
skin) rather than systemic (affect the whole
body). There are lots of different types of
skin lymphoma. Most develop from T cells,
with the most common being mycosis
fungoides. They are typically chronic
(long-term) conditions and are not
usually life-threatening.
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters Spring 2020 21MEDICAL
OPINION
Understanding
blood tests
Blood tests
provide important
information about how
your body is responding
to the lymphoma and
its treatment.
22 Lymphoma Matters Spring 2020Patient.co.uk and the NHS website have more information on blood tests. MEDICAL
OPINION
We have received a number of enquiries
asking for more information about blood
tests, why they are done and what the
results tell us. In this article, we
hope to answer some of these questions.
You are likely to have regular responding to the lymphoma when they look at your
blood tests as part of your and its treatment. If you blood test results to decide
diagnosis, throughout your are in follow-up, you are what the results mean for
treatment and as part of likely to have blood tests you. Factors they might
your follow-up. at your check-ups but less consider include results from
frequently than you did other tests and knowledge
Blood tests are done to:
• help diagnose a few types
of lymphoma (a biopsy is
before. The lymphoma and
its treatment can cause
frequent changes in your
of any medical conditions
you have. They can explain
what your test results
needed to diagnose most blood results. Your blood mean and don’t be afraid
lymphomas)
• find out more about
the lymphoma before
test results should be more
stable when you are in
follow-up, so less frequent
to ask your medical team if
anything about your results
concerns you.
treatment is planned
• check your general health
before or during treatment
tests are needed.
What do my blood test
What is a ‘reference range’?
• assess how your treatment
is affecting you
results mean?
Your medical team should
When blood test results
come back from the
• check whether you have
recovered enough from one
tell you if your blood test
results are normal or if
laboratory, they are reported
together with a ‘reference
range’ (or ‘normal range’).
cycle of treatment before there are any problems. Most people’s results are
starting the next one You can ask to see your
• monitor the lymphoma and
your general health during
results, but they can be
difficult to interpret. Do
within the reference range.
Around 1 in 20 healthy people
have results outside the
follow-up after treatment not be alarmed if your test reference range. Many factors
and during any periods of results seem to be outside can influence your blood test
active monitoring (or the reference range. Many results, for example, age, sex
'watch and wait'). people have results outside or ethnicity.
the reference ranges that are
Blood tests are done not a cause for concern. Your Lab Tests Online have
frequently as part of medical team consider your information on reference
diagnosis and treatment. individual circumstances ranges for common blood
They are useful in giving
your medical team
Don't be afraid to ask your medical team
important information
if anything about your results concerns you.
about how your body is
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters Spring 2020 23MEDICAL Lab Tests Online have information on reference ranges at labtestsonline.org.uk
OPINION
Figure: The different
blood cells that develop
from stem cells
New blood cells are released
from the bone marrow into
the bloodstream.
tests. However, blood tests of each type of blood cell is in the blood. Haemoglobin
are not done in the same often called the ‘count’. is a protein in red blood cells
way in all laboratories. that carries oxygen around
Blood cells are made
Laboratories might the body. Further tests on
from blood stem
have slightly You can ask to the blood, such as what the
cells in your bone
different ranges, see your blood blood cells look like under
marrow (the
use different tests, but they the microscope, can give
spongy tissue
techniques can be difficult other useful information.
in the centre of
or might use to interpret.
your bones). Stem Possible low blood counts
different units to
cells are basic cells include:
report their results.
Your medical team are
best placed to advise about
that can develop into
more specialised cells. Blood • anaemia – a low count of
red blood cells or a low level
stem cells can become: of haemoglobin in the blood
your blood test results as
they know your individual
circumstances.
•
red blood cells, which carry • thrombocytopenia –
a low platelet count
•
oxygen around your body
Blood tests used for •
platelets, which help your
blood to clot, preventing
neutropenia – a low count
of a type of white blood
people with lymphoma bruising and bleeding cell called a neutrophil.
There are many different
blood tests used for people •
white blood cells, which
fight infection as part of
Other types of white blood
cell might be low too.
with lymphoma. The most your immune system.
common is the full blood You can develop low blood
count. Why is the full blood counts for several reasons:
The full blood count (FBC)
is a test that measures how
count done?
A FBC checks for low blood
• lymphoma in your bone
marrow takes up space
many blood cells there are counts. It also measures how needed for healthy blood
in your blood. The number much haemoglobin there is cells and blood stem cells
24 Lymphoma Matters Spring 2020Find out more about blood tests at lymphoma-action.org.uk/BloodTests MEDICAL
OPINION
• some treatments stop your
bone marrow from working
of treatment. If your blood
counts are too low, your
have Waldenström’s
macroglobulinaemia
properly as they affect both
lymphoma cells and healthy
treatment might be delayed
until they recover. Your blood
• levels of abnormal
proteins in your blood,
blood stem cells counts usually recover on measured by serum
• some types of lymphoma
cause antibodies to form
their own in time but some
people are given supportive
protein electrophoresis, if
you have Waldenström’s
that attack your own treatments like growth factors macroglobulinaemia
healthly blood cells; this
is called ‘autoimmunity’.
to help boost blood counts. • your blood group (if you
need a blood transfusion)
If you have low blood counts
If you are having a newer
drug that you take every • if you have signs of an
infection, which can be
day, you have regular blood
due to the lymphoma, measured by the CRP level
tests to check how you are
treatment for the lymphoma or from a blood culture
responding to the treatment.
can help your blood counts (growing any bacteria in
recover. Monitoring your What other blood tests your blood)
blood if you are on ‘watch
and wait’ can help your
are used?
Many other blood tests
• if you have or have had
a viral infection that
medical team decide when are used for people with could be related to
you need to start treatment. lymphoma. For example, the lymphoma or that
they can be done to find out: could flare up while your
The FBC is a very important
•
immune system is low
blood test when you are how well your liver and (viruses such as HIV,
on treatment as most kidneys are working
•
hepatitis B virus, hepatitis
treatments for lymphoma whether you have any C virus, cytomegalovirus,
can cause low blood counts. signs of inflamation – this or Epstein–Barr virus).
These treatments include is done by measuring
chemotherapy, antibody substances in the Your medical team might
therapy and many targeted blood, such as lactate suggest other blood tests
drugs. Radiotherapy does not dehydrogenase (LDH) or depending on your individual
usually cause low blood counts C-reactive protein (CRP) circumstances.
unless a large area of your bone and by measuring the Patient.co.uk and the
marrow is being treated. erythrocyte sedimentation NHS website have more
rate (ESR) information on blood tests.
If you are having
chemotherapy or antibody
therapy, your blood counts
• your plasma viscosity
(PV) (the thickness of
Lab Tests Online has an
index with more detailed
usually begin to recover your blood) – this is an information on many
a week or two after each important test if you different blood tests.
treatment. Your medical
team monitor your FBC after Acknowledgements: With thanks to Dr Bhupinder
each treatment to make Sharma, Radiology Consultant, The Royal Marsden
sure your blood counts are Hospital NHS Foundation Trust, London, for reviewing
at a safe level for you to this article. This is an edit of detailed information which
have your next planned dose can be found at lymphoma-action.org.uk/BloodTests
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters
Lymphoma Winter
Matters 2018/19
Spring 2020 25
19PERSONAL
EXPERIENCE
‘The past is a
foreign country;
they do things
differently there.’
LP HARTLEY
I’m not the same person I
was before my diagnosis
of Burkitt lymphoma – KATHLEEN
I have been in remission from Burkitt had a rare cancer that my medical team had
lymphoma, a type of high-grade non- not treated before. As for me, I had barely
Hodgkin lymphoma, for over 12 years. heard of the word ‘lymphoma’. Looking back,
I walked into hospital relatively fit but left,
What had started as backache and a several months later, bald, feeling lousy and
lump in my armpit, saw me referred incapable of walking unaided.
to my local hospital.
I had been told my lymphoma was aggressive
I had a series of meetings with consultants and would be treated aggressively with full-
and many tests later was told I had time stays in hospital, where I would be given
lymphoma, but that further tests were R-CHOP chemotherapy and methotrexate.
needed to identify the exact type. Unfortunately I had a reaction to the latter,
On 4 November 2006, I was diagnosed endured C. difficile and developed sepsis,
with Burkitt lymphoma, stage 4. which was life-threatening and reduced
Venturing into the unknown was my mobility significantly.
frightening, especially when I was told I I had tubes, cannulas, Hickman® and PICC
26 Lymphoma Matters Spring 2020Read more about Burkitt lymphoma at lymphoma-action.org.uk/Burkitt PERSONAL
EXPERIENCE
lines for chemotherapy. There were tubes The real highlight was on 23 April 2007. I
to feed me and catheters to remove had braced myself for the worst, so it was
urine. I was unable to get in or out of actually a shock when I was told I was in
bed. I could not clean, wash and dress remission. I still celebrate
myself, or feel my feet. I needed help for this date.
the most basic of tasks. I could no longer While my
read, concentrate or sleep. Worst of all While my
treatment had treatment had
was the inability to enjoy food and the
finished, my finished, my
continuous nausea.
recovery had recovery had only
The most overwhelming feeling only just begun. just begun.
throughout the process was fatigue. The question I had
Clinical staff warned me about this, but to face was how to
in all honesty, I don’t think they really move on from feeling
understand how debilitating this can be. I ‘institutionalised’ to returning to the ‘real
remember my sister and her son visiting me world’ and adapting to a ‘new normality’.
in hospital and not having the strength to
reach out and put on my glasses. Without To help with this, I received support from
being able to see them, I was unable to specialist nurses and had regular check-ups
communicate with them effectively, and with my consultant over 5 years.
that memory still haunts me. I became a member of a Lymphoma Action
Despite enduring the treatment, there Support Group and am a Buddy. I am
were a number of things that have also a member of the Reader Panel that
stayed with me: ensures the organisation’s information
is easily understood. This has kept a link
• the incredible support offered by my
late husband, family and friends
which has helped me stay informed of
latest developments in treatments for
• the wonderful care and consideration I
received from my medical team
lymphoma. At a local level, I have been
a cancer buddy for over a decade at the
•• the honesty of my consultant
living on banana milkshakes, ice-pops
hospital that saved my life.
and the picnics provided by my late Cancer changed me in a variety of ways:
husband hair loss, scarring, weakened muscles and
• the joy of having a shower for the first
time in many days
lack of feeling in toes and fingers. I had got
into habits that still continue, like wetting
• certain TV programmes that still
remind me of my time in hospital. I
my head under the shower as I did when
I had no hair. These are minor concerns
can’t watch ‘Strictly Come Dancing’ in comparison with the emotional and
without thinking about chemotherapy. mental problems I have faced. There is the
frustration of not being able to do things
I could do before. Some of this I have put
The most overwhelming down to ‘chemo brain’, which causes me
problems with concentration and with
feeling throughout the
finding the correct word. Surprisingly
process was fatigue.
though, I have become more creative and
LymphomaAction LymphomaAction www.lymphoma-action.org.uk Lymphoma Matters Spring 2020 27PERSONAL Find out more about side effects of lymphoma at lymphoma-action.org.uk/SideEffects
EXPERIENCE
enjoy many crafts that I would not have number of companies who would provide
tackled in the past. travel insurance, albeit after some detailed
questioning about my pre-existing medical
Because my immune system was condition and at an increased price.
compromised when I was being treated, I
have become paranoid about infection One important message I have is the
control; I hesitate to shake hands need to care for carers. Family and
with people and nothing is friends have to master their own
designed to infuriate me more Cancer impacts fears. Cancer impacts upon
than someone sneezing close upon whole whole families, friends and
by, even after all these years. communities. Relationships
families, friends
can change. Those that matter
If I have aches, pains or and communities. continue as before; others may
unexplained lumps, I do not change beyond recognition.
hesitate to see my doctor.
No, I am not turning into a Having undergone treatment for
hypochondriac, but I am only too well cancer, I have changed as a person and,
aware that cancer generally needs to be I am told, am more sensitive to others
identified quickly and I do not propose to experiencing difficulties. It has also
take any chances. reaffirmed my belief in the importance
of gratitude and living life
Kat hleen
Travel was important to me before cancer to the full.
so I was delighted to discover there were a
DID YOU KNOW?
More about
Burkitt lymphoma
Burkitt lymphoma is a very fast
growing type of high-grade
• It develops from B lymphocytes
(white blood cells that fight infection).
non-Hodgkin lymphoma.
• It is uncommon – about 250 people
• Symptoms often develop quickly,
over just a few days or weeks.
are diagnosed with Burkitt lymphoma
every year in the UK. • Treatment usually begins very soon
after diagnosis with a combination
• It is the most common type of
non-Hodgkin lymphoma in children,
of strong chemotherapy drugs and
antibody treatment rituximab.
•
although it can occur at any age.
It affects about three times more
• Most people stay in hospital for
most or all of their treatment, which
men than women. can take several months.
28 Lymphoma Matters Spring 2020You can also read
