by Marcelle Pick, OB/GYN NP
These words are similar, yet they describe two very different diseases of the lymphatic system.
Most of us first become aware of the lymphatic system as it pertains to cancer. We hear with dread that a friend’s cancer has “gone into her lymph nodes” or metastasized. The reason this is so serious is that the lymphatic system travels everywhere, so if undetected, cancer can move relatively quickly along this network, becoming increasingly harder to treat over time.
Once a cancerous tumor has been detected, practitioners will often remove and microscopically examine the lymph nodes closest to it to see if the cancer has migrated. Depending on what they find, they then rate the cancer in severity and determine the treatment most appropriate.
The most common cancers in both men (prostate cancer) and women (breast cancer) are related to primary lymph drainage channels in their bodies. In men the inguinal nodes, in the crease of the groin, filter and release accumulated lymph from the prostrate. In women the axillary nodes, located in the armpit, filter and release accumulated lymph from the breasts. In the process, these nodes may sweep up any cancer cells that break away from the original tumor, but do not always succeed in trapping them there. When cancer cells or pathogens spread from one part of the body to others they are said to metastasize.
Lymphoma is different from other forms of metastasized cancer. This is a truly complex, minimally understood group of cancers, but generally speaking, lymphoma is a cancer of the lymphocytes. Lymphocytes are a type of white blood cell found in the bloodstream, the lymphatic system and the lymphoid organs. There are two major types, T-cells and B-cells, which work in concert with several others to regulate your immune system response. In lymphoma these lymphocytes begin to multiply uncontrollably.
The diagnosis of Hodgkin’s lymphoma (Hodgkin’s disease) or non-Hodgkin’s lymphoma (NHL) depends on which kind of lymphocytes start to proliferate. In Hodgkin’s lymphoma (the less prevalent disease), it is the B-cell lymphocytes that run rampant. While more common, NHL is more difficult to characterize because there are multiple subsets, involving B-cell or T-cell lymphocytes, natural killer (NK) cells, and other unknown cell subtypes.
There are many places where you can find further information on lymphoma. Visit the following websites to read more:
Lymphedema (often spelled lymphoedema) is a condition in which lymph fluid pools in the spaces between cells, causing pain and swelling. This occurs most frequently in the arms and legs. If left unchanneled, the presence of so much lymph fluid interferes with the natural workings of both the cells themselves and the surrounding lymphatic vessels and nodes, backing them up and making the area prone to infection.
While its origins are still unclear, primary lymphedema is genetically linked, and can be present at birth or develop at the onset of puberty or in adulthood.
Secondary lymphedema, or acquired lymphedema, can develop as a result of surgery, radiation, infection, or trauma to the lymphatic system. It can also arise as a result of disseminated lymphomas, but the lymphedema itself is not malignant. When lymph nodes are surgically removed or altered, the risk of developing lymphedema in the surrounding tissues is greater.
A significant number of women who undergo surgery for breast cancer develop chronic lymphedema, but unfortunately there’s no simple formula to predict who will and who won’t. Some women have two nodes removed and get lymphedema, some have ten removed and experience no swelling at all.