Actor's death a cruel reminder
The recent death of 39-year-old actor Andy Whitfield is a stark reminder of the disease known as lymphoma.
Lymphoma is a cancer of the immune system. It is the sixth most common cancer in New Zealand and more than 100 cases are diagnosed annually in Wellington alone. Some of these are rapidly fatal, as was the case with Whitfield, who played Spartacus in the TV series of the same name, but in other cases it is a very indolent disease and can be cured.
Lymphoma is classified as being either Hodgkin's or non-Hodgkin's. Hodgkin's lymphoma is relatively uncommon.
For men, the lifetime risk of getting Hodgkin's lymphoma is 1:559. It is even less – 1:766 – for women. This has not changed much over time, whereas the incidence of non-Hodgkin's lymphoma appears to be rising markedly. No-one knows why and a lot more research needs to be done.
It is impossible to screen for lymphoma with the aim of catching it early. Lymphoma can present at all sites of the body. However, most lymphomas arise from lymphatic glands.
Most of us will know about the lymph glands in the neck because when we get a cold or flu they often become larger and will be palpable. People who develop lymphoma will often have palpable lymph glands, as well as an enlarged spleen. They may experience unexplained weight loss, fatigue and have a temperature. They may also get night sweats.
The trouble is, a lot of these symptoms will often occur in much more benign conditions such as colds and flus. We need to remember that most of the time when you see your GP with these sort of symptoms, a flu or viral illness will be the explanation. It is only when these symptoms persist without any reasonable explanation that more rigorous investigation is needed.
Causes of lymphoma may well be viral or even caused by chemicals such as pesticides.
Sometimes when someone presents with enlarged, rubbery, firm lymph glands, the diagnosis may be much more self-evident.
It needs to be remembered that the great bulk of lymphadenopathy is not due to lymphoma and is not a cancer.
More than 99 per cent of people who present with enlarged lymph glands do not have lymphoma. Enlarged glands caused by lymphoma are generally not painful.
If you have a lymph node that is firmer, rubbery and stays enlarged, see your doctor immediately.
If we discover lymphoma early, then the prognosis is better.
The Dominion Post