NEWLY DIAGNOSED: Clarify your non-Hodgkin's diagnosis

Most cancers are indicated in a simple way, by geography within the body; bladder cancer is pretty much bladder cancer. Lymphomas are not immediately as clear. They refer to cancers arising in lymph nodes (neck, armpit, groin etc) or the lymph vessels, which traverse the full length and breadth of the body. Inevitably, this complicates a lymphoma diagnosis.

Sometimes people will not have all the information and they'll say "I have non-Hodgkin's lymphoma" or "b-cell lymphoma." This isn't enough.

Researchers worldwide have made every attempt to make sure that lymphoma diagnoses are as uniform as possible so that these diseases can be studied and effective treatments can be appied. Thus, your precise lymphoma diagnosis dictates the treatment you receive and it also helps others with the same diagnosis on SupportGroups.com to find you, and for you to find them, and for you to find the right information elsewhere on the web.

A proper non-Hodgkin's lymphoma diagnosis should be made by a hematopathologist or blood pathologist, and it will include at least three and maybe four features:

1 SUBTYPE
2 STAGING
3 CATEGORIES
4 GRADE (not always included)

1 SUBTYPE

'Non-Hodgkin's lymphoma' is an umbrella term encompassing 40 to 50 separate cancers of the lymph system (the total amount is uncertain because it is always changing). As noted by Dr. Jonathan Friedberg, "the difference between treatment and prognosis of, for example, marginal zone lymphoma and Burkitt lymphoma is as great as the difference between prostate cancer and breast cancer."

The first step in an accurate diagnosis involves classification into a subtype, such as:

Diffuse large B-cell lymphoma (DLBCL).
Follicular lymphoma
Cutaneous T-cell lymphoma (CTCL)
MALT lymphoma
Mantle cell lymphoma
Mycosis Fungoides
Small lymphocytic lymphoma (SLL)

2. STAGING

Lymphoma has four stages, expressed in Roman numerals (I, II, III IV). Each stage expresses a greater spread throughout the body.

3. CATEGORIES

This feature indicates whether you are experiencing what are known as 'B symptoms': weight loss, night sweats and/or fatigue. If you ARE experiencing them, the letter 'B' is attached to the staging. If you are NOT experiencing them, the letter 'A' is added (as in 'Asymptpmatic').

4. GRADE (OPTIONAL)

Some lymphomas are assigned a grade, either 1, 2 or 3. Grade is assigned by determining how aggressive the cancer is—at what clip it's dividing. This isn't used for all lymphomas, but when it is used, the idea is simple: the more aggressive the lymphoma, the higher the grade assigned by the blood pathologist. Patients with follicular lymphoma, for example, are often given a grade.

ENSURING AN ACCURATE DIAGNOSIS

Here's what you can do to ensure as precise a lymphoma diagnosis as possible, and avoid diagnostic mistakes that could cost you time and treatment:

1. INSIST that your biopsy be reviewed by a hematopathologist or blood pathologist—this will contribute to a more accurate diagnosis than one given by an ordinary pathologist.

2. REQUEST that your diagnosis be delivered you to you containing all the necessary constituent parts:

Subtype: ____________________________________

Stage: [ I ] [ II ] [ III ] [ IV ]

Category: [ A ] [ B ]

Grade: [ 1 ] [ 2 ] [ 3 ]