This month Jane Fonda, the Oscar-winning actress, and activist, announced she has been diagnosed with non-Hodgkins lymphoma (NHL), a type of cancer.
Fonda, 84, shared the news in a post on her Instagram account.
So, my dear friends, I have something personal I want to share, she wrote. Ive been diagnosed with non-Hodgkins lymphoma and have started chemo treatments.
However, her outlook was positive. This is a very treatable cancer, she continued. 80% of people survive, so I feel very lucky.
According to the American Cancer Society, NHL is a common cancer in the US accounting for 4% of all cases. The group estimates that in 2022 around 80,500 adults and children will be diagnosed with the disease.
This isnt Fondas first experience with cancer. She has previously spoken of having skin cancers removed, along with a non-cancerous tumor in her breast (before having a mastectomy several years later).
NHL is a cancer of one of your immune cells, lymphocytes. Its one of your blood cells, and their normal function is to fight infection, Dr. Dima El-Sharkawi, consultant hematologist at The Royal Marsden NHS Foundation Trust in London, told Healthline.
However, theres not just one type of NHL.
When we say NHL, thats a pretty wide umbrella, Dr. Guillermo de Angulo, pediatric hematologist/oncologist at KIDZ Medical Services in Florida, explained to Healthline.
It could be anything from a B cell lymphoma or a T cell lymphoma to a Burkitts lymphoma or what we call anaplastic large cell, he continued.
El-Sharkawi added that most NHL cases are B cell lymphomas and broadly speaking, they can be high-grade or low-grade.
High-grade lymphomas, she shared, involve more rapid cell turnover. As such, patients typically present as more unwell and with a greater number of symptoms.
On the other hand, low-grade lymphomas grow at a slower rate and are sometimes not discovered until a patient has a scan or test for another reason.
It has not been disclosed which subtype of NHL Fonda has. But, due to the high cure rate she pointed to, both El-Sharkawi and de Angulo said it may be a high-grade B cell lymphoma.
When you talk about lymphomas, we divide them into two groups: Hodgkins lymphoma (HL) and NHL, de Angulo said.
HL has certain characteristics, and we look for certain proteins or markers that identify and confirm whether it is Hodgkins. If its [doesnt have these], we classify it as NHL.
According to de Angulo, the symptoms of NHL are similar to HL. One of the signs we often see, he said, is an enlarged lymph node or a palpable mass.
These typically occur in the neck, armpits, or groin area but, in rarer instances, can present in other areas of the body.
Patients can have lymphoma affecting their stomach or liver, and you can even get lymphoma affecting the brain, El-Sharkawi stated.
The location of the mass or enlarged node can lead to secondary symptoms. For example, if [it] is in an area where its compressing a structure or pressing a nerve, it can cause irritation or pain, shared de Angulo.
Aside from an enlarged node or mass, there are several other key signs, including:
The only way to definitively diagnose NHL is to biopsy the affected area, stated El-Sharkawi, because there are other reasons for swollen glands and enlarged lymph nodes.
In most cases, there are no known causes of NHL, Dallas Pounds, director of services at UK-based charity Lymphoma Action, told Healthline.
However, its thought there may be a few potential risk factors.
In terms of genetics, theres no particular gene linked to the development of NHL unlike some other types of cancer, like breast cancer.
That said, there does seem to be some familial predisposition, noted El-Sharkawi. If youve got a first-degree relative with NHL, then you are slightly more likely (over the general population) to get it [but] its still very rare.
Fondas age may be a factor in her diagnosis. Generally speaking, NHL is more common in the over-60s and 70s, El-Sharkawi said. However, she added, it can be in any age group children may develop NHL.
De Angulo explained that individuals with existing health conditions such as certain autoimmune diseases may also be at higher risk of NHL. People that have undergone certain forms of treatment, such as for ulcerative colitis or lupus, can [have] increased risk of lymphoma.
Furthermore, patients who have undergone solid organ transplants (such as liver or kidney) are also sometimes at greater risk, he said. This is because of the immunosuppressive medications they have to take after the operation.
When youve had a solid organ transplant, you want to suppress the immune system so you dont reject the organ thats been transplanted, he explained. But, that same immune system is the one that makes sure you dont get lymphoma.
Every person diagnosed with lymphoma will have an individual treatment plan depending on them as an individual and their presenting symptoms, said Pounds.
While low-grade lymphomas grow more slowly, they are only treatable but not curable with current therapies.
High-grade lymphomas, however, are potentially curable with chemotherapy, explained El-Sharkawi. Because [they] are more rapidly dividing, theyre more susceptible to the chemo, which essentially targets the ability of those cells to divide and proliferate.
Chemotherapy is generally used because, unlike targeted therapies, such as radiotherapy or surgery, the treatment can reach numerous areas. This is critical as blood is constantly moving around the body.
Additionally targeted antibody therapy is given in combination with chemotherapy, which can increase the chances of remission.
Fonda shared that she has started six months of chemotherapy treatments. These are primarily conducted on an outpatient basis, de Angulo said, and administered across six cycles.
Other treatments for lymphomas are available, although these tend to be in relapsed/refractory [high-grade patients] so when the disease has either come back after treatment or they didnt respond, noted El-Sharkawi.
These include smart drugs, stated de Angulo, which attack the cells that express a certain antigen.
Another option is called CAR-T therapy. [This] is an exciting new way of treating lymphoma, El-Sharkawi enthused. Essentially, the patients T cell lymphocytes are manipulated in a laboratory setting so that they know to target the B lymphocytes, before being put back into the body.
Its like a living medicine made from their own blood cells, she added.
NHL is a type of blood cancer that impacts the immune cells and is one of the most common cancers in the US. It can affect people of all ages but is more often seen in those over 60.
There are numerous NHL subtypes, but symptoms generally include an enlarged lymph node or mass, night sweats, tiredness, and weight loss.
Chemotherapy is the most popular treatment type, although new targeted therapies continue to emerge and be of benefit.
The outlook for an individual with non-Hodgkins lymphoma will depend on several factors, said Pounds. But many people will respond well to treatment and enter a time of remission or stability after it.
Link:
Jane Fonda Diagnosed with Non-Hodgkin's Lymphoma: What to Know - Healthline
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