Actor Jeff Bridges’ announcement on Twitter this week that he has been diagnosed with lymphoma has put a new spotlight on the disease.
The cancer, which affects the lymphatic system portion of the immune system, can be classified as more than 70 types by doctors, according to Healthline. Since certain kinds of lymphoma particularly affect older adults, it’s important to know more about them and considerations for treatment.
What is lymphoma?
According to WebMD, lymphoma “begins in infection-fighting cells of the immune system, called lymphocytes.” The cells, which transform and grow out of control when a person has lymphoma, are in various parts of the body, including the spleen, lymph nodes and bone marrow.
The two types of lymphoma are non-Hodgkin’s, the kind most people with lymphoma have, and Hodgkin’s. Each type involves different kinds of lymphocyte cells, and every lymphoma grows at varying rates and responds differently to a treatment.
What are the symptoms of lymphoma?
If you suspect you may have lymphoma, you should see your doctor, but here are a few warning signs you can look out for:
- Swollen, painless lymph nodes, usually in the neck, armpit or groin
- Fever
- Cough
- Shortness of breath
- Fatigue
- Itching
- Weight loss
- Night sweats
What types of lymphoma affect older adults?
Lymphoma can affect anyone, but certain types affect older adults in particular. People who are in their 60s or older are more at risk for non-Hodgkin’s lymphoma, and those who are older than 55 have a higher risk of getting Hodgkin’s lymphoma.
More specifically, there are three kinds of lymphoma that Healthline reported will mostly affect older adults.
- Waldenstrom macroglobulinemia: a rare kind of cancer that is a subtype of lymphoplasmacytic lymphoma.
- Follicular lymphoma: a type of non-Hodgkin’s lymphoma that begins in the white blood cells. The average diagnosis for this is 60 years old.
- Mixed cellularity Hodgkin’s lymphoma: contains lymphocytes and Reed-Sternberg cells, which are large, abnormal lymphocytes found in Hodgkin’s lymphoma, according to Cancer.gov.
What considerations should be made for treatment in older adults?
Certain considerations for additional factors need to be made when treating older adults for lymphoma, according to CancerTherapyAdvisor.com.
“We know that in almost any cancer diagnosis, older age is an adverse prognostic factor. Meaning, worse outcomes,” said Dr. Andrew M. Evens, who is now a physician-scientist at the Rutgers Cancer Institute of New Jersey. “But in Hodgkin’s lymphoma that difference, or that inferiority based on older age, especially once you get over 60, and even more so after age 70, is much more prominent than other cancers. In Hodgkin lymphoma, just based on that sole factor, age above or below 60 or 65, the survival difference can be 40 or 50 percentage points worse versus younger patients.”
To decide on a treatment strategy, Dr. Dominique Bron, head of the hematology department at the Institut Jules Bordet in Belgium, and Dr. Pierre Soubeyran, head of clinical research and coordinator of the hematological research group at the Bergonié Cancer Institut in France, said in a 2017 study that a multistage process should be put in place to decide on treatment.
“Today, the management of lymphoma in older patients is a multistep approach starting with the estimation of the life expectancy of the patient, and the prognosis of the lymphoma," they said. "A second step evaluates the physical, physiological, cognitive and social-economic status of the patient raising the question of the potential severe adverse events induced by the treatment. Finally, and probably more importantly, the patient should express his expectations in terms of quality of life,”
