Do You Know the Risk Factors for Non-Hodgkin's Lymphoma?
Amy Hendel | April 26, 2018
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What do Gene Wilder, Jackie Kennedy, Mr. T, and Michael C. Hall all have in common? They’re celebrities who were diagnosed with non-Hodgkin’s lymphoma (NHL). NHL is the seventh most common cancer affecting adults in the U.S., and the incidence of this cancer nearly doubled between 1975 and 2013. To intercept or limit the disease, it’s important to know its risk factors. So here's your first question: True or False: Being male and older are strong risk factors for NHL
True. Getting older is a strong risk factor for NHL, with most cases occurring in the 60+ population. There are specific types of NHL that occur more frequently in younger adults and children: Lymphoblastic lymphoma, Burkitt lymphoma, and large cell lymphoma. Overall, risk of NHL is higher in men, but there are some types of NHL that seem to occur more commonly in women. There are no clear reasons as to why gender risk is higher in men or why specific types of NHL are more prevalent in women.
True or False: Risk of NHL can be increased after treatment with chemotherapy for other cancers
True. Some chemotherapy drugs used to treat other cancers may be linked to increased chance of developing NHL years later. Patients treated for Hodgkin lymphoma, for example, seem to have an increased risk of developing NHL later in life. It’s still not clear if the risk is directly related to the chemotherapy or to the disease itself. There are also certain chemical exposures (benzene), herbicides, and insecticides that may raise the risk of developing NHL and other cancers.
True or False: NHL is one of the few cancers with no genetic influence
False: A 2011 review demonstrated that certain pathway genes were strongly linked to risk of B-cell lymphomas. Another study in 2012 showed a link between 12 genes and tumor genesis of types of NHL. Other studies have suggested that risk for NHL may be linked to unrepaired or mis-repaired DNA strand breaks. This makes sense because lymphatics are dependent on immune function integrity – so even one small genetic change has potential significant impact and could impair DNA.
True or false: Smoking and alcohol use have survival implications in NHL
True: Having a heavy drinking pattern prior to diagnosis has much poorer survival rates and higher risk of death once diagnosed with NHL. Drinking more than four alcohol-based drinks daily was linked to this impact. When it comes to women, there was a differential between wine and liquor consumption, with a more frequent liquor habit more significantly linked to this poorer survival rate. A diagnosis of obesity before diagnosis was another risk factor for poorer survival.
True or false: It is a myth that having rheumatoid arthritis (RA) raises your risk of developing NHL
False – but with a caveat. There may be a link between certain autoimmune diseases like RA and the risk of developing NHL. Some experts think that it’s not the autoimmune disease per say, but rather treatments like methotrexate and tumor necrosis factor (TNF) that may be the factor at play as far as increased risk. Other autoimmune diseases that may raise the risk of NHL include systemic lupus erythematosus (SLE or lupus), Sjögren’s syndrome, and celiac disease.
True or false: Radiation exposure survivors are at higher risk of NHL
True. There are studies that show that survivors of atomic bombs (Hiroshima) and nuclear reactor accidents have an increased risk of developing certain cancers including NHL, leukemia, and thyroid cancer. It’s also been shown that individuals treated with radiation therapy for cancers like thyroid cancer and Hodgkin lymphoma may then have a slightly increased risk of developing NHL later on. Combined radiation and chemotherapy treatment offers the highest risk. NHL surveillance with CT scan is also a risk factor.
True or false: Viruses like the flu raise the risk of developing NHL
False. The yearly flu is not a risk factor for developing NHL. There are certain viruses that do seem to raise the risk. These viruses affect the DNA and transform lymphocytes into cancer cells. One virus common to Japan, human T-cell lymphotropic virus(HTLV-1), increases the risk of certain types of T-cell lymphoma. It can be shared by contaminated blood and breast milk. Epstein-Barr virus (EBV) is a risk factor for Burkitt lymphoma. Human herpes virus 8 (HHV-8) is linked to a rare primary effusion lymphoma.
True or false: Having hepatitis C raises the risk of NHL
True. Any long-term infection that taxes the immune system appears to raise the risk of lymphoma. This is because the more lymphocytes that are manufactured to fight the chronic infection, the greater the chance of mutations. Helicobacter pylori associated with stomach ulcers, chlamydia psittaci (which causes a lung infection), Campylobacter jejuni found in young adults in Mediterranean countries, and hepatitis C are linked to increased risk of developing certain lymphomas.
True or false: Breast implants raise the risk of developing a rare type of NHL
True. Some women who have breast implants seem to be at risk of developing a rare type of lymphoma called anaplastic large cell lymphoma (ALCL) in their breast tissue. Research suggests that a specific type of implant – those with textured surface as opposed to smooth surface – is linked to the increased risk.
True or false: A high carb diet raises the risk of developing NHL
False. Some studies seem to show that a diet high in unhealthy fats and meat may raise your risk. This finding is also associated with other cancers, but experts caution that more research is needed. It is important to note the link between high consumption of refined carbohydrates and sugar and obesity, as obesity is a risk factor for certain cancers like NHL.
True or false: Following a healthy lifestyle can help to lower risk of NHL
True. Consuming a diet rich in fruits and vegetables, fish, and plant-based proteins, whole grains, heart healthy fats, and reduced fat dairy products can help to lower risk of developing many of the lifestyle-related cancers including NHL. Maintaining a healthy weight and having an active lifestyle can also help to reduce risk. Buying organic products, especially when it comes to the dirty dozen, can reduce pesticide exposure. Other ways to lower risk: Refrain from smoking and drinking excess alcohol, get adequate sleep, and reduce stress overall.