Jeff Bridges, son of the late Hollywood legend, Lloyd Bridges, and star of True Grit and Starman, ... [+] announced his diagnosis of lymphoma on October 20th, 2020.
Hollywood legend, Jeff Bridges, recently revealed his diagnosis of lymphoma. While the specific type of lymphoma was not disclosed, the beloved star of The Big Lebowski did post on Twitterwhile referencing the cult-classic character with which he is often identifiedthat his prognosis was good.
As fans around the world wished the Academy Award-winning star of Crazy Heart a speedy recovery, the unexpected diagnosis left many with questions about this relatively unusual but not uncommon cancer. With the help of Louis F. Diehl, MD, Professor of Medicine at Duke University Medical School and one of the most treasured mentors throughout my medical training, Ill review five key things to know about lymphoma.
Lymphoma is a cancer of the lymphatic system, which is part of the bodys immune system. The two main subtypes, Hodgkin Lymphoma (HL, a.k.a. Hodgkin disease) and Non-Hodgkin Lymphoma (NHL), begin in a subset of white blood cells called lymphocytes which fight off infections.
NHL can be further classified by growth rate: indolent (slow-growing) cancers such as follicular lymphoma versus aggressive cancers like diffuse large B cell lymphoma (DLBCL). The type of lymphocyte affected is another way of categorizing NHL: B-cell lymphomas are most common and include DLBCL, Burkitt, follicular and mantle cell lymphoma; T-cell lymphomas include cutaneous T-cell lymphomas and adult T-cell leukemia/lymphomas.
Lymphoma and leukemia in many ways are the same disease, explains Dr. Diehl, who trained at Walter Reed Army Medical Center and has specialized in liquid tumors for nearly 40 years. The cell that goes bad and causes these diseases lives in the bone marrow, blood and lymph nodes.These bad cells can become cancer in any one of these locations and then spread. He added: If the most disease is in the blood, we call it leukemia; if the most disease is in lymph nodes, we call it lymphoma.
Burkitt's lymphoma cells. Computer illustration of malignant B-cell lymphocytes seen in Burkitt's ... [+] lymphoma.
According to the American Cancer Society (ACS), several risk factors have been associated with HL but the reasons are unknown. Epstein-Barr Virus, which causes infectious mononucleosis, a.k.a. mono; age, mostly young adults in their 20s and those over 55; and an impaired immune system (e.g. people with HIV) can increase the risk of HL. Risk factors for NHL include older age (over 60), white race, family history among first-degree relatives, autoimmune diseases (lupus, Sjgren) and certain infections (HTLV-1, EBV, HHV-8). But often, the true causes of lymphomas arent that clear.
Theres no known specific cause, says the Duke oncologist. But we see a connection in jobs with machine products, as well as fertilizers, Agent Orange and older hair dye products. Dr. Diehl adds that survivors of 9/11, particularly firefighters, are at risk for developing lymphomas by inhaling carcinogenic smoke released by burned synthetic and plastic materials.
Photo Essay At Nice University Hospital, Archet Hospital About Bone Marrow Donation, France. ... [+] Sampling Of Bone Marrow That Will Be Done In The Operation Room. The Puncture Is Done At The Level Of The Iliac Bone With A Mallarme Trocar. (Photo By BSIP/UIG Via Getty Images)
The most common symptoms reported by the Lymphoma Research Foundation include fever, fatigue, unintentional weight loss, night sweats, chills, shortness of breath, chest pain/pressure, lack of energy, swollen lymph nodes (often painless), easy bruising and bleeding, and frequent infections. Diagnostic tools start with a physical exam where your doctor will check for enlarged lymph nodes in your neck, underarm or groin. A biopsy of a lymph node or bone marrow must be performed in order to obtain tissue/cells which are sent for various tests to determine if lymphoma cells are present and if so, what type. Additional diagnostic tests including imaging (e.g. x-ray, CT, MRI, PET scan, ultrasound) and endoscopic procedures (e.g. bronchoscopy, colonoscopy, cystoscopy, laparoscopy).
Louis F. Diehl, MD, an army veteran who trained at Walter Reed Army Medical Center, is a medical ... [+] oncologist at Duke University Hospital and has been caring for patients with lymphomas and leukemias for nearly 40 years.
Treatment will depend on the type and stage of lymphoma. HL is often treated with chemotherapy (e.g. ABVD which consists of Doxorubicin, Bleomycin, Vinblastine and Dacarbazine); radiation therapy, where high-energy rays destroy cancer cells; immunotherapy which uses monoclonal antibodies to target a specific protein on the cancer cell; as well as stem cell transplantation. Surgery is rarely used to treat HL, except for biopsy and staging. Dr. Diehl is certainly optimistic about the trajectory of treatment, especially immune-based therapies.
If you look at the history of lymphoma treatment, we began by adding more and more drugs that were toxic to cancer cells but also to many healthy cells, referring to chemotherapy. The former 23-year army veteran reflected further:Over the last 20 years, clinicians and researchers have used the patients own immune system against the cancer. Monoclonal antibodies, for instance, specifically target a substance on cancer cells; other immunotherapies break down the cancer cells defense system. Andweve created linkers which attach T cells to cancer cells, then activate the former to kill the latter.
Woman with cancer has her infusion port flushed before undergoing chemotherapy.
For some patients, treatment completion can be both stressful and exciting. Its a relief to finish multiple rounds of chemo-radiation, but recurrence of the cancer can be worrisome. Some types of lymphoma may never be cured, warranting regular treatments to keep the cancer in check. Living with cancer long-term can be challenging and nerve-wracking. Post-treatment, your doctor will want to monitor you closely with physical exams, labs and imaging. In addition to recurrence, treatment side effects may appear after months or years. Your cancer care team should recommend a diet and physical activity plan. Remember, the mixture of depression, anxiety and stress is normal. When lymphoma is part of your life, emotional and psychological support can be immensely helpful. In Life After Cancer, the ACS shares many beneficial tips including counseling, support groups and spirituality.
Lymphoma and leukemia can affect children. Chemotherapy can lead to hair loss.
After nearly four decades caring for cancer patients, I asked my former mentor what if anything surprised him. Im still surprised by the complexity of the disease and the spirit of the patients. The average patient is one heck of a fighter. So tough. So gracious.
In light of caring for sick and dying patients in the midst of the Covid-19 pandemic, I reflected on President Trumps decision on January 28th, 2020 to withhold knowledge of the virulence and lethality of SARS-Cov2. His rationale? He didnt want to create a panic. Ten months later, the novel coronavirus has killed over 225,000 lives in the United States.
In this era of politicized public health, I asked Dr. Diehl, the ultimate empathic and evidence-based leader, about conveying difficult diagnoses an art he has mastered over his distinguished medical career. You cannot lie to a patient. Oncologists try to put on a positive spin, but its still the truth. This edict applies to our elected officials who should also not lie to the public, particularly about life and death issues impacting every aspect of our livelihood.
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The Dude Has Cancer: Five Things To Know About Lymphoma - Forbes