- Actress and activist Jane Fonda has announced that she has been diagnosed with non-Hodgkin’s lymphoma.
- This is a type of blood cancer that affects the body’s immune cells.
- There are many forms of non-Hodgkin’s lymphoma, with “high grade” being the most common and most treatable..
- Treatments have relatively good success rates and new therapies continue to emerge.
This month, Jane Fonda, the Oscar-winning actress and activist, announced that she had been diagnosed with non-Hodgkin’s 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 that I want to share,” she wrote. “I was diagnosed with non-Hodgkin’s lymphoma and started chemotherapy treatments.”
However, his outlook was positive. “It’s a very treatable cancer,” she continued. “80% of people survive, so I feel very lucky.”
This isn’t Fonda’s first experience with cancer. She has previously opened up about having skin cancers removed, as well as a non-cancerous breast tumor (before having a mastectomy several years later).
“NHL is a cancer of one of your immune cells, the lymphocytes. It’s one of your blood cells, and their normal function is to fight infection,” Dr Dima El-Sharkawi, consultant haematologist at the Royal Marsden NHS Foundation Trust in London, told Healthline.
However, there is not just one type of NHL.
“When we say NHL, that’s a pretty broad umbrella,” said Dr. Guillermo de Angulo., pediatric hematologist/oncologist at KIDZ Medical Services in Florida, explained to Healthline.
“It can be anything from B-cell lymphoma or T-cell lymphoma to Burkitt’s lymphoma or what we call anaplastic large cell,” he continued. .
El-Sharkawi added that most cases of NHL are B-cell lymphomas – and “generally speaking they can be high-grade or low-grade.”
High-grade lymphomas, she shared, involve faster cell turnover. As such, patients generally present as sicker 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.
NHL Fonda’s subtype has not been disclosed. But, due to the high recovery rate she pointed out, El-Sharkawi and de Angulo said it could be high-grade B-cell lymphoma.
“When you talk about lymphomas, we divide them into two groups: Hodgkin’s lymphoma (HL) and NHL,” de Angulo said.
“HL has certain characteristics, and we are looking for certain proteins or markers that identify and confirm whether it is Hodgkins. If it is [doesn’t have these]we classify it as NHL.
According to de Angulo, the symptoms of NHL are similar to those of HL. “One of the signs we often see,” he said, “is an enlarged lymph node or a palpable mass.”
These usually occur in the neck, armpits or groin – but, in rarer cases, can occur in other parts of the body.
“Patients can have lymphoma affecting their stomach or liver, and you can even have lymphoma affecting the brain,” El-Sharkawi said.
The location of the lump or enlarged knot can lead to secondary symptoms. For example, “if [it] is in an area where it is compressing a structure or pressing on a nerve, it can cause irritation or pain,” de Angulo explained.
Besides a knot or enlarged mass, there are several other key signs, including:
- Night sweats (up to soaking wet sleepwear and sheets)
The only way to definitively diagnose NHL is to biopsy the affected area, El-Sharkawi said, “because there are other reasons for swollen glands and swollen lymph nodes.”
“In most cases, there are no known causes of NHL,” Dallas Pounds, director of services at UK charity Lymphoma Action, told Healthline.
However, it is believed that there may be a few potential risk factors.
In terms of genetics, there is no particular gene linked to the development of NHL, unlike some other types of cancer, such as breast cancer.
That said, “there seems to be some familial predisposition,” El-Sharkawi noted. “If you have a first-degree relative with NHL, you are slightly more likely (compared to the general population) to get it – [but] it is still very rare.
Fonda’s age may be a factor in her diagnosis. “Generally speaking, NHL is more common in people over 60 and 70,” El-Sharkawi said. However, she added, “it can be in any age group – children can develop NHL.”
De Angulo explained that people with existing health conditions — such as certain autoimmune diseases — may also be at higher risk of developing NHL. “People who have had certain forms of treatment, such as for ulcerative colitis or lupus, may [have] increased risk of lymphoma.
Additionally, patients who have had “solid” organ transplants (such as liver or kidney) are also sometimes at higher risk, he said. This is due to the immunosuppressive drugs they have to take after the operation.
“When you’ve had a solid organ transplant, you want to suppress the immune system so that you don’t reject the organ that was transplanted,” he explained. “But, that same immune system is the one that makes sure you don’t get lymphoma.”
“Each person diagnosed with lymphoma will have an individual treatment plan based on them as an individual and their presenting symptoms,” Pounds said.
While low-grade lymphomas grow more slowly, they cannot be treated but not cured with current therapies.
High-grade lymphomas, however, “are potentially curable with chemotherapy,” El-Sharkawi explained. “Because [they] divide faster, they are more responsive to chemo, which essentially targets the ability of these cells to divide and proliferate.
Chemotherapy is generally used because, unlike targeted therapies, such as radiotherapy or surgery, the treatment can reach many areas. This is essential because blood is constantly moving through the body.
Additionally, targeted antibody therapy is given in conjunction with chemotherapy, which can increase the chance of remission.
Fonda shared that she began six months of chemotherapy treatments. These are mostly conducted on an outpatient basis, de Angulo said, and administered over six cycles.
Other treatments for lymphoma are available, although they “tend to be relapsed/refractory”. [high-grade patients] — so when the disease came back after treatment or they didn’t respond,” El-Sharkawi noted.
These include “smart drugs,” de Angulo said, “that attack cells that express a certain antigen.”
Another option is called CAR-T therapy. “[This] is an exciting new way to treat lymphoma,” El-Sharkawi enthused. Essentially, the patient’s T lymphocytes are manipulated in the laboratory so that they know how to target B lymphocytes, before being reintroduced into the body.
“It’s like a living medicine made from their own blood cells,” she added.
NHL is a type of blood cancer that affects immune cells and is one of the most common cancers in the United States. It can affect people of all ages, but is more often seen in people over 60.
There are many subtypes of NHL, but symptoms typically include lymphatic enlargement or mass, night sweats, fatigue, and weight loss.
Chemotherapy is the most popular type of treatment, although new targeted therapies continue to emerge and be beneficial.
“The outlook for someone with non-Hodgkin’s lymphoma will depend on several factors,” Pounds said. “But many people will respond well to treatment and then go into a period of remission or stability.”