Red Sox Manager John Farrell Diagnosed with Lymphoma

Red Sox Nation is in shock today after the announcement that Manager John Farrell has been diagnosed with cancer, specifically lymphoma.

The announcement came during Farrell’s routine pre-game briefing. Stepping to the mike, Farrell said, “I know we usually start out with the injury report.  “I’ll probably start out with myself on this one.”

Farrell underwent what was to be a routine hernia surgery earlier in the week. During the procedure, doctors found a mass which they removed. Testing showed that it was lymphoma. Fortunately, it was found early and was described as Stage 1. The 53-year-old typically stoic manager fought back tears as we went on to say that the cancer is localized and highly treatable:

“Thankfully it was detected in the hernia surgery, so I can honestly say I’m extremely fortunate it was found. There’s going to be a good outcome to this.”

Farrell will step down immediately as manager, handing over the duties to bench coach Torey Lovullo in his absence. He will undergo nine weeks of chemotherapy and hopes to be back with the team by spring training.

Support from Red Sox players, past and present, came swiftly. Former Red Sox pitcher, Jon Lester, who had his own battle with lymphoma in August 2006, is confident  that Farrell will be just fine:

“If you know John, he’s pretty strong-willed. I’d imagine he’ll be fine. I’m sure it’s a little bit of a blow for his family. I’m sure he’ll be fine through this whole process.”

What is lymphoma?

Lymphoma is cancer that begins in cells of the lymph system. The lymph system is part of the immune system, which helps the body fight infection and disease. Because lymph tissue is found all through the body, lymphoma can begin almost anywhere.

The two main types of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). Most people with Hodgkin lymphoma have the classic type. With this type, there are large, abnormal lymphocytes (a type of white blood cell) in the lymph nodes called Reed-Sternberg cells. Hodgkin lymphoma can usually be cured.

Lymphoma, including Hodgkin lymphoma and non-Hodgkin lymphoma (NHL), is the most common blood cancer in the United States and is estimated to represent approximately 5 percent of all new cancers diagnosed in the United States in 2014. Nearly 71,000 new cases of NHL and nearly 9,200 new cases of Hodgkin lymphoma were estimated for 2014.

1280px-Blausen_0909_WhiteBloodCellsThere are two types of lymphocytes in the blood- B-cells and T-cells, each with a different job within the immune system. B-cells normally help protect the body against bacteria or viruses by making proteins called antibodies. The antibodies attach to the bacteria or viruses and attract other immune system cells that surround and digest the antibody-coated germs.

There are several types of T-cells, each with a specialized job. Some normal T-cells help protect the body against “foreign invaders”- viruses, fungi,and some bacteria. T-cells can also release substances called cytokines that attract certain other types of white blood cells, which then digest the infected cells. T-cells are also thought to destroy some types of cancer cells, as well as the cells of transplanted organs. Some types of T-cells play a role in either boosting or slowing the activity of other immune system cells. Because there are many different lymphocytes, there are many different forms of NHL.

Non-Hodgkin lymphoma begins when a lymphocyte becomes abnormal. The abnormal cell divides to make copies of itself. The new cells divide again and again, making more and more abnormal cells. The abnormal cells don’t die when they should. They don’t protect the body from infections or other diseases. The buildup of extra cells often forms a mass of tissue called a growth or tumor. Because lymph tissue is found throughout the body, adult non-Hodgkin lymphoma can begin in almost any part of the body.

Symptoms of NHL can be nonspecific, as well as identical to those of patients with Hodgkins Lymphoma:

  • Painless swelling in the lymph nodes in the neck, underarm, groin, or stomach.
  • Fever for no known reason.
  • Drenching night sweats.
  • Feeling very tired.
  • Weight loss for no known reason.
  • Skin rash or itchy skin.
  • Pain in the chest, abdomen, or bones for no known reason.

While many effective treatment options exist, low grades of NHL usually recur, and some people go in and out of remission for years, some for 20 years or more. In certain patients with low grade disease, treatment may not be necessary until there are signs of progression. However, 30%-60% of patients with aggressive NHL can be cured. Many people treated for NHL will receive some form of chemotherapy, radiation therapy, biologic therapy, or a combination of these. Bone marrow or stem cell transplantation may sometimes be used.

Non-Hodgkins Lymphoma is becoming a disease on the leading edge of new research techniques that may be applied to other cancers.  These include: antibody treatments, vaccines, tumor profiling (like a fingerprint), and new therapies that are biologically targeted to unique abnormalities specific to certain lymphomas.

Source: National Cancer Institute

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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