Maybe you know him as the Senator from Tennessee who mounted an unsuccessfully Presidential bid in 2008. Or perhaps as the Minority Counsel for the Republicans during the Watergate hearing. Or for his movie career in films like The Hunt for Red October, or for his five year stint as District Attorney Arthur Branch on Law and Order, or perhaps even as the advertising spokesperson for reverse mortgages.
But no matter which way you knew him, news of Senator Fred Thompson‘s death came as a shock to many. Thompson died at the age of 73, after a ten year battle with non-Hodgkin’s Lymphoma (NHL).
Thompson’s cancer was picked up in 2004 after a routine physical exam. He was diagnosed with a rare form of non-Hodgkin’s lymphoma called nodal marginal zone lymphoma (NMZL). This form tends to grow more slowly than other forms of NHL. He had been treated with a medication called retuximab (RITUXAN®), but was no longer on the drug when he decided to run for President in 2008. At that time he told Fox News:
“I have had no illness from it, or even any symptoms. My life expectancy should not be affected. I am in remission, and it is very treatable with drugs if treatment is needed in the future — and with no debilitating side effects.”
It has not been revealed when Thompson’s lymphoma returned, but a statement from his family said:
“It is with a heavy heart and a deep sense of grief that we share the passing of our brother, husband, father, and grandfather who died peacefully in Nashville surrounded by his family….He enjoyed a hearty laugh, a strong handshake, a good cigar, and a healthy dose of humility. Fred was the same man on the floor of the Senate, the movie studio, or the town square of Lawrenceburg, his home.”
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’s 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. Patients with lymphoma without Reed-Sternberg cells are said to have non-Hodgkin’s lymphoma.
There 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.
Nodal marginal zone lymphoma (nodal MZL) is a rare cancer of the B-cell lymphocytes, occurring in only about 1-3 % of patients with lymphoma.
Nodal means the lymphoma started in the lymph nodes. The marginal zone is a specific area of a lymph node where B cells are produced. This is where the abnormal B-cells are found in nodal MZL.
NMZL usually affects people in their 60s and older.
Patients with NMZL can be asymptomatic, or may have symptoms similar to patients with other forms of lymphoma:
If a patient is asymptomatic, patients may elect putting off treatment. This is referred to as a “watchful waiting approach.”
Other approaches include radiation therapy, chemotherapy with medications such as chlorambucil or fludarabine, or a drug called rituximab (RITUXAN®), which is a monoclonal antibody that targets B-cells.
A monoclonal antibody like Rituximab can activate the immune system to attack a cancer cell. It binds to a surface protein, called CD20, located on mature B lymphocytes (B cells). Once attached, the antibody activates the body’s immune system, which then attacks the cancer cells.