Labels of Hodgkins & Non-Hodgkins Lymphoma
Hodgkins Disease was named after Thomas Hodgkin (1798-1866) who was an English scholar and physician working at Guy's Hospital in England. In his 1832 paper On Some Morbid Appearances of the Absorbent Glands and Spleen, cases of a particular type of lymphoma were reported. This resulted in a later paper acknowledging his discovery of this cancer type by coining the term Hodgkins Disease.
In 1898 Carl Von Sternberg described giant 2 nuclei cells however he never clearly separated Hodgkin's Disease from active tuberculosis since a number of his patients had both disorders. This was achieved by Dorothy Reed in 1902. Since Hodgkin's Disease could be detected by microscopy, those lymphomas not displaying Reed-Sternberg cells were described as Non-Hodgkins Lymphomas. This pathological classification system which has been in existence now for over 100 years has had a number of negative impacts for patients.
1. Provision of Inaccurate Survival Information to Patients.
For any patient it is vital they are given an accurate understanding about the seriousness of their lymphoma type. Non-Hodgkins Lymphoma encompasses some 33 different lymphoma subtypes each with its own clinical course. Often when diagnosed, patients may only be told they have NHL with their prognosis being vaguely discussed. Patients searching for their own answers may thus be very mislead by survival curves for NHL. When facing a serious illness like lymphoma it is essential that patients be given the opportunity to receive accurate information allowing them to plan for their future.
2. Facilitates Public Confusion.
Many people do not understand that Hodgkin's Disease is a type of lymphoma, nor that lymphoma is a type of blood cancer. Using technical language such as NHL confuses the general public, breast cancer for example isn't referred to as ductal carcinoma, nor bowel cancer as adenocarcinoma. Keeping it simple will assist public comprehension of the disease and hopefully encourage a greater interest in fighting it.
3. Minimizes the Tragedy of the Disease.
Use of the prefix non diminishes the severity of being diagnosed with lymphoma. Using a negative to describe a cancer type could be a contributing factor to the poor level of public awareness and interest in lymphoma.
4. Impairs our Understanding of the Disease.
Lymphoma is one of the fastest growing cancers in the Western world. Unlike lung cancer and melanoma the cause for this disease is for the most part currently unknown. To find answers it is essential that accurate data is kept on the number of new lymphoma cases each year. As there are over 30 different types of lymphoma knowing whether this increase is occurring in all lymphomas or is restricted to a few subtypes may contribute to our understanding of the disease and its cause.
The Lymphoma Support and Research Association recognises that patients diagnosed with all types of lymphoma have serious diseases, deserve disease specific information and will benefit from a greater public understanding of their illness. As a result we prefer to use the latest World Health Organisation Classification system for lymphoma which divides the disease into 3 basic groups. Hodgkin's Lymphoma, B-Cell Lymphoma and T-Cell Lymphoma.
