What Causes Lymphoma?

I have mixed feelings about an article I read a couple of days ago.

The article is called "What Causes Lymphoma (the Epidemiology of Blood Cancer)?" and it was published by The Examiner.  The author, I should point out, hosts a radio show on cancer, and is an excellent advocate for cancer patients.

But something about the article kind of nags at me.

The article addresses the question, What causes lymphoma? (as the title suggests). It then runs down some of the possibilities: exposure to certain chemicals, some pesticides, maybe some hair dies and solvents -- some associations being stronger than others. People with autoimmune disorders seems more vulnerable, as do people who had certain previous cancer treatments. Exposure to the EBV virus seems like a possibility.

I think maybe one thing that bothers me is that the article is so general. Not many specific lymphomas are mentioned, so it's hard to make a connection between some environmental issue and a particular disease. It also fails to mention that sometimes lymphoma seems to come from spontaneous genetic mutation.

Now, the author does make clear that sniffing a pesticide isn't automatically going to give you cancer: "We know that there is more to the equation than exposures to toxins and viruses.  After all, many people exposed to these agents do not get lymphoma and many people with lymphoma do not have known exposures to these agents.  Our immune system plays a critical role in defeating cancer and lymphoma actually is cancer of the immune system.  This is why understanding what causes lymphoma is critically important not only for lymphoma, but also for unlocking the mysteries to other cancers and other diseases."

It's also clear that this article is a kind of teaser for his radio show, which will discuss the epidemiology of lymphoma on May 15 (and it sounds like a great show).

But here's what bothers me about it. I agree, as he says, that "Curiosity may kill a cat, but a better understanding of 'what causes cancer' will save untold lives through prevention and through the development of better treatments." Curiosity in a cancer researcher? Absolutely. But in a patient? Maybe not always.

The article called to mind a conversation I had with someone who had a family member diagnosed with Follicular Lymphoma. She was getting a little obsessed with the "What caused this?" question, and asked me about it. I told her I had no idea what caused Follicular Lymphoma, particularly her family member's, but mentioned a few of those associations that the article mentioned. "He's a swimmer," she said. "Could it have come from swimming in a lake?"

I told her, of course, that I had no idea. But for a long while, she really needed to know, just what did he do to bring this upon himself?

And I think that's not healthy for anyone, especially a cancer patient. Does it matter how it happened? Don't we have enough to worry about without the added guilt about choices we made at some other time earlier in our lives? Now, I suppose one could argue that a 50 year smoker "brought it on themselves" (though I would never wish cancer on anyone). But what about someone who worked on a farm for 50 years and was exposed to pesticides? What's the point of regretting a lifetime of hard work, and of taking care of your family by doing it?

I don't mean to trash the article. As I said, I think the subject is fascinating, and I'll no doubt listen to the webcast of the show. But I want cancer patients reading to take it for what it is -- interesting subject matter that will have consequences for the researchers who are trying to help us. And not a cause for obsessing over things we can't control. We have enough of those.