Cover

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Half Title, Title Page, Copyright, Dedication, Quotation

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Contents

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pp. ix-x

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Foreword

W. Jeffrey Baker

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pp. xi-xiv

A diagnosis of cancer changes a person’s life forever. Fear and uncertainty about the future can be disabling. The task of negotiating the labyrinth of the modern medical system is daunting and treatment decisions can be overwhelming. ...

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Preface to the Second Edition

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pp. xv-xviii

In November 1996, I was diagnosed with non-Hodgkin lymphoma (NHL), a form of cancer. At the time of my diagnosis, I knew very little about lymphoma. Suddenly cast adrift on an unexpected medical leave from work, however, I exploited my background as a biologist to learn everything I could about the disease and its treatment. ...

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Preface to the First Edition: Journeys in a Dark Wood

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pp. xix-xxiv

In November 1996, I was diagnosed with non-Hodgkin lymphoma, a form of cancer that affects the cells of the immune system. I had recently accepted a new position at a liberal arts college and moved from Boston to western Massachusetts. I’d been very busy settling into my new and challenging job and hadn’t yet developed a strong local network of friends. ...

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Introduction

Michael R. Bishop

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pp. xxv-xxxii

There is nothing that prepares an individual for the diagnosis of lymphoma—or any cancer, for that matter. When a new diagnosis of lymphoma is shared with patient, family, or friends, the response varies with each person who is hearing it. The perspective that matters the most, of course, is that of the person who is diagnosed with the lymphoma. ...

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Part I: Living with Lymphoma

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pp. 1-2

Learning you have cancer is never easy. Different people have different reactions: some are devastated, while others are angry; some are overwhelmed with a sense of loss, while others feel greater appreciation for what they do have; some are determined to fight to the utmost, while others resolve to accept whatever happens with grace. ...

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Chapter 1. What Is Lymphoma?

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pp. 3-14

I am a neurobiologist. In 1994, I began an academic position at a liberal arts college in a beautiful area in the Berkshire Mountains of western Massachusetts. After many years spent working in the laboratory, I found the combination of teaching and doing research to be very challenging: both exciting and stressful. ...

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Chapter 2. Symptoms and Diagnosis

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pp. 15-60

Being diagnosed with cancer can be overwhelming. Even the word itself is ominous. And almost always, the diagnosis is followed by a plunge into an unfamiliar world of medical tests and procedures. None of these procedures are fun; some of them are frightening, bewildering, or intimidating. ...

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Part II: Treating Lymphoma

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pp. 61-68

While chemotherapy and radiation therapy continue to be mainstays of lymphoma treatment, more selective “magic bullet” approaches—particularly those involving antibodies directed against proteins found on lymphoma cells—have become frequent components of lymphoma therapy as well. ...

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Chapter 3. Chemotherapy

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pp. 69-135

Chemotherapy is the use of drugs—chemicals—that are toxic to malignant cells to treat disease. In some cases, chemotherapy is used with the intention of trying to cure cancer. When a cure is not considered possible, chemotherapy may be used to alleviate symptoms of disease and prolong life. ...

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Chapter 4. Radiation Therapy and Surgery

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pp. 136-150

Radiation therapy, like chemotherapy, is intended to selectively kill malignant cells while sparing normal cells as much as possible. Like chemotherapy, radiation therapy (also called radiotherapy) is most active against rapidly dividing populations of cells. Unlike most forms of chemotherapy, radiation can be applied locally, to specific areas of the body, ...

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Chapter 5. Monoclonal Antibodies and Other Magic Bullet Therapies

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pp. 151-180

We’ve come a long way in lymphoma treatment over the past fifty years. The majority of people with Hodgkin lymphoma can now be cured, and they will move on from their brush with death to have normal, healthy lives. Many people with aggressive NHL and some with indolent NHL can now be cured as well. ...

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Chapter 6. Stem Cell Transplants

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pp. 181-208

The first time I met my oncologist, she told me about stem cell transplants. She didn’t know whether I would be cured with front-line therapy, and she wanted to reassure me that we had backup options. A stem cell transplant is a procedure that uses high doses of antineoplastic drugs, or of radiation, ...

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Chapter 7. Unconventional Therapies

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pp. 209-246

Shortly after I was diagnosed with NHL, I started digging around on the Internet to try to find out my prognosis. The survival statistics I turned up were discouraging: they indicated that it was more likely than not that I’d be dead within the next few years. While my oncologist tried hard to sound encouraging, it was clear that she, too, thought the odds were stacked against me. ...

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Chapter 8. Survivorship

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pp. 247-260

Many people use the term cancer survivor to refer to anyone diagnosed with cancer who is still alive. From this perspective, we are lymphoma survivors from the instant we are diagnosed with the disease (or perhaps from the moment a malignant cell first set up residence in our bodies). ...

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Part III: Understanding Lymphoma

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pp. 261-262

The final part of this book is focused less on understanding what it is like to experience lymphoma and lymphoma treatment and more on understanding the underlying disease. Chapter 9, “Basic Cell Biology and Cancer,” is an introduction to cell biology; ...

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Chapter 9. Basic Cell Biology and Cancer

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pp. 263-279

This chapter describes basic cell biology and then looks closely at what goes wrong on the cellular level when someone develops cancer. Cancer arises when there is a disruption of the normal mechanisms that govern how frequently cells divide, how long cells survive, and where cells grow. ...

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Chapter 10. The Immune System

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pp. 280-313

Lymphoma involves a class of cells called lymphocytes. If you have lymphoma, it means that, at some point, somewhere in your body, a lymphocyte made an error in copying the genetic information that directs how that cell was supposed to look and behave. When the cell reproduced itself, it passed this error on to its daughter cells. ...

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Chapter 11. Lymphoma Classification and Staging

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pp. 314-367

In this chapter I discuss the different types of lymphoma. I describe the system currently used to classify the lymphomas and discuss the individual types of lymphoma in some detail. I also describe how the stage of disease—which defines how far lymphoma has spread through a person’s body—is determined. ...

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Chapter 12. Possible Causes of Lymphoma

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pp. 368-392

At some point, many people who are diagnosed with lymphoma become focused on the question “Why did this happen to me?” Wanting to understand what caused a catastrophic illness is natural and may be a universal drive. But for most people with lymphoma, this is not yet a question that can be easily answered. ...

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Afterword

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pp. 393-394

It’s been a long time now since I was diagnosed with cancer, and I am considered cured of lymphoma. I am no longer a young woman, and the changes that cancer wrought in my life are now part of who I am: from my chronic cough, new hair texture, and abysmal handwriting to my existence as someone who will never have children and is no longer an academic scientist. ...

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Acknowledgments

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pp. 395-396

During the course of my battle with lymphoma, I realized how very important it is for someone struggling with a life-threatening illness to have something to live for. I would first like to acknowledge my family—the people whose love and support during this time were essential to my survival. ...

Glossary

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pp. 397-424

Index

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pp. 425-444