Well, many times we don't actually know. We do know what exactly happens in the cells. We can see that the cells undergo a genetic change. And as they do that, they may grow quicker than they should, and they may persist and not die off like they should. That causes them to slowly accumulate over time. But exactly what brought about that genetic change, we don't always know.

This is not a disease that's passed down in families, although families can be more susceptible. But we think there are some susceptibility genes that may put you at risk for being more likely to get lymphoma. That does, however, require something else to happen, often in the way of exposures to toxins or viruses or something else.

Well, I think it's important to recognize what the goals of treatment are. Low-grade lymphomas have an advantage in that they can take a very long time to cause any symptoms, and certainly a very long time to put the patient's health at risk. However, we do not have a curative treatment that will fix the cancer right away. So we want to weigh up the potential risks and side effects that come with treatment compared to, clearly, the risks and side effects that come from the cancer. So, if you have a cancer that is very low-grade, growing very slowly, giving you no symptoms, we would hold off on treatment and only initiate it when you truly need it.

Well, important to know that chemotherapy may have two components. Chemotherapy, or chemical drugs that are targeting the cancer, immunotherapy, or antibody treatments that are going after proteins that are on the outside of the cancer or lymphoma cells. The goal of chemotherapy is to kill quickly- growing cells, which is a good thing because lymphoma, many times, those cells are growing quickly. The challenge, however, is there are healthy cells that may also be growing quickly. Immunotherapy, as I mentioned, binds or attacks proteins on the outsides of cells. But some of the lymphoma cells and some of the normal cells have the same proteins. So those cells may be depleted, and your immune system may become a little bit more suppressed as one of the potential side effects of therapy.

Well, I really wish that was true. Unfortunately, that's not exactly correct. There isn't a treatment or exercise program that directly targets or goes after the lymphoma cells. Generally, however, what a healthy balanced diet and a good exercise program is doing is improving your general well-being, improving your immune system function, and allowing you to tolerate the chemotherapy and fight against the cancer to a greater degree. The good news is that many studies have shown that a healthy patient who's in good shape actually has a better outcome when receiving treatment for lymphoma. So that's a strong motivation for you to be healthy by eating well and exercising regularly.

Get as much information as you can. Partner with your physician, your nurse practitioner, your PA and other members of the team and ask questions. The goal moving forward is for you to have the best outcome possible. So that sharing of information between your team and you is critical to your outcome and the best results we could hope for.