Skip to Main Content

Leukemia and Lymphoma

Dr. Tuckson speaks with Dr. Joseph Flynn, chief administrative officer of Norton Medical Group and physician-in-chief at Norton Cancer Institute.
Season 14 Episode 12 Length 26:59 Premiere: 01/20/19

About

Join host Dr. Wayne Tuckson, a colorectal surgeon, as he interviews experts from around the state to discuss health topics important to Kentuckians.


Funding for this program is made possible in part by:


About the Host

A native of Washington, D.C., Dr. Wayne Tuckson is a retired colon and rectal surgeon based in Louisville. For more than 20 years, he has served as host for Kentucky Health, a weekly program on KET that explores important health issues affecting people across the Commonwealth. A graduate of Howard University School of Medicine, Tuckson is a past president of the Greater Louisville Medical Society and is a recipient of the Community Service Award from the Kentucky Medical Society, the Thomas J. Wallace Award for “Leadership in Promoting Health Awareness and Wellbeing for the Citizens of Jefferson County” given by the City of Louisville and the Lyman T. Johnson Distinguished Leadership Award given by the Louisville Central Community Centers.


Leukemia and Lymphoma: Treating Complex and Common Cancers

White blood cells are essential components of human biology as our body’s first line of defense against bacteria, viruses, and other foreign invaders. The cancers leukemia and lymphoma occur when the normal process of white blood cell production to fight infection is disrupted through mutations in white blood cells in the lymphatic system (lymphoma) or in blood forming tissues such as bone marrow (leukemia). Leukemia and lymphoma are common cancers with many variations, but in recent years, breakthroughs in research have helped physicians treat them more effectively, and in many cases patients with these cancers can manage their disease.

In this episode of Kentucky Health, Dr. Wayne Tuckson welcomes an oncologist with Norton Healthcare in Louisville to learn about the different types of leukemia and lymphoma and how to treat them.

Dr. Joseph Flynn, D.O., MPH, FACP, is the chief administrative officer of Norton Medical Group and physician-in-chief at Norton Cancer Institute.

“Approximately 80,000 people a year will be diagnosed with lymphoma, and another 60,000 with leukemia, so they’re around the seventh most common malignancies we see in adults,” Flynn says.

Identifying Cancers of the Blood
“Leukemia is just abnormal growth of white blood cells,” Flynn states. “White blood cells are in our body to fight infection. Really, in cancer in general, whether it’s breast cancer or any cancer, either the cells look funny and don’t function normally, or they grow abnormally. In leukemia, you typically see both.”

Lymphoma is also a cancer affecting white blood cells, but originates in the lymphatic system – “your lymph nodes, your spleen, and you can also see (lymphoma) in you bone marrow as well. In any of those tissues that are normal places for fighting infection, you can see lymphoma.”

There are several different sub-types of leukemia, while lymphoma is largely identified as the categories of Hodgkin’s or non-Hodgkin’s – and within those categories there are sub-types as well. Breakthroughs in genetic research have allowed oncologists, hematologists (doctors specializing in blood) and researchers to more accurately pinpoint different sub-types of leukemia and lymphoma, leading to more targeted treatment.

“If you look at chronic lymphocytic leukemia, that’s a continuum between leukemia and lymphoma, and there’s a number of those entities,” Flynn says. “Back in the days when I trained, we weren’t able to discern between them as well. In the advent of what we call flow cytometry, or immuno-phenotyping the cells, looking at very small molecular surface markers, we can tell now how (leukemia and lymphoma) differ. Certainly we have a better understanding of their natural history.”

Flynn presents a series of slides showing microscopic images of various types of leukemia and lymphoma, where irregular cells in the blood and bone marrow are visible. Incidence rates for these diseases have been relatively stable over the past 20 years. There was a rise in lymphomas at the height of the HIV/AIDS crisis, Flynn notes, due to the weakened immune systems of persons infected with HIV. Having a persistently suppressed immune system is a risk factor for developing blood cancer, Flynn says, and there is a genetic component to some sub-types of lymphoma as well.

Persons with swollen lymph nodes that persist for long periods of time should be examined for possible lymphoma, while chronic leukemia is often first detected during a blood test during a checkup. Symptoms of acute leukemia are infections, excessive bleeding, and an enlarged spleen.

According to Flynn, patients who have been diagnosed with either leukemia or lymphoma need a very strong hematopathologist on their oncology team in order to identify the exact sub-type of their disease. Leukemia and lymphoma can occur in both children and adults, with some sub-types more common in one age cohort as opposed to the other. The diseases can be both acute and chronic, and the treatment protocol will be based on the pathology and diagnosis, and tailored to that particular cancer.

“Now, with immunotherapies, we’re able to give specific treatments that will have a profound impact on those cells,” Flynn says.

Advances in Treating Leukemia and Lymphoma
For decades, Flynn says that the standard treatment protocol for both leukemia and lymphoma was chemotherapy. Chemotherapy was first applied in the 1940s after military physicians noticed how mustard gas in World War II had wiped out the bone marrow of a group of soldiers exposed to it. A variant of that chemical was then used to treat lymphoma.

Chemotherapy continued to be the most common treatment for blood cancer until the late 1990s, Flynn says. But researchers were also trying to develop methods that patients could tolerate better, without having the adverse side effects of chemotherapy such as hair loss, vomiting, and infections.

“The end of the 1990s was really the advent of immunotherapy, or targeted therapy, with a drug called rituximab, which bonds to the surface protein of these cancer cells,” Flynn says. “Along that same timeline, during the early 2000s was the start of Gleevec.”

The latter drug, introduced by Dr. Brian Druker in Oregon, targeted a protein in chronic myelegenous leukemia. Gleevec could be administered in pill form, and revolutionized treatment of that sub-type of leukemia. “There are many people alive today who take a pill every day to treat their chronic leukemia,” Flynn says.

Further innovations during the early 21st century have resulted in therapies that work for other leukemias and lymphomas, and have given physicians more tools than ever before to help patients manage their disease. Flynn believes the definition of cancer remission is changing due to these breakthroughs.

“The classic timeframe for remission was, if in five years the cancer doesn’t come back, you’re considered cured,” he says. “For some of these chronic leukemias, they’re really incurable, but they’re treatable. So now, the idea may be that if you have chronic lymphocytic leukemia for instance, you are taking a pill, and you may live a normal healthy life with the addition of taking a pill.

“It would be similar to if you were diagnosed with diabetes,” he continues. “If you are not succumbing to your disease, by definition you are not cured, but you really have survived with your disease quite well and can live a normal life.”

Flynn also says that bone marrow transplants are still common treatments for patients with leukemia and lymphoma. He urges all persons watching the program to consider becoming a bone marrow donor, since patients needing the transplant require a specific genetic match. “Finding that person that can match your makeup is a tricky thing,” he says. “You don’t want to give a treatment where those cells you took see your whole body as abnormal or foreign, and then they attack that.”

Another promising therapy for patients with certain types of both diseases is CAR-T cell therapy, which was recently discussed by Dr. Khuda Dad Khan on a recent Kentucky Health program about cancer and immunotherapy. With this procedure, a patient’s T-cells (lymphocytes that fight infection) are extracted, genetically altered, and then re-inserted into the blood, where the modified cells identify and attack cancer cells.

Flynn is excited about the future of cancer treatment based on the rapid and ongoing advances in knowledge and research. Many major strides have already been made in this century.

“People say, ‘It’s awful to get cancer,’ and I agree, ‘It is awful,’” he says. “There’s never a good time to get cancer, but there’s never been a better time with the things we’re able to do for people.”

Season 14 Episodes

2019 Legislative Review: Bills Related to Health and Health

S14 E25 Length 26:47 Premiere Date 05/12/19

Lead and Other Everyday Environmental Dangers

S14 E24 Length 26:59 Premiere Date 05/05/19

Tobacco Cessation: The Power of Group Education and Support

S14 E23 Length 28:46 Premiere Date 04/28/19

Quality and Safety in Healthcare: What's Important

S14 E22 Length 27:07 Premiere Date 04/21/19

Vaccinations: Who, What, When, and Why?

S14 E21 Length 26:33 Premiere Date 04/14/19

The Adolescent Brain and Substance Use

S14 E20 Length 27:09 Premiere Date 04/07/19

Epilepsy: Medical and Surgical Treatment

S14 E19 Length 27:33 Premiere Date 03/31/19

Community Health Workers: Care Away from the Clinic

S14 E18 Length 27:23 Premiere Date 03/24/19

The Flu: It's Not Just a Bad Cold

S14 E17 Length 26:56 Premiere Date 02/24/19

Financial and Mechanical Ways to Protect Our Teeth

S14 E16 Length 27:07 Premiere Date 02/17/19

Aging Optimally

S14 E15 Length 27:15 Premiere Date 02/10/19

Colon Cancer: To Screen or Not to Screen Is Not a Question

S14 E14 Length 27:16 Premiere Date 02/03/19

Autism

S14 E13 Length 26:34 Premiere Date 01/27/19

Leukemia and Lymphoma

S14 E12 Length 26:59 Premiere Date 01/20/19

Hypertension: The Silent but Consequential Disease

S14 E11 Length 26:57 Premiere Date 01/13/19

Genetic Testing: Not a Parlor Game

S14 E10 Length 27:01 Premiere Date 01/06/19

Trauma and Toxic Stress

S14 E9 Length 26:57 Premiere Date 12/16/18

Cancer and Immunotherapy

S14 E8 Length 27:10 Premiere Date 12/09/18

Intestinal Biome: We're in This Gut Together

S14 E7 Length 27:47 Premiere Date 11/18/18

Community Health Centers: Taking the Clinic to the Patient

S14 E6 Length 27:20 Premiere Date 11/11/18

Arthritis

S14 E5 Length 26:58 Premiere Date 11/04/18

Thyroid Disease

S14 E4 Length 27:21 Premiere Date 10/28/18

Breast Cancer

S14 E3 Length 27:05 Premiere Date 10/21/18

Weight Loss: Reasons, Options, Benefits

S14 E2 Length 28:48 Premiere Date 10/14/18

Chiropractic: A Good Back and Neck for a Healthy Body

S14 E1 Length 25:23 Premiere Date 10/07/18

See All Episodes

caret down

TV Schedules

Jump to Recent Airdates

Upcoming

Sports Medicine: It's Not Just for the Athlete

Dr. Nathan McKinney talks about preventing and treating musculoskeletal injuries.

  • Friday February 3, 2023 1:30 pm ET on KETKY
  • Friday February 3, 2023 12:30 pm CT on KETKY
  • Sunday February 5, 2023 12:30 am ET on KETKY
  • Saturday February 4, 2023 11:30 pm CT on KETKY
  • Sunday February 5, 2023 7:00 am ET on KET2
  • Sunday February 5, 2023 6:00 am CT on KET2
  • Sunday February 5, 2023 9:00 am ET on KETKY
  • Sunday February 5, 2023 8:00 am CT on KETKY

It’s Big, It’s Important, and It’s Trying Real Hard Ringo

Secretary Eric Friedlander of Kentucky's Cabinet for Health and Family Services talks about how CHFS's population health policies impact the state.

  • Sunday February 5, 2023 12:30 pm ET on KET
  • Sunday February 5, 2023 11:30 am CT on KET
  • Sunday February 5, 2023 5:30 pm ET on KETKY
  • Sunday February 5, 2023 4:30 pm CT on KETKY
  • Monday February 6, 2023 2:00 pm ET on KET2
  • Monday February 6, 2023 1:00 pm CT on KET2
  • Friday February 10, 2023 1:30 pm ET on KETKY
  • Friday February 10, 2023 12:30 pm CT on KETKY
  • Sunday February 12, 2023 12:30 am ET on KETKY
  • Saturday February 11, 2023 11:30 pm CT on KETKY
  • Sunday February 12, 2023 7:00 am ET on KET2
  • Sunday February 12, 2023 6:00 am CT on KET2
  • Sunday February 12, 2023 9:00 am ET on KETKY
  • Sunday February 12, 2023 8:00 am CT on KETKY

Sleep Apnea: There's More to It Than the Noise

Pulmonologist and sleep medicine specialist Dr. Warren Shaikun talks about sleep disorders and their treatment.

  • Sunday February 12, 2023 12:30 pm ET on KET
  • Sunday February 12, 2023 11:30 am CT on KET
  • Sunday February 12, 2023 5:30 pm ET on KETKY
  • Sunday February 12, 2023 4:30 pm CT on KETKY
  • Monday February 13, 2023 2:00 pm ET on KET2
  • Monday February 13, 2023 1:00 pm CT on KET2
  • Friday February 17, 2023 1:30 pm ET on KETKY
  • Friday February 17, 2023 12:30 pm CT on KETKY
  • Sunday February 19, 2023 12:30 am ET on KETKY
  • Saturday February 18, 2023 11:30 pm CT on KETKY
  • Sunday February 19, 2023 7:00 am ET on KET2
  • Sunday February 19, 2023 6:00 am CT on KET2
  • Sunday February 19, 2023 9:00 am ET on KETKY
  • Sunday February 19, 2023 8:00 am CT on KETKY

Causes and Impact of LGBTQ+ Health Inequity

T. Gonzales, director of the Center for Health Equity for Louisville Metro Dept. of Health and Wellness, discusses how bias and ignorance adversely impact health outcomes for the LGBTQ+ community.

  • Sunday February 19, 2023 12:30 pm ET on KET
  • Sunday February 19, 2023 11:30 am CT on KET
  • Sunday February 19, 2023 5:30 pm ET on KETKY
  • Sunday February 19, 2023 4:30 pm CT on KETKY
  • Monday February 20, 2023 2:00 pm ET on KET2
  • Monday February 20, 2023 1:00 pm CT on KET2
  • Wednesday February 22, 2023 4:00 am ET on KET
  • Wednesday February 22, 2023 3:00 am CT on KET
  • Friday February 24, 2023 1:30 pm ET on KETKY
  • Friday February 24, 2023 12:30 pm CT on KETKY
  • Sunday February 26, 2023 12:30 am ET on KETKY
  • Saturday February 25, 2023 11:30 pm CT on KETKY
  • Sunday February 26, 2023 7:00 am ET on KET2
  • Sunday February 26, 2023 6:00 am CT on KET2
  • Sunday February 26, 2023 9:00 am ET on KETKY
  • Sunday February 26, 2023 8:00 am CT on KETKY

Treatment of Substance Abuse: It's Complicated

Joyce Johnson, clinical director of outpatient services at Intensive Health and Stepworks Recovery Centers, discusses strategies to treat and manage substance abuse.

  • Sunday February 26, 2023 12:30 pm ET on KET
  • Sunday February 26, 2023 11:30 am CT on KET
  • Sunday February 26, 2023 5:30 pm ET on KETKY
  • Sunday February 26, 2023 4:30 pm CT on KETKY
  • Monday February 27, 2023 2:00 pm ET on KET2
  • Monday February 27, 2023 1:00 pm CT on KET2
  • Friday March 3, 2023 1:30 pm ET on KETKY
  • Friday March 3, 2023 12:30 pm CT on KETKY
  • Sunday March 5, 2023 12:30 am ET on KETKY
  • Saturday March 4, 2023 11:30 pm CT on KETKY
  • Sunday March 5, 2023 9:00 am ET on KETKY
  • Sunday March 5, 2023 8:00 am CT on KETKY
Jump to Upcoming Airdates

Recent

Sports Medicine: It's Not Just for the Athlete - S18 E14

  • Monday January 30, 2023 2:00 pm ET on KET2
  • Monday January 30, 2023 1:00 pm CT on KET2
  • Sunday January 29, 2023 5:30 pm ET on KETKY
  • Sunday January 29, 2023 4:30 pm CT on KETKY
  • Sunday January 29, 2023 12:30 pm ET on KET
  • Sunday January 29, 2023 11:30 am CT on KET

Diabetes: It's Not Just Your Fathers' Insulin - S18 E13

  • Sunday January 29, 2023 9:00 am ET on KETKY
  • Sunday January 29, 2023 8:00 am CT on KETKY
  • Sunday January 29, 2023 7:00 am ET on KET2
  • Sunday January 29, 2023 6:00 am CT on KET2
  • Sunday January 29, 2023 12:30 am ET on KETKY
  • Saturday January 28, 2023 11:30 pm CT on KETKY
  • Friday January 27, 2023 1:30 pm ET on KETKY
  • Friday January 27, 2023 12:30 pm CT on KETKY
  • Monday January 23, 2023 2:00 pm ET on KET2
  • Monday January 23, 2023 1:00 pm CT on KET2
  • Sunday January 22, 2023 5:30 pm ET on KETKY
  • Sunday January 22, 2023 4:30 pm CT on KETKY
  • Sunday January 22, 2023 12:30 pm ET on KET
  • Sunday January 22, 2023 11:30 am CT on KET

Vaccinations: The Good, the Bad, the Misconceptions - S18 E12

  • Sunday January 22, 2023 9:00 am ET on KETKY
  • Sunday January 22, 2023 8:00 am CT on KETKY
  • Sunday January 22, 2023 7:00 am ET on KET2
  • Sunday January 22, 2023 6:00 am CT on KET2
  • Sunday January 22, 2023 12:30 am ET on KETKY
  • Saturday January 21, 2023 11:30 pm CT on KETKY
  • Friday January 20, 2023 1:30 pm ET on KETKY
  • Friday January 20, 2023 12:30 pm CT on KETKY
  • Monday January 16, 2023 2:00 pm ET on KET2
  • Monday January 16, 2023 1:00 pm CT on KET2
  • Sunday January 15, 2023 5:30 pm ET on KETKY
  • Sunday January 15, 2023 4:30 pm CT on KETKY
  • Sunday January 15, 2023 12:30 pm ET on KET
  • Sunday January 15, 2023 11:30 am CT on KET

Birth Control: Methods to Prevent Conception - S18 E11

  • Sunday January 15, 2023 9:00 am ET on KETKY
  • Sunday January 15, 2023 8:00 am CT on KETKY
  • Sunday January 15, 2023 7:00 am ET on KET2
  • Sunday January 15, 2023 6:00 am CT on KET2
  • Sunday January 15, 2023 12:30 am ET on KETKY
  • Saturday January 14, 2023 11:30 pm CT on KETKY
  • Friday January 13, 2023 1:30 pm ET on KETKY
  • Friday January 13, 2023 12:30 pm CT on KETKY
  • Monday January 9, 2023 2:00 pm ET on KET2
  • Monday January 9, 2023 1:00 pm CT on KET2
  • Sunday January 8, 2023 5:30 pm ET on KETKY
  • Sunday January 8, 2023 4:30 pm CT on KETKY
  • Sunday January 8, 2023 12:30 pm ET on KET
  • Sunday January 8, 2023 11:30 am CT on KET

Down Syndrome: Chromosome Number 21 is Just the Beginning - S18 E4

  • Sunday January 8, 2023 9:00 am ET on KETKY
  • Sunday January 8, 2023 8:00 am CT on KETKY
  • Sunday January 8, 2023 7:00 am ET on KET2
  • Sunday January 8, 2023 6:00 am CT on KET2
  • Sunday January 8, 2023 12:30 am ET on KETKY
  • Saturday January 7, 2023 11:30 pm CT on KETKY
  • Friday January 6, 2023 1:30 pm ET on KETKY
  • Friday January 6, 2023 12:30 pm CT on KETKY
  • Monday January 2, 2023 2:00 pm ET on KET2
  • Monday January 2, 2023 1:00 pm CT on KET2
  • Sunday January 1, 2023 5:30 pm ET on KETKY
  • Sunday January 1, 2023 4:30 pm CT on KETKY
  • Sunday January 1, 2023 12:30 pm ET on KET
  • Sunday January 1, 2023 11:30 am CT on KET

COVID-19 and Monkeypox: Deja Vu All Over Again - S18 E3

  • Sunday January 1, 2023 9:00 am ET on KETKY
  • Sunday January 1, 2023 8:00 am CT on KETKY
  • Sunday January 1, 2023 12:30 am ET on KETKY
  • Saturday December 31, 2022 11:30 pm CT on KETKY
Top

Explore KET