Conditions associated with a misbehaving immune system more commonly are associated with immune system-related cancers. From the 30,000 foot view, it is not hard to see why. The immune system is critical in detecting and eliminating early cancers.

In Sjogren’s Syndrome (SS) in particular, the condition itself is caused in part by the proliferation of B cells. If a particular B cell (clone) starts multiplying unchecked, it can result in the development of a type of cancer called lymphoma.  

Unfortunately, Sjogren’s carries an increased risk for a particular family of lymphomas called non-Hodgkin lymphomas (NHL). Three types related to SS including mucosa-associated lymphoid tissue (MALT), marginal zone B cell lymphoma (MZBCL), and diffuse large B cell lymphoma (DLBCL). MALT is by far the most common of the three. Thankfully it is the most easily treated. 

How does cancer develop?

Lymphomas in Sjogren’s syndrome arise from the chronically inflamed tissues. It is a multi-step process and likely is influenced by some of the genetic factors that made us susceptible to developing SS in the first place. 

Over time, B cells that are chronically stimulated can develop mutations. Eventually, these mutations can result in something called clonal expansion. It is when a particular clone starts duplicating itself over and over that the process becomes malignant, or cancerous. 

Many times, epigenetic changes contribute to the development of cancers. These are changes that turn gene expression on and off. The controls of these switches are still being investigated but we know many aspects of an anti-inflammatory lifestyle are protective. Instead of our genes, our lifestyle and environment may account for 90–95% of our most chronic illnesses including cancer!! 

But what is the risk? 

Common statistics will cite that Sjogren’s carries a 6.1 to 44.4 fold higher risk of lymphoma. 

That statistic sounds incredibly scary, right? 

Here’s the deal though: Lymphoma itself is not terribly common so even with this elevated risk, 95 out of 100 Sjogren’s patients will never develop lymphoma. 

Admittedly though, knowing 5 out of 100 will be diagnosed, still gives me some anxiety...

I suspect may cause some of you to feel similarly. 

So let's dig into what we can do about it…

Be proactive. 

The cancers associated with SS are often slower developing cancers.

Here are symptoms and other conditions that should be brought to your physician’s attention: 

• Persistent parotid gland enlargement, enlarged lymph nodes or a large spleen 
• Low complement levels (these are typically monitored periodically in SS)
• Bruising, especially an increase in bruising 
• Prior infection with: 
• H. pylori- causes stomach ulcers
• Borrelia burgdorferi, Borrelia afzelii- cause of Lyme disease
• Chlamydophilia psittaci- a bacterial respiratory infection related to bird exposure
• Campylobacter jejuni-a bacterial cause of food poisoning 
• Ebstein Barr virus (EBV)- viral infection related to mononucleosis 

Reduce your risk where you can. 

We are NOT beholden to this disease or our genetics!

We know that lifestyle and environmental exposures play a large role in our overall health! These changes work best over the long term.

Stepwise. Sustainable. Solutions. 

• Stop smoking. It is NOT easy but is one of the best things you can do for your health. 
• Start eating a plant-focused diet that is high in vegetables, fruits, whole grains. Limiting added sugars, processed foods- especially processed meats and charred foods is also recommended. (link to the 5 foods not to fear)
• Stay active! Walking, swimming, cycling, tai chi- just keep moving in a way that works for you. Start slowly but ideally, we want to work up to 150 minutes per week. 
• Watch your alcohol intake. For women, this is 1 drink a day or less. 
• Minimize exposure to known cancer-causing chemicals in our environment including asbestos (link to the talc article), benzene (link to IG or FB post on sunscreen having benzene in it), radon, and heavy metals (link to post on contamination in makeup). 
• Get vaccinated for hepatitis B and human papillomavirus (HPV)

Accept what we can’t change.

So yes, Sjogren’s does increase our risk of certain lymphomas. 

It is what it is. 

Thankfully, the overall risk is low. 

Accepting this though can be easier said than done though:

• Find a healthy outlet for stress- perhaps it’s movement, maybe it is a regular coffee date with a trusted friend. 
• Talk to a professional- a therapist can help you find connections between your thoughts, emotions, and behaviors. 
• Practice meditation or yoga- meditation focuses on experiencing the here and now and both can help us learn how to tap into our rest & digest mode. 
• Get ample sleep- not only does sufficient sleep help our stress levels but also improves our immune function.

P.S. In honor of this month being Leukemia & Lymphoma Awareness Month, I am donating 25% of my BeautyCounter commissions this month to the Leukemia & Lymphoma Society. 

Sources: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521879/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515569/

https://www.mdanderson.org/publications/focused-on-health/how-stress-affects-cancer-risk.h21-1589046.html 

Gandolfo, S. et. al., Sjogren’s Syndrome- Associated Lymphoma. Chapter 6. Sjogren’s Syndrome: Novel Insights in Pathogenic, Clinical and Therapeutic Aspects. 2016.