Follicular Lymphoma Flow Chart


(Created 2015. Checked June 2017)

Why This Chart

The National Cancer Institute states that cancer is a genetic disease

The US National Institute of Health, under the title Epigenetics and Lifestyle acknowledges and lists many lifestyle behaviors that can create epigenetic effects within the human body.

The chart below builds on this new information as a guide for follicular lymphoma survivors to better understand how steps they can take themselves will help in managing their lymphoma for long-term success.

(Please note that this is not alternative medicine).

How Follicular Lymphoma Starts

At the time a person is diagnosed with fNHL, his or her lymphoma will typically be well advanced, likely having started many years before. Even a single small node under 2 cm. contains billions of malignant cells.

The lymphoma will have arisen mainly from risk factors including adverse lifestyle practices, toxic environmental exposure and possible chronic infection.

It’s true that many people are exposed to the same risk factors and don’t get lymphoma. But the reason a specific person gets a specific cancer is due to pre-existing gene mutations, some mutations already present at birth (the “bad luck” factor)…but not all, since some mutations are acquired later.

Referring to the Follicular Lymphoma Flowchart…

The lifestyle factors mentioned above are shown in the upper left Lifestyle box. Lifestyle practices vary widely from one individual to another. Not all are bad. Some may be good. Some good lifestyle practices can be misapplied. The environmental toxin factor and infection factor are also included in this box. The output arrow from the Lifestyle box consists of a mixture of good and bad things, so it appears in yellow.

The Epigenome box is top and center. (Think of it like the software in your computer). It receives signals from virtually ALL things going on in our lives 24/7 and transmits them to the genes and DNA in our Genome (like the hardware). Signals flowing from the Epigenome to the Genome, first received from the Lifestyle box, are a mixture of good and bad, so this arrow is also yellow.

Both the Epigenome and the Genome can be considered equivalent to major “processing centers”. Genes and DNA in the Genome are subject to mutations caused by signaling received from the Epigenome. In addition, the Epigenome, as the “master controller”, regulates the EXPRESSION of genes in the Genome from dim to bright, possibly even turning some genes off entirely. This process is now known as epigenetics.

BOTH the Genome and the Epigenome send signals out to our cancer promoting oncogenes (which we refer to as our “enemy”), and to our tumor suppressor and DNA repair genes (referred to as our “friends”). Details in the February 2016 Newsletter.

The yellow signals received by both the Epigenome and the Genome are “broken apart” genetically into good and bad components. The bad signals in red are received by our oncogenes which promote tumor growth and aggressiveness. The good signals in green activate our tumor suppressor and DNA repair genes to constrain the lymphoma, extend clinical remission and possibly even reverse the lymphoma (known as natural regression).


So there you have the big picture starting with how follicular lymphoma arises and how it can eventually be overcome. In the middle, the battle will involve gene expression over which we, as proactive survivors, can be highly influential.

Note ultimately that it is our NORMAL cell population that regulates the tumor suppressor and DNA repair genes in our body, while “de-programming” the oncogenes. This is the means…in fact the ONLY one…that will enable follicular lymphoma to eventually be overcome.

Our Four Pillar Gene Remediation Strategies (4P-GRS) program covered in Article 3 and developed over several years has the details.