non hodgkin's lymphoma symptoms | Non-Hodgkin's lymphoma: symptoms, treatment, survival

Non-Hodgkin's lymphoma: symptoms, treatment, survival

Non-Hodgkin's lymphoma is a cancer that develops in the cells of the immune system, the system that fights infections and other diseases.

The lymphatic system is part of the immune system and includes:

The lymph vessels. The lymphatic system consists of a network of lymphatic vessels that fork and reach all the tissues of the body.
Sap. In the lymphatic vessels, it circulates a transparent liquid, the lymph, which contains the white blood cells, the B and T lymphocytes. especially
lymph nodes. The lymphatic vessels are connected to small circles of small masses of tissue called lymph nodes. The lymph nodes are grouped in the neck, under the arms, chest, abdomen and groin and, within them, keep the white blood cells. They are used to trap and remove bacteria or other harmful substances that may eventually be present in the SAP.
Other organs. Among the other organs that are part of the lymphatic system include: The tonsil, thymus and spleen. The lymphatic tissue is found in other parts of the body, including the stomach, skin and small intestine
The lymphatic tissue is in the different parts of the body, so that the lymphoma can develop practically everywhere. It usually comes from the lymph nodes above the diaphragm, the thin muscle separating the chest and abdomen; You can develop in a group of lymph nodes or, in some cases, also in other parts of the lymphatic system.

Non-Hodgkin's lymphoma develops when a failure occurs in one of the lymphocytes (usually T-lymphocytes). Divisions and repetitions of abnormal cells, the new cells, in turn, are duplicated, producing increasingly abnormal cells that do not die as normal cells. Abnormal cells are not able to protect the organism from infections or other diseases; They accumulate the formation of a mass of tissue called tumor.

The causes
Physicians seldom understand why non-Hodgkin's lymphoma affects some patients and not others; However, research shows that some risk factors increase the risk of acquiring this cancer.

Among the risk factors for non-Hodgkin's lymphoma include:

Weakening of the immune system. The risk of lymphoma may increase if the immune system is low (e.g. due to hereditary disease or certain medications used after a transplant).

Infections. Some infections do not increase the risk of contracting lymphoma, cancer, but are not contagious, which is not transmitted from patient to patient. Among the main types of infection able to increase the risk of lymphoma include:

Human immunodeficiency virus (HIV), which is the virus that causes AIDS. Someone infected with HIV have a risk of contracting certain types of increased non-Hodgkin's lymphoma.

Epstein-Barr (EBV). EBV infection was associated with an increased risk of lymphoma. In Africa, EBV infection is linked to Burkitt lymphoma.

Helicobacter pylori. It is the bacterium that causes stomach ulcers: increases the risk of lymphoma in the lining of the stomach.

Human T-lymphotropic virus type 1 (HTLV-1). HTLV-1 infection increases the risk of acquiring lymphoma and leukemia.

Hepatitis C virus. Some research has shown that the risk of lymphoma is increased in patients infected with hepatitis C virus new research to better understand the role of hepatitis C virus will be needed

Non-Hodgkin's lymphoma: symptoms, treatment, survival

Age. Non-Hodgkin's lymphoma may also develop in young people, but the risk of acquiring it increases with age. Most patients with non-Hodgkin's lymphoma are over 60 years old.

Researchers are studying obesity and other possible risk factors for non-Hodgkin's lymphoma, such as those working in contact with pesticides or certain chemicals may be more at risk. Researchers are also investigating a possible correlation between the use of pre-1980 hair dye and non-Hodgkin's lymphoma.

Having one or more risk factors does not necessarily mean getting sick, the majority of patients who have risk factors will never be affected by a tumor.

Symptoms

Non-Hodgkin's lymphoma can cause a variety of symptoms:

Swelling (not painful) to the lymph nodes of the neck, armpits or groin,

Apparently unexplainable thinness,

Fever that does not diminish,

Intense night sweats,

Cough, difficulty breathing or chest pain,

Weakness and fatigue that does not disappear,

Pain, swelling or sensation of abdominal plenitude.

In most cases, these symptoms are not caused by a tumor, but may be caused by infection or other disorders. If the symptoms last more than two weeks, you should consult your doctor to get a diagnosis and therapy.

Diagnosis

If you suffer from swollen lymph nodes or other symptoms that might indicate non-Hodgkin's lymphoma, the doctor will try to diagnose the cause of the problem, probably inform about your health problems and your Family.

I presume you will have to undergo the following tests:

Visit. Your doctor will check if there are swollen lymph nodes in the neck, under the arms and in the groin area and whether the spleen or liver is swollen.

Blood tests. The complete analysis controls the number of white blood cells, but also other types of cells and other substances, for example dehydrogenase of the enzyme lactate (LDH). Lymphoma can increase the level of LDH.

Chest X-ray. X-rays may present swelling of the lymph nodes or other signs of problems in the chest.

Biopsy. A biopsy is the only safe way to diagnose lymphoma. Your doctor may remove a lymph node set (resection biopsy) or only partially (incisional biopsy). A (needle suction technique called) usually very thin needle is not able to aspirate a sufficient sample to treat the pathological diagnosis of lymphoma, then it is necessary to remove all the lymph nodes Nodes. The doctor uses the microscope to see if the cancer cells are present in the tissue.

Care and treatment

The doctor can describe the therapeutic possibilities and expected results, you can work with him to create a treatment plan that meets your needs.

The Doctor may refer you to a specialist, or you may be yourself requiring some advice on the specialist to consult. Among specialists able to treat non-Hodgkin's lymphoma include:

The hematologist,

The oncologist,

The radiologist.

Your doctor may advise you to choose an oncologist specializing in the treatment of lymphomas, often these specialists work in university hospitals or in the most advanced medical facilities. The team that follows you may also include an oncology nurse and a dietician.

The choice of treatment depends mainly on:

Non-Hodgkin's lymphoma type (such as follicular lymphoma)

Placement (the area where the tumor is located),

Staging, or tumor growth rate (indolent or aggressive),

Age

All other health problems.

If you have indolent non-Hodgkin's lymphoma that does not have any particular symptoms, you may have to wait before using a treatment. The doctor will keep you under control, in order to start the treatment as soon as you present the symptoms. This postponement of therapy is called "vigilant expectation".

If you suffer from indolent lymphoma that had symptoms, you will likely have chemotherapy and biological therapy. Radiation therapy can be used in patients with stage I or II lymphoma.

If lymphoma is aggressive the therapy is usually both chemotherapy is biological; It can also be accompanied by radiation therapy.

If lymphoma reappears after treatment is called recurrent or recurrent cancer: those who suffer from relapse of lymphoma will have to resort to chemotherapy and/or radiation therapy in a more aggressive, and then to a stem cell transplant.

It is advisable to learn about the side effects and effects of therapy on normal daily activities: chemotherapy and radiation, in fact, often damaging cells and healthy tissues, so that side effects are common. Side effects may be different from one patient to and may even vary from one session to another. Before the start of the treatment, the following team will explain what side effects you can achieve and suggest how to deal with them. The younger the patient, it is easier to cope with the effects of treatment and sideways.

Throughout the therapy, you can make use of supportive care, namely the therapy aims to prevent or fight infection, control pain and other symptoms, alleviate the side effects of cancer therapy and help you Treat the psychological aspects of tumor diagnosis.

Finally, you can choose to ask your doctor to get involved in a clinical trial, which is, looking for new therapeutic methods, when they are available.

Vigilant waiting

The watchful expectation is the postponement of therapy when the tumor begins to manifest symptoms. Doctors often advise patients suffering from indolent lymphoma, which can cause symptoms, even for a long time. Sometimes the tumor can even decrease without any intervention. Postponing treatment can avoid the side effects of chemotherapy or radiation therapy.

If you and your doctor decide to opt for the vigilant wait, your doctor will do regular checks (after 3 months). Therapy starts only if the symptoms start or worsen.

Some people choose not to wait, why bother to have untreated cancer. Who first decided to wait vigilant then she gets caught by concerns should look at the situation with your doctor.

Before we go for the vigilant expectation, we should ask your doctor the following questions:

Now, if I choose to wait, after that I can still change my mind?

If I wait, will it be harder to cure my illness?

How many times do I have to check?

Between a control and the next, I have to refer to such problems?

Chemotherapy

Chemotherapy against non-Hodgkin's lymphoma uses special medications to kill lymphoma cells is called systemic therapy because drugs need to get into the bloodstream to reach cancer cells In almost every part of the body.

Chemotherapy drugs are administered orally, intravenously or by intrathecal. You can do an ambulatory chemotherapy, in the office or health care of the professional doctor or at home. Some patients had to be hospitalized.

Chemotherapy is administered in different cycles. After each cycle must observe a period of rest. The length of the rest period and the number of cycles depend on the stage in which the lymphoma is located and the types of medications used.

If you suffer from a lymphoma in the stomach caused by an H. pylori infection, your doctor may treat it with antibiotics. After the infection has been treated with the antibiotic, even lymphoma will disappear.

Side effects are essentially dependent on the type and dose of medication medications. Chemotherapy, in fact, are likely to damage not only sick cells, but also healthy cells that quickly divide:

Blood cells: Chemotherapy destroys many healthy blood cells, so there is a greater risk of infection, procuring bruises or starting to bleed easily; Also, it feels very weak and tired. The team that will follow will do blood tests to check if there are healthy cells in sufficient numbers. If there are few, there are medications that can help the body to produce new ones.

The cells of the hair bulbs. Chemotherapy can cause hair loss. The hair grows back after the end of therapy, but their texture and color may be slightly different.

The cells of the digestive mucosa. Chemotherapy can lead to loss of appetite, nausea, vomiting, diarrhea, and mouth and lip ulcers. Ask for advice from the team that follows you on therapies that can help you overcome these problems.

Medications used for non-Hodgkin's lymphoma may also cause skin rashes or blisters, headaches or other disorders. The skin can become darker and nails can start Solcarsi or blacken.

The Doctor is able to propose different methods to keep under control most of these side effects.

Before you begin chemotherapy we recommend that you ask your doctor the following questions:

What medications will be given? What are the positive effects we can expect?

When you start therapy? When will it end? How many times do you play?

Where am I going? Will I be able to drive, once the session is over?

What can I do to better cope with therapy?

How do you determine if the treatment is effective?

What side effects do I have to warn you about? Can I prevent or curarne some?

Will there be permanent side effects?

Biological therapy

Patients with certain types of non-Hodgkin's lymphoma may use biological therapy, this type of therapy helps the immune system to fight the tumor.

Monoclonal antibodies are the biological therapy used against lymphoma, it comes to the synthesis of proteins able to bind to tumor cells and help the immune system to kill lymphoma cells. Patients receive this type of intravenous therapy, in the office, a clinic or a hospital.

They may experience flu-like symptoms such as fever, shivering, headache, weakness and nausea. Most side effects are easy to maintain. In rare cases, side effects may be more severe and are composed of respiratory problems, low pressure or intense skin rashes. Your doctor or nurse can inform you in advance about any impact and how to manage them.

Before biological therapy, we should ask the following questions to your doctor:

What is the therapy?

I'm going to have to go to the hospital?

How do you determine if the treatment is working?

How long is the biological therapy?

Will I have side effects during treatment? For how long? What can be done to manage or avoid?

Radiotherapy

Radiotherapy for non-Hodgkin's lymphoma uses high-energy rays to kill lymphoma cells; It is able to reduce the size of tumors and contribute to the prevention of pain.

The two types of radiation therapy used in lymphoma cases are as follows:

External radiation therapy. A large machine directs the radiation to the area of the body where the cancer cells are collected. It is a local therapy because it only affects cells in the affected area. Most patients have to go to the hospital or clinic five days a week for several weeks.

Systemic radiation therapy. Some patients received an injection of a radioactive substance that moves through the body. Radioactive material is linked to monoclonal antibodies that go in search of cancer cells; The radiation finally destroys the tumor cells.

The side effects of radiation therapy are mainly dependent on the dose and the part of the body to be treated; For example, direct external irradiation against the abdomen can cause nausea, vomiting and diarrhea, while those at the neck and chest can cause dryness in the throat, sore throat and swallowing problems. The skin of the treated area may blush, become dry and brittle; In the area affected by the radiation, you can also lose their hair or hair.

Even those who receive systemic treatment may suffer from fatigue; Also more likely to have infections.

If you do radiation and chemotherapy at the same time, side effects can be more intense and difficult to bear; You can always ask for help from your doctor who will suggest how to alleviate them.

Many patients, during the treatment with external radiation, complain of the deep fatigue, especially in the last weeks of treatment. Rest is important, but doctors generally recommend that a life as active as possible.

Before radiotherapy, we should ask the following questions to your doctor:

Why do I need radiation therapy?

When do I have to start? When it ends?

How will I feel during the treatment?

How can you tell if the treatment is working?

Are there any permanent side effects?

Stem cell transplant

If non-Hodgkin's recurring lymphoma after treatment, you may receive a stem cell transplant. Hematopoietic stem cell transplantation (autologous stem cell transplant) will allow you to undergo more aggressive chemotherapy and/or therapy. The larger doses destroy the lymphoma cells of the two non-Hodgkin healthy cells in the bone marrow.

Stem cell transplants take place in the hospital: Stem cells are explanted and frozen. After aggressive treatment that kills lymphoma cells, stem cells are thawed and reimplanted using a flexible tube placed in one of the main veins of the neck or chest. New stem cells are formed from those transplanted.

Stem cells can be from your body or that of a donor:

Autologous transplant. In this type of transplant using patient stem cells. They are explanted before treatment and can be cured to eliminate all the tumor cells present between them. Then it freezes and preserves. After treatment, they are thawed and reimplanted.

Allogeneic. In some cases, healthy stem cells are available from a donor, for example by a brother, sister or relative or even by other people. Doctors use blood tests to see if the donor's cells are compatible with yours.

Syngeneic graft. In this type of transplant using a patient's twin cells.

Before the stem cell transplant, we should ask the following questions to your doctor:

What are the risks and benefits of stem cell transplant?

What type of graft do I need? If I need a donor, how are we going to find it?

How long is the hospital? I also have to follow a supportive treatment? How can I protect myself from germs?

As it can be understood that the therapy is effective?

How can I mitigate side effects?

How will stem cells affect my daily life?

What are the chances of complete healing?

Support Therapy

Lymphoma and therapy can cause other non-Hodgkin's health problems, you will probably also be subjected to a supportive treatment that keep them under control and improve your quality of life during treatment.

To better control infections, they can receive antibiotics and other medications. Probably the following team, you will advise you to avoid crowded places and people cooled or suffering from other infectious diseases. Any infection, in fact, can be very serious and should be treated immediately.

Lymphoma and non-Hodgkin's therapy can also cause anemia, which can make you feel extremely tired. You can overcome this problem with medication and blood transfusion.

Diet and exercise

It is essential to take care of themselves by following a healthy diet and trying to keep as active as possible. To maintain adequate weight is necessary to take the right amount of calories. It is also important to take enough protein to maintain its strength: Eating well will help you feel better and have more energy.

In some cases, especially during treatment or in phases immediately after, you may want to not eat because you feel tired or have nausea. Probably you feel that the food tastes different from the usual; Also the side effects of therapy (for example, lack of appetite, nausea, vomiting or sores in the mouth) can prevent you from eating well. The doctor, dietitian, or other members of the following team, you can suggest the best ways to deal with these problems.

Many people say they feel better if they can stay active. Walking, yoga, swimming or other activities will help you maintain strength and increase energy. With exercise, you can decrease nausea and pain, and can better withstand therapy and stress. Before you start any physical activity, remember to ask your doctor for advice; In addition, if the activity causes pain or other problems, inform your doctor or nurse.

Translation and integration 

Scientific review and correction by Dr. Guido Distemper (pharmacist)

The information contained in this article must not in any way replace the doctor-patient relationship; On the contrary, it is advisable to seek advice from your doctor before you implement a given advice or indication.