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Lymphoma is a type of cancer that appears in lymphocytes. These cells play an important role in the immune system by helping the body to fight against infections and diseases. Lymphoma develops when the lymphocytes grow out of control and grow abnormally or live longer. There are more than 70 types of lymphoma, and any of these types may begin to develop in a part of the lymphatic system. Although it can affect all the organs in the body, it is most commonly seen in the bone marrow, thymus, tonsils, lymph nodes and spleen.
Although the lymphoma can occur when the genes that control the cell growth no longer functioning properly, it is not known exactly what causes it. However, some of the identified risk factors are:
Many of these symptoms can also be warning signs of other illnesses. For example, in a viral or bacterial infection, swelling or growth of the lymph nodes is normal. However, this may be a symptom of lymphoma if it takes a long time. In addition, influenza-like symptoms may be prolonged rather than get better in one to two weeks and get worse progressively. Anyone with permanent symptoms should go to the doctor without wasting time.
Most of the lymphomas originate from B and T cells that are two main white blood cells, and are grouped into two main groups:
Hodgkin’s lymphoma (Hodgkin’s disease) is characterized by the presence of large and abnormal tumor cells called Reed Sternberg, whose origin is derived from B-lymphocytes in the bone marrow and it’s a rare type of Lymphoma. It is the least dangerous type of lymphoma with early diagnosis and treatment. Although it develops all over the body, it usually starts in the upper lymph nodes. The most common areas; chest, neck and underarms.
It often spreads from the lymph nodes to the lymph nodes. In rare cases, it may spread to the other parts of the body, such as the lungs and bone marrow, especially in the final stage of the disease. It is usually seen in young adults between 20-34 years of age. But it can also be seen in children and adults. There are two main subtypes:
The most common type of lymphoma. Most of the defined lymphoma types are grouped under this group and can be expressed as direct lymphoma. It usually starts in the lymph nodes or tissues but sometimes also affects the skin. It may occur at any age, but is generally tend to develop in older adults. It can be categorized into two main types:
NHL Types can be grouped as they grow and growth rate:
The type of treatment is varied Depending on the type and severity of the lymphoma.
When the person goes to the doctor with the presence of nodules detected in the neck, armpits or groin and / or complaints related to the disease, a manual examination is performed first. If lymphoma is suspected, further tests are performed to confirm the diagnosis.
Biopsy is the process of taking tissue samples from the area suspected of cancer and since it is more than 70 different types of lymphoma, it is very important to make a correct diagnosis in pathological examination. To do this, two different types of methods are used:
Tissue samples removed by both methods are examined under the microscope by pathologists.
It is made for the purpose of investigating Lymphoma cells. It is usually taken from the hip bone anesthetized by local anesthesia. Sometimes pain can be felt during this procedure. The sample can be analyzed in the laboratory to determine the size of the lymphoma.
It can help to determine the size of lymphoma by evaluating the number and appearance of different blood (red blood cells, white blood cells and platelets) cells by analyzing the patient’s blood sample.
Genetic structures of the cells which determined to be lymphoma are also analyzed to ensure that the subtype is correctly identified. This result is extremely important for the success of lymphoma treatment.
The condition of lymphoma, which is classified in four stages, is determined by the region where the cancer develops and the growth rate.
For example, as Non-Hodgkin Lymphoma progresses, it begins to spread in the liver, bone marrow and lungs. It is the most advanced stage, but successful treatments can be obtained depending on type of treatment. Patients are also divided into categories as A and B according to symptoms:
Treatment options vary depending on the type of lymphoma, growth rate and stage of growth. In addition, the general health and age of the patient are the determining factors in the treatments to be applied. The most common treatment modalities are:
If there is no symptoms of slow growing (indolence) lymphoma, the patient is recommended active surveillance. In this method, physical examinations, blood tests and imaging tests are performed at the periods determined and no treatment may be needed for years. However, if lymphoma is activated, a new treatment plan may be developed suitable for the patient.
In this method, to kill the cancerous cells, chemical medications are usually given to the patient by dripping from the veins. How chemotherapy is applied depends on the course of the disease and different drug combinations are used. During treatment, due to the healthy cells can also be damaged, side effects such as gastrointestinal disorders, hair loss, appetite and weight loss, and weakness may occur.
With this method, cancerous cells are killed but applied to a limited or large area. Sometimes it can be used as support therapy for chemotherapy depending on the course of the disease. Sometimes it can be used to relieve the pressure created by growing lymph nodes without relieving the purpose of treatment.
Side effects include hair loss, loss of appetite, fatigue, nausea, dry mouth, cough, irritation in the throat, and skin rashes. These effects may vary depending on which part of the body is treated.
In order to make the treatment of lymphoma more effective, medications named monoclonal antibodies, which vary depending on the type of present lymphoma, can be used together with chemotherapy. These drugs bind themselves to the surface of cancerous cells to stimulate the immune system to attack and kill cells.
These medications, also called targeted medications, can be used in combination with chemotherapy as well as can be used alone. It can be given by intravenous or oral route. Small molecules in these drugs directly enter the cell, inhibit the mechanisms of tumorization process and minimally affect healthy cells. Its side effects are light and can be controlled.
It is usually used to treat conditions in which the bone marrow is damaged and can no longer produce healthy blood cells. It can also be performed to replace blood cells that have been damaged or destroyed by too much cancer treatment. This process is done in two ways:
Bone marrow transplantation is performed according to the result of the treatment with chemotherapy, radiotherapy and immunotherapy.
Surgical Intervention can be used in only skin (cutaneous) lymphomas to remove some healthy tissue around the cancerous area.
Since the duration of treatment may vary according to the type of lymph cancer, the stage of the disease and the response of the patient to the methods to be used in the treatment process, it is not possible to give a definite treatment period. After successful treatment, the patient is regularly examined by the doctor on a periodic basis against the risk of recurrence of lymphoma.
It is a common complication of lymphoma and may be more serious during the treatment process. It can usually heal months or years after treatment. This process is likely to develop infection. In some cases the doctor may prescribe antibiotics to prevent possible infections.
Chemotherapy and radiotherapy in the treatment of lymphoma may cause infertility. This is a temporary condition but can sometimes be permanent. The sperm samples of men and the women’s eggs can be stored before treatment.
There may be risk of developing another cancer during or after lymphoma treatment. Especially chemotherapy and radiotherapy damage the healthy cells, the affected cells can turn into cancer years after treatment. A second risk of cancer can be reduced by not smoking, eating well, exercising regularly, and not becoming overweight.
Other possible health issues:
In the case of slow-progressing lymphomas, the patient may experience an average of 15-20 years of lifetime even if no treatment is taken. However, because the aggressive lymphomas spread rapidly, the patient may die within months or weeks if not treated.