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Lymphoma Cancer Treatment in India

by Rishabh

What is Lymphoma Cancer?

A cancer that starts in the immune system cells (lymphocytes) is known as lymphoma cancer. The reason for lymphoma cancer is the uncontrollable growth of cells and their multiplication.

Lymphoma cancer can be categorized into two types –

  • Hodgkin Lymphoma
  • Non-Hodgkin Lymphoma (NHL)

Both Hodgkin and Non-Hodgkin Lymphoma have many types. Lymphoma can be categorized in total 30 different types in which some types are common while some are rare.

Hodgkin Lymphoma

Hodgkin’s Lymphoma, also known as Hodgkin’s disease, is one of the two common forms of lymphatic system cancers. In Hodgkin’s Lymphoma, the cells present in the lymphatic system may grow unusually spreading beyond the lymphatic system. A body may also lose its ability to fight against different infections due to the progression of Hodgkin’s disease. There are no known causes of Hodgkin’s Lymphoma. A slight risk of genetic predisposition and exposure to viral infections can be regarded as the causes of Hodgkin lymphoma.

Symptoms of Hodgkin Lymphoma

Swelling in the groin, neck or armpit is considered as the most common symptom of Hodgkin lymphoma. Some of the other symptoms include –

  • A persistent itch in the entire body
  • Frequent sweat especially at night
  • Breathlessness or cough
  • Weight loss
  • Unexplained high temperatures
  • Tiredness

Some people are diagnosed with abnormal cells in their marrow that can result in lower number of healthy blood cells in the blood. Some of the symptoms due to lower number of healthy blood cells include –

  • Excessive bleeding that include very heavy periods in women, nose bleeds and also small blood spots under the skin
  • Tiredness and breathlessness
  • A higher risk of infection

Types of Hodgkin Lymphoma

Hodgkin lymphoma can be categorized into different types that include –

Nodular Lymphocyte – Predominant Type: This type is considered as rare and approximately 5% of all Hodgkin lymphomas diagnosed are of nodular lymphocyte-predominant type.

Classical Types: The four common types of Hodgkin lymphoma include

  • Lymphocyte-rich
  • Nodular sclerosing
  • Lymphocyte-depleted
  • Mixed cellularity

Hodgkin Lymphoma Stages

Stage 1: Here in this initial stage, the lymphoma affects only 1 group of lymph nodes.

Stage 2 : In the second stage, two or more groups of lymph nodes are affected that are on the similar side of the diaphragm.

Stage 3: In the third stage, lymph nodes are affected on below and above the diaphragm.

Stage 4: In the last stage, the spread of the lymphoma to the organs that are outside the lymph nodes include lungs, liver or bones.

Diagnosis of Hodgkin Lymphoma

Swollen lymph nodes is one of the symptoms of Hodgkin lymphoma that is associated with the diagnosis of lymphoma. A biopsy is also carried out that helps in revealing the presence of Hodgkin’s lymphoma. Some of other tests that help in checking the spread of lymphoma include –

  • Lumbar puncture
  • Chest X-ray
  • Blood tests
  • Magnetic resonance imaging (MRI) scans
  • Bone marrow sample
  • Positron emission tomography (PET) scan
  • Computerized tomography (CT) scans

Treatment of Hodgkin Lymphoma

The specific treatment for Hodgkin lymphoma largely depends on the stage, overall health and type of disease. The aim is to kill all the present cancer cells. Some of the treatment options include –

Stem Cell Transplant : In this treatment, a diseased bone marrow is replaced with healthy stem cells in order to grow new bone marrow. This treatment can be the only option if Hodgkin lymphoma occurs again despite being treated. The removal of a patient’s blood stem cells is done that are then stored and frozen for later use. A patient then receives high-dose of radiation and chemotherapy for destroying cancerous cells in the body. The stem cells are then softened and injected into the body by the means of veins and they then helps in building new healthy bone marrow.

Chemotherapy : This therapy makes use of chemicals for destroying lymphoma cells. These drugs travel to the bloodstream and finally reach to all parts of the body. Radiation therapy is often combined with chemotherapy for treating those people who are suffering from early-stage classical type of Hodgkin’s lymphoma.

Radiation Therapy : High-energy beams that include x-rays are used in this therapy for destroying cancer cells. Radiation therapy is usually used after the chemotherapy for treating classical Hodgkin’s lymphoma. Radiation therapy is used alone for treating those people who are suffering from early stage lymphocyte-predominant of Hodgkin’s lymphoma.

Non-Hodgkin Lymphoma

Non-Hodgkin lymphoma, also referred to as NHL or non-Hodgkin’s lymphoma, is a type of cancer that begins in lymphocytes (a part of the immune system of the body). NHL can be categorized into 40 different types. There are no known causes of Non-Hodgkin lymphoma. People who have weak immune systems that also include those people, who are suffering from HIV infection or had an organ transplant, can develop Non-Hodgkin lymphoma.

Types of Non-Hodgkin Lymphoma

T-cell or B-cell lymphomas are categorized under lymphomas that depends on whether these lymphomas have began from T-cell lymphocytes or B-cell lymphocytes. B-cell lymphomas are considered as the most common that include –

  • Follicular lymphoma
  • Diffuse large B-cell lymphoma

Some of the not so common types are –

  • Lymphoplasmacytic lymphoma
  • Extranodal marginal zone lymphoma of mucosa-associated tissue
  • Small lymphocytic lymphoma (SLL)
  • Mediastinal large B-cell lymphoma
  • Mantle cell lymphoma
  • Nodal marginal zone lymphoma
  • Burkitt lymphoma

T-cell lymphoma types include –

  • Lymphoblastic lymphoma
  • Peripheral T-cell lymphoma
  • Anaplastic large cell lymphoma
  • Skin (cutaneous) lymphoma

Symptoms of Non-Hodgkin Lymphoma

  • Concentration problem, seizures, headache or personality changes can occur if the brain is affected by the cancer
  • Night sweats
  • Weight loss
  • Abdominal swelling or pain results in vomiting, loss of appetite, nausea and constipation
  • Fever and chills that come and go
  • Swollen lymph nodes in the groin, neck and underarms areas
  • Shortness of breath or coughing can occur when the cancer affects lymph nodes or thymus gland in the chest that puts pressure on other airways or on the windpipe
  • Itching

Stages of Non-Hodgkin Lymphoma

Stage 1: In the initial stage, the lymphoma affects only 1 group of lymph nodes.

Stage 2: The lymphoma in the second stage is present in 2 or more groups of lymph nodes on the same side of the diaphragm.

Stage 3: The lymphoma in the third stage is there on both sides of the diaphragm.

Stage 4: The lymphoma in the last change has spread beyond the lymph nodes to organs like lungs, bone marrow or liver.

Diagnosis of Non-Hodgkin Lymphoma

A tissue biopsy is done for diagnosing Non-Hodgkin lymphoma. When there is painless and enlarged lymph node that does not have any infection then a biopsy is required. Other tests include –

  • Spinal tap that depends on the location, stage and type of the Non-Hodgkin lymphoma
  • Blood tests
  • Chest x-ray
  • PET scan
  • MRI scans for epidural or spinal lymphoma
  • Bone marrow biopsy
  • Upper GI endoscopy
  • Computed tomography (CT) scans of the pelvis, chest, neck and abdomen
  • Testicular ultrasound is done for evaluating the opposite testicle for a testicular lymphoma primary site
  • Upper GI series and small bowel x-rays
  • Head and neck examination

Treatment of Non-Hodgkin Lymphoma

The treatment of Non-Hodgkin lymphoma depends on its stage, symptoms and the type. The aim of the treatment is to eliminate the lymphoma without causing any damage to the surrounding cells. The common treatment options for Non-Hodgkin lymphoma include –

  • Monoclonal Antibodies: This treatment is used for destroying lymphoma cells. Monoclonal antibodies can also be combined with chemotherapy drugs for delivering high concentration of the drugs to the tumor cells.
  • Chemotherapy: Anti-cancer drugs are used for destroying lymphoma cells that are injected through the vein or can also be taken by mouth. This treatment has proved very beneficial for lymphoma as anti-cancer drugs enter into the bloodstream that also reaches to every part of the body.
  • Radioimmunotherapy: This treatment uses a monoclonal antibody that also combines a radioactive particle to it. This helps in destroying the lymphoma cells and simultaneously it also destroys many more cells that are in the radiation path.
  • Radiation Therapy: High dose x-rays are used for treating cancer cells that are still there after surgery. This therapy is usually used for treating Non-Hodgkin lymphoma cancer. External radiation is a method by which radiation is given directly to the cancer from a machine that is outside of the body.

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