General Practice 2022

Lymphoma: what é, symptoms, causes and treatment

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Lymphoma: what é, symptoms, causes and treatment
Lymphoma: what é, symptoms, causes and treatment
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Lymphoma is a type of cancer that affects lymphocytes, which are cells responsible for protecting the body from infection and disease. This type of cancer develops mainly in the lymph nodes, also known as snouts, which are found in the armpit, groin and neck, leading to the formation of lumps and which can cause symptoms such as fever, night sweats, excessive tiredness and weight loss for no apparent reason.

In general, lymphoma is more common in adults than in children, and some people may be at greater risk of developing the disease, such as those who have a family history of lymphoma, who have a disease that causes immunity low or who have been infected with certain viruses such as HIV, Epstein-Barr or HTLV-1.

There are two types of lymphoma, which can be differentiated by the characteristics of malignant cells found in diagnostic tests, such as:

  • Hodgkin's lymphoma, which is rarer, affects older people and targets specific body defense cells, type B lymphocytes;
  • Non-Hodgkin's lymphoma,which is more common and usually develops from B and T lymphocytes. Read more about non-Hodgkin's lymphoma.

The diagnosis of both types of lymphoma is made through blood tests, imaging tests and bone marrow biopsy, and the treatment is mainly based on chemotherapy, radiotherapy and bone marrow transplantation. If it is diagnosed early and treatment is started as soon as possible, the chances of curing lymphoma are high.

Main symptoms

The main symptoms of lymphoma are constant fever, night sweats and the presence of enlarged lymph nodes, perceived by the presence of lumps in the neck, armpit or groin. Other symptoms that may be indicative of lymphoma are:

  • Excessive fatigue;
  • Itching;
  • Disease;
  • Loss of appetite;
  • Slimming without apparent cause;
  • Shortness of breath and coughing.

In addition to these symptoms, the spleen, which is an organ responsible for the production of defense cells, located on the upper left side of the abdomen, can be affected by lymphoma and become swollen and painful. lymph node becomes very enlarged, it can press on a nerve in the leg and cause numbness or tingling. Know other symptoms of lymphatic cancer.

In the presence of several of these symptoms, it is recommended to go to the doctor for exams and, if the diagnosis is confirmed, the appropriate treatment can be started according to the guidance of the general practitioner, hematologist or oncologist.

What is the difference between lymphoma and leukemia

In leukemia, malignant cells begin to multiply in the bone marrow, whereas in lymphoma, the cancer begins in the lymph nodes, or tongues. In addition, although some symptoms are similar, such as fever and night sweats, in leukemia it is more common to experience bleeding and purple spots on the body, and in lymphoma, the skin is more itchy.

What are the causes

The causes of lymphoma are still not well defined, but people over 60 are more likely to develop non-Hodgkin's lymphoma. Other factors that may also be associated with the appearance of lymphoma are infections with the HIV virus, the Epstein-Barr virus, which causes mononucleosis, HTLV-1, which is responsible for certain types of hepatitis, and Helicobacter pylori infection, which can be found in the stomach.

In addition, having a disease that causes low immunity, having an autoimmune disease, such as lupus or celiac disease, as well as working in places with a lot of exposure to chemicals, such as pesticides, can influence the emergence of lymphoma.See what can cause lymphatic cancer.

How to confirm the diagnosis

The diagnosis of lymphoma is made through the evaluation of symptoms by the general practitioner, hematologist or oncologist and results of some tests, such as:

  • Blood tests: used to evaluate blood cells and enzymes, as changes in the leukogram, such as an increase in lymphocytes, and an increase in lactic dehydrogenase (LDH) may indicate the presence of of lymphoma;
  • X-ray: provides images of body parts that may be affected by lymphoma;
  • Computed tomography: allows visualization of images of parts of the body with more details than X-ray, being able to detect lymphoma;
  • Magnetic resonance imaging: like computed tomography, it is used to detect areas of the body affected by lymphoma through images;
  • Pet-scan: is a type of CT scan, which helps in detecting metastasis, which is when lymphoma spreads to various parts of the body;

The doctor also recommends performing a bone marrow biopsy, which consists of removing a small part of the bone from the pelvis to analyze the marrow cells and find out if they have been affected by lymphoma.

How the treatment is done

Based on the results of the tests, the hematologist or oncologist will indicate the treatment depending on the type, size, degree and region where the lymphoma is found, as well as the age and general condition of the person. In this way, lymphoma can be treated by the following options:

1. Chemotherapy

Chemotherapy is a treatment that consists of administering drugs through a vein, through a catheter, to eliminate the cancer cells that cause lymphoma. The chemotherapy drugs most commonly used to treat lymphoma are doxorubicin, bleomycin, dacarbazine and vinblastine and are usually used on the same day as part of a treatment protocol, with the choice of protocol by the physician depending mainly on the type of lymphoma diagnosed.

Chemotherapy protocols are performed every 3 or 4 weeks, because as these drugs have strong side effects, such as hair loss, nausea and vomiting, lack of appetite and decreased immunity, a longer period is necessary for the body to recover. According to the type of lymphoma, the doctor will determine how many times it will be necessary to repeat the drugs, that is, how many cycles of chemotherapy will be performed.

2. Radiotherapy

Radiotherapy is a treatment used to destroy cancer cells through radiation emitted by a machine directly into the lymph node affected by lymphoma, in which markings are made on the skin so that this radiation is administered to the same site each time.

Before starting the radiotherapy treatment, the radiotherapist, with the help of imaging tests, makes a plan of the body site where the lymphoma is located and will indicate the radiation dose, amount and duration of the sessions.

Most of the time, radiotherapy is used in conjunction with other treatment methods to increase the chances of eliminating the cells that cause lymphoma, and it causes side effects such as loss of appetite, nausea, feeling hot at the applied location. Here's what to eat to alleviate the effects of radiation.

3. Immunotherapy

Some types of lymphoma can be treated with immunotherapy, which are drugs that help the immune system fight lymphoma cells, and the side effects are less than those of chemotherapy.

These drugs are also used with other treatment techniques, increasing the chances of curing lymphoma. Some immunotherapy drugs used to treat lymphoma are rituximab, bortezomib, and lenalidomide.

4. Bone marrow transplant

Bone marrow transplantation is a treatment that consists of destroying diseased lymphoma cells and replacing them with he althy stem cells.Before receiving he althy stem cells, high-dose chemotherapy is required to kill all the cancer cells in the body. Learn more about what stem cells are and how they can help.

There are two types of bone marrow transplantation, which are autologous, when the stem cells are received from the person, and allogeneic, which is when the stem cells are acquired from another person. In order to receive bone marrow from another person, it must be compatible, so before the transplant, blood tests are performed, both in the person who has lymphoma and in the person who will donate the bone marrow.

5. Gene therapy

Currently, a new treatment for lymphoma called CAR-T-cell is being started, which is when the body's defense cells are removed and reprogrammed with a specific type of particle and then these same cells are introduced into the body helping to increase immunity and fight cancer cells.This treatment is still being studied and is not available in all hospitals. Learn more about how treatment is performed using the CAR-T-cell technique.

6. Surgery

In some cases, when lymph nodes increase a lot due to lymphoma, they can reach other organs such as the spleen and therefore the doctor may recommend surgery to remove this organ. Before performing the treatment, it is sometimes necessary to perform a minor surgery to remove a lymph node, in order to perform a biopsy to analyze the cancer cells.

Is lymphoma curable?

The results of treatments vary according to the type and degree of lymphoma, but in most cases it is cured if treated according to medical recommendations. In addition, when the disease is discovered and treated early, the chances of cure are even greater.

New treatments, new research and better support care for the person undergoing treatment are being developed and therefore better results and, consequently, an increase in the quality of life are expected.

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