Non-Hodgkin's lymphoma: Causes and Treatments

Non-Hodgkin's lymphoma: Causes and Treatments

What is Non-Hodgkin's lymphoma

Non-Hodgkin's lymphoma is a type of cancer of the lymphatic system, an important component of the immune system. When this disease occurs, that is to say that lymphocytes, a type of white blood cells in the bone marrow, the rate, thymus and ganglions, multiply in a disorderly and uncontrolled way. It can reach other organs like the brain.

Non-Hodgkin's lymphoma is 5 times more common than Hodgkin's lymphoma and affects about 16 in every 100,000 people. It is best known in men and women, and occurs more at the age of 60 at age 70. People with compromised immune systems - who are HIV-positive, for example, who have received treatment and immunosuppressive drugs - are at higher risk. About 10% of those infected with HIV had non-Hodgkin's lymphoma.

There are several types of non-Hodgkin's lymphoma. On the Identified according to the appearance of the cells under the microscope. Among them, there are two main categories: indolent lymphomas and aggressive lymphomas. The first ones develop more slowly and have fewer symptoms. The seconds are growing faster.

Non-Hodgkins lymphoma

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Causes of Non-Hodgkin's lymphoma

The exact cause of non-Hodgkin lymphoma is not known, but doctors believe that a virus or the activation of abnormal genes could be the cause of some cases of this condition. The following risk factors would be responsible for some cases:

age (60 years or older);

autoimmune conditions (rheumatoid arthritis)

exposure to pesticides, chemical solvents and dyes;

exposure to certain viral infections such as those caused by the Epstein-Barr virus;

immunodeficiency conditions such as AIDS, congenital immunodeficiency or drug immunosuppression;

prior exposure to chemotherapy or radiotherapy.

It is possible to develop non-Hodgkin's lymphoma, even in the absence of these risk factors.

Diagnostic of Non-Hodgkin's lymphoma

Your doctor will ask you about your symptoms and you will undergo a physical exam. If he suspects non-Hodgkin's lymphoma, he will perform other tests to confirm the diagnosis.

Blood tests will check for abnormal blood cells and organ function (eg liver, kidneys). X-rays, ultrasounds, CT scans or positron emission tomography will scan the lymph nodes that your doctor can not examine because they are located deep inside your body.

Lymph node biopsy (excision of a small lymphatic gland sample for microscopic examination) will confirm the diagnosis. A doctor may take a bone marrow biopsy to determine if the cancer has spread there. This test requires the insertion of a needle into the lower back to remove tissue and microscopic examination of the tissue to determine if cancer cells are present.

Thanks to the information obtained from these tests, non-Hodgkin's lymphoma will be given a stage and a grade. By using these features, you and your doctor can decide the best treatment for you.

The following are the clinical stages used in the evaluation of non-Hodgkin's lymphoma:

stage 1: the cancer is present in a single ganglionic group;

stage 2: the cancer is present in more than one ganglion group, these groups are located on the same side of the diaphragm (thin muscle located under the lungs which promotes respiration and which separates the thorax from the abdomen);

stage 3: the cancer is present in ganglionic groups on both sides of the diaphragm;

stage 4: cancer has reached one or more organs (eg, liver, lungs, brain, bone marrow);

recurrent: term used for cancer that has reappeared after treatment.

The two grades of non-Hodgkin's lymphoma are indolent lymphomas and aggressive lymphomas. Indolent lymphomas grow more slowly and cause fewer symptoms than aggressive lymphomas.

Symptoms of non-Hodgkin's lymphoma

The signs or symptoms of non-Hodgkin's lymphoma (NHL) may vary depending on the type of NHL, where it originated and how advanced it is. Other medical conditions can cause the same symptoms as the NHL

The most common symptom of NHL is swelling of the lymph nodes in the neck, armpit or groin. Swollen glands are usually painless, but may eventually put pressure on the surrounding tissues or organs and cause discomfort or pain.

Other common symptoms of NHL are:

rash or itchy skin on the chest, stomach and back

unexplained fatigue

Some NHL symptoms are generalized, which means they affect the whole body. These are B symptoms, or systemic symptoms, that usually include these:

Unexplained fever greater than 38 ° C, which does not go away

heavy night sweats (enough to wet nightwear and bedding)

unexplained weight loss equivalent to more than 10% of body weight in the previous 6 months

Symptoms depending on where the NHL appears

NHL can cause other signs and symptoms depending on where it originated.

An NHL in the chest can cause the following symptoms:

breathlessness

cough

feeling of pressure in the chest

chest pain

swelling and bluish red discoloration of the head, arms and upper chest (caused by superior vena cava compression syndrome)

An NHL in the abdomen can cause the following symptoms:

difficulty digesting

swelling in the abdomen

abdominal pain or discomfort

loss of appetite

feeling of fullness after eating a little

nausea or vomiting

spleen or swollen liver

Non-Hodgkins lymphoma

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An NHL at the brain and spinal cord, which together form the central nervous system (CNS), can cause the following symptoms:

headache

double vision

numbness of the face

difficulty thinking

difficulty speaking

weakness

personality changes

epileptic seizures

A bone marrow NHL can cause bone pain in the legs, ribs, spine or pelvis. It can also lower the number of blood cells, which can lead to the following symptoms:

infections that persist or reappear constantly

tendency to bleeding or bruising

tired

An NHL skin often appears as masses under the skin that are red or purple and itchy.

Treatments of Non-Hodgkin's lymphoma

You are cared for by a specialized team in a facility authorized to treat cancers. This team works in regular contact with your doctor. Depending on your situation, several professionals may be involved: hematologist, medical oncologist and radiotherapist, pathologist, nurse, psychologist, social worker, etc.

Management of non-Hodgkin's lymphoma is primarily based on chemotherapy. This treatment uses a combination of anticancer drugs that act throughout the body on cancer cells. Chemotherapy is often associated with monoclonal antibody therapy. In this case, we are talking about immunochemotherapy. It is currently the standard treatment for ganglionic non-Hodgkin's lymphoma.

Depending on the situation, treatment may involve radiotherapy or hematopoietic stem cell transplantation. In some cases of indolent lymphoma, therapeutic abstention may be proposed.

Side effects differ depending on the treatments. They are explained to you by the doctor who follows you and who makes sure of their support.

Transient or definitive sterility can occur in men after certain chemotherapies. Before starting, it is therefore essential to discuss with the medical team the possibilities of sperm preservation. Possibilities for the preservation of oocytes or embryos can be considered for women treated with pelvic radiotherapy.

Other complementary care and support can be implemented to deal with the possible consequences of the disease and its treatments: fatigue, pain, need for psychological support, social problems, etc. This care, called supportive care, is provided by different professionals (psychologist, social worker, etc.) who, depending on the case, work in a health facility, in a home hospital, in a city consultation, in the part of a health network, a patient association, etc.

Chemotherapy

The chemotherapeutic agents used depend on the type of NHL and its stage. You may be given a single chemotherapeutic agent or some of them. High dose chemotherapy is used in preparation for a stem cell transplant.

immunotherapy

Only immunotherapy can be given or combined with chemotherapy to treat certain types of NHL.

Targeted treatment

Only targeted drugs can be given or combined with chemotherapy to treat certain types of NHL. Some targeted drugs deliver radiation directly to lymphoma cells. This treatment is called radio immunotherapy.

Radiotherapy

External radiotherapy may only be used as the primary treatment for some types of early-stage NHL that have not spread to different parts of the body. It can also be combined with chemotherapy to treat aggressive or more advanced NHL.

Occasionally, whole-body external beam radiation (total body irradiation) is administered in preparation for a stem cell transplant. It can also be administered to the brain (commonly referred to as the brain) to prevent NHL from spreading to the central nervous system (CNS) or CNL NHL.

Physicians may use radiation therapy to reduce the size of the tumor or larger than normal lymph nodes that exert pressure on the nerves, causing pain. Administering radiation therapy to these areas can help reduce the size of large tumors and relieve pain.

Watchful observation

Watchful observation is also called active surveillance. It may be an option for some indolent NHL types that still do not cause symptoms. The care team is watching closely for signs that the NHL is progressing. She starts treatment if the disease develops and causes symptoms.

Surgery

Surgery is used primarily to remove a lymph node in part or in whole to diagnose NHL. Sometimes surgery is done to remove the spleen (splenectomy). In some cases, surgery may be required to remove the entire tumor if it has not invaded nearby tissues or organs.

Stem cell transplant

Stem cell transplantation can be used to treat people who have a high risk of recidivism and are in remission. A stem cell transplant can also be used to treat NHL that recurs (recurrence) after treatment or no longer responds to treatment.

Followed

Post-treatment follow-up is an important component of caring for people with cancer. You will need to have regular follow-up visits. They are usually scheduled every two months for the first year or so, then gradually, you will meet the doctors less and less often. These visits allow the care team to monitor your progress and find out how you are recovering from the treatment.

MONITORING

After the treatments, a regular and prolonged follow-up must be put in place over several years. It is based on medical consultations, blood tests and scans. The schedule and duration of this follow-up are adapted on a case-by-case basis by the specialized team that performed the treatment, in conjunction with the treating physician.

Clinical tests

Some NHL clinical trials are underway in Canada and accept participants. Clinical trials aim to find new, better methods for cancer prevention, detection and treatment. Learn more about clinical trials.

Non-Hodgkins lymphoma

Please if you have any questions about Non-Hodgkin's lymphoma, you can ask us by commenting below this text, we'll answer you as soon as possible.

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