berkins lymphoma cancer

Cancer of the lymphatic system

Term: Malignant lymphoma
Clinical forms: Hodgkin's lymphoma, non-Hodgkin's lymphoma
Malignant lymphomas originate in the lymphatic system, thus in the body's immune system. Many of these diseases are characterized by swelling of the lymph nodes, but other organs may be affected and swell.

Introduction
Malignant lymphomas depart from the lymphatic system, the defense system of our organism. Many of these diseases are characterized by swollen lymph nodes (lymphadenopathy). The cells of the lymphatic system are found in almost all tissues of the organism, which has the effect that other organs (e.g. the colon, the stomach, the lungs, the brain) are sometimes also affected.

Lymphomas generally represent a small share of all cancer diseases, but they have significantly increased in recent years around the world. In Switzerland, there are about 1300 more patients each year; Just under half are more than 70 years old when they discover their cancer (Source: Swiss League Against Cancer).
Terminology and anatomy
Lymphatic system:
The lymphatic system comprises several organs, e.g. lymph nodes, bone marrow, thymus, spleen and tonsils, as well as all lymphatic vessels. In some of these organs it forms or matures lymphocytes and other white blood cells, which form antibodies against micro-organisms, toxic substances and other foreign bodies while supporting their elimination. Two types of lymphocytes (B and T lymphocytes) must be distinguished.

B lymphocytes:
B lymphocytes are formed in the bone marrow where some of these cells mature. Their defence function is to target antibodies against cells and substances outside the organism.

T lymphocytes:
T lymphocytes are also produced in the bone marrow and then ripen in the thymus which is a lymphatic organ located behind the sternum. There form different cells, which have also an important function in the defense of the organism.

Immunosuppression:
Blocking of immunitares reactions with medications, called immunosuppressants.
Brief overview
Non-Hodgkin's malignant lymphoma (NHL)
This is a non-uniform group of diseases. Coarse classifications take into account the kind of cells and their evolution. The result is four groups with
Different, that is:

B-cell lymphomas, they account for about 90%.
T-cell lymphomas.
Indolent lymphomas, of low malignancy; They generally have a slow evolution and usually only occur at an advanced age (over 60 years).
Aggressive malignant lymphomas also arise in young men and they usually have a rapid evolution.
These are respectively two qualities that distinguish cancer diseases: e.g. aggressive B-cell malignant lymphomas or T-cell indolent lymphomas or B-cell indolent lymphomas.

Malignant Hodgkin lymphoma
Synonyms are Hodgkin's disease and malignant lymphogranuloma. Hodgkin's lymphoma is manifested with two peaks of frequency, the first between 15 and 35 years, a second in the age range of over 60 years.

Since 2001 who has been revamping and completing the classification of malignant lymphomas by adapting them continually, while taking into account the latest knowledge.
Causes and Forms
The causes and mechanisms of their appearance are still not elucidated. However, we know a few factors that promote malignant lymphomas:

Link with infections, especially viral infections, e.g. with Epstein-Barr virus and other herpes group viruses. For gastric lymphoma with low malignancy, it is assumed that it is the bacterium Helicobacter pylori which plays a decisive role.
Suppression of the immune system (chemotherapy, immunosuppression after transplantation, etc.).
Genetic factors (modification or defect of the genotype).

It is also suspected that toxic substances of the environment and radioactive radiation can be triggered by lymphoma, but so far this has not been formally proven.
Non-Hodgkin lymphomas (NHL)
The starting point consists of the different types of white blood cells and levels of ripening, which results in a huge multiplicity of different cancers. Some manifest in a form of low malignancy or in an aggressive form, but there are different degrees of severity for all these forms. It is not uncommon for other organs to be affected outside the lymph nodes. The most common are the so-called B-cell lymphomas and among the latter the following: large cell lymphoma B, which is subdivided into an impressive number of subtypes.
Follicular lymphomas, slow progression, but repeated recurrences.
Leukemia (LLC), Lympho! Chronic IDE; A disease that appears preferably in the second half of life The most common blood cancer of adulthood.
The so-called multiple myeloma, which starts from the bone marrow, goes on to be a special form of an NHL.
Hodgkin lymphoma
15 to 35% of all malignant lymphomas are part of this group. These are mostly degenerate B lymphocytes and the disease is almost always confined to the lymph nodes.
The clinical picture
Malignant lymphomas begin in part in a sneaky way, but also in an acute way with rapid evolution. It is not uncommon for the disease to be discovered by chance during another examination (X-ray, ultrasound, etc.). The characteristics are as follows:

swollen lymph nodes: it often appears first near the neck, sometimes at the neck and in the groin and in the armpits. The consistency of the lymph nodes is typically firm, the latter are sometimes agglutinated to the environment, very little or not at all painful, and they do not decrease spontaneously in volume, contrary to swollen lymph nodes due to infections. In some NHL, nodules are also formed under the skin. Swollen lymph nodes can also occur in the abdomen or in the thorax. Pressure on the trachea or esophagus causes dyspnea and swallowing difficulties; In case of damage to the brain occur headaches, if any paralysis, etc.
General signs of disease: decreased performance, fatigue, pallor, sometimes itching. These general symptoms are rarer for indolent lymphoma (of lesser malignancy), but they are common in cases of aggressive lymphoma and Hodgkin's disease. Night sweats, fever and weight loss are additional symptoms that indicate the need for urgent treatment.
Enlargement of the spleen (splenomegaly), more rarely the liver, sometimes with a sensation of satiety and oppression in the upper abdomen.
Anemia, high susceptibility to infections and a tendency to bleed are the sequelae of reduced formation of intact blood cells.
Stadium Classification
It is important for the planning of therapy that is done most of the time according to the ANN-Arbor classification.

Stage 1: Only one ganglion group is reached.
Stage 2: Several lymph nodes above or below the diaphragm are reached.
Stage 3: The lymph nodes above and below the diaphragm are reached.
Stage 4: Cancer is no longer confined to the lymph nodes, other organs are also affected such as bone marrow, intestine, liver etc.

What can we do?
As soon as there are dubious symptoms, it is important to consult a doctor. The first step is to detect aggressive lymphomas in time so that they can be treated.
The diagnosis of a cancer is a heavy burden for the patient and his entourage. Contact with other patients and with self-help groups can be of some help in such a situation.
Different methods of complementary medicine make it possible to improve the quality of life. However, it is essential that the treating physician be informed of the taking of medications that stimulate the immune defence, as they could influence the efficacy of chemotherapy, this also applies to the preparation of Mistletoe (Viscum album) And for a high dosage of vitamins.
When to consult?

A visit to the doctor is necessary when the swelling of the lymph nodes persists, especially if the latter are firm and painless, glued to the surrounding tissues and impossible to move. Such changes can be felt primarily in the neck, in the underarms and in the groin area

Diagnosis
The first indications are based on the history of the disease and on palpation of swollen glands and swollen organs such as spleen and liver. Blood and bone marrow tests are then done. The definitive diagnosis requires biopsy of a ganglion, followed by microscopic examination and immuno-histochemical examination (using antibodies). To determine the stage or extent of the disease, positron emission tomography (PET) and other medical imaging techniques such as computerized tomography (CT), if applicable, Magnetic resonance tomography (TRM), etc., are used.
A precise diagnosis requires a lot of effort, but it is the condition for determining the best-suited therapy.

Therapy
Chemotherapy and/or radiotherapy are the main pillars of treatment; It may be added if necessary a transplantation of blood stem cells, adapted to the type of cancer, its extent, the stage of the disease and the age of the patient.
The hopes of healing have been significantly improved; This is due among other things to therapies of a new kind, the so-called antibody-based therapies, which make it possible to destroy the malignant cells in a targeted way. Their use applies in particular to aggressive B-cell lymphomas, partly also to low-malignancy lymphomas.

In the case of radioimmunotherapy, radioactive substances are contiguous to the antibodies before they are administered in order to selectively irradiate the cancer cells from the inside.
All the remedies mentioned may cause serious side effects, which can be mitigated or avoided by adjuvant medication. The most typical effects are exhaustion, discomfort, diarrhea, hair loss, fever, rashes, changes in blood count with increased disposition to infections, risk of bleeding, etc.

Surgical procedures are limited to the splenectomy or ablation of a highly inflated spleen, which apart from the disappearance of the feeling of oppression also serves to avoid the risk of rupture of the organ. The removal of the lymph nodes at the same time is used to determine the degree of progression of the disease, so-called "staging", in other words the determination of the stage of a cancerous disease.

Prognosis
Thanks to modern methods of treatment the prognosis of Hodgkin's lymphoma is favorable and one can even envisage healing rates of more than 80%, even in some cases of an advanced stage. But therapy can also lead to risks: 10 to 15% of cured patients appear after more than 15 years of other malignant tumours, which is considered a late sequelae of the therapy concerned, which does not only damage the tissue of lymphoma , but also the body's own defense and healthy tissues.

The prognosis of non-Hodgkin lymphomas depends on its respective form:

The aggressive untreated NHL usually causes death in a few months. They however benefit from a good prognosis if the therapy is appropriate, but significantly less than for Hodgkin's lymphoma. With rapid and intensive therapy, one often gets a remission or even healing. Recurrences can also be treated again using chemotherapy and rays, but the chance of healing decreases after recurrence.
NHL indolent (low malignancy) are sometimes not even treated at the beginning; Studies have shown that early treatment does not bring benefits but rather disadvantages. The therapy only starts when symptoms appear on the side of the tumor. But in principle it is to be remembered that a definitive cure of such lymphomas is not yet possible to date. We get a remission, but after a while some recurrences occur. However, therapy allows many patients to keep a good quality of life for a long time.