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Treating Lymphoma: The Various Procedures

Cancer is a word that most of us dread to hear from our doctors. We know that its something that should not be taken lightly, plus we cant even count how many times we have seen in the movies and television about the difficulties of the disease and more often than not the sad ending that follows. So hearing you have cancer of the lymph cells, which what lymphoma really is, is more than enough to give you and your family a scare. Treating lymphoma is never easy both physically and mentally for the patient. Having the full support of the family is a good thing to have in situations like these.

Lymphoma develops when the lymph cells begin to multiply quickly beyond what is normal. This abnormal growth soon forms tumors. These lymph cells are found in blood and lymph nodes thus with the grown of the cancer cells it is only natural that the lymph nodes enlarge and manifests as painless lumps in the neck, armpits or groin.

There are two main types of lymphoma. The most common one is the Hodgkin’s lymphoma. This type is distinguished from the rest by the presence of the Reed-Sternberg cell. The spread of the cancer cells in Hodgkin’s lymphoma is more predictable and often quite limited unlike the non-Hodgkin’s lymphomas where cancer cells develop first in other organs before spreading into the lymph nodes. The non-Hodgkins types of lymphomas are classified according low-grade, intermediate-grade or high-grade lymphomas which basically is based on how quickly the cancer cells spread.

Because of the number of types of lymphomas, the treatments vary. Often the treatments are combinations of various therapies and procedures. It is normal to have a number of treatments for a single lymphoma case. Once the type of lymphoma has been diagnosed and identified, the next step is to determine what stage it is in now. The kinds and extent of treatment of the cancer is dependent on the age of the patient and the degree or stage of the lymphoma. The treatment methods are either through chemotherapy, radiation therapy, antibody therapy (or biological therapy) and bone-marrow or stem cell transplantation. Again, combining one or two of these treatment methods is possible to address the present condition of a patient.

Chemotherapy uses various drugs to kill the tumor or cancer cells. The drugs can be taken orally or through injection. The advantage of using chemotherapy is that the drugs do not cause that much damage to the nearby normal and healthy cells. Radiotherapy, on the other hand, uses X-rays to kill the tumor cells. The rays damage the DNA of the cancer cells and because the DNA is damaged the cancer cells are unable to multiply which halts that growth of the cancer. Nearby healthy cells are damaged from the radiation bombardment so the goal in radiotherapy is minimize the damage to nearby, healthy cells. That is why those who undergo radiotherapy is scheduled to receive small doses of radiation at a time to lessen the damage to the cells.

Another treatment is the antibody therapy which uses antibodies which target unique molecules of a cancer cell. This attack from the antibody will eventually kill the cancer cells. And finally, the last way of treating lymphoma is by bone marrow or stem cell transplantations. These are medical procedures where the stem cells that were destroyed by high doses of chemotherapy and/or radiotherapy are replaced through surgery.


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The Types of Non-Hodgkins Lymphoma

Lymphomas are cancers of the lymph system which ironically is part of the bodys defense mechanism to fight off infections and diseases. But sometimes the abnormal growth of the healthy lymphatic cells causes the tissues to mass up creating tumors and eventually becoming cancer cells. If left untreated, the cancer cells can easily break away from the tissues and begin infecting other parts of the lymphatic system and eventually moving to other organs of the body. There are essentially two kinds of lymphomas, the Hodgkins lymphoma and non-Hodgkins lymphoma.

Hodgkins lymphoma is characterized by the presence of Reed-Sternberg cells. Other lymphomas do not contain these cells so the rest of the lymphomas were classified as non-Hodgkin’s lymphoma or NHL. There are a number of sub-types of non-Hodgkin’s lymphoma. Each are quite distinct targeting specific age groups aside from having unique forms.

One kind of NHL is the lymphoblastic lymphoma or LBL which commonly occurs in children. In fact about 30% of documented cases of lymphomas in children have been classified as lymphoblastic lymphomas. LBL is very aggressive kind of NHL and has caused quite a number of deaths in the past. But because of modern medicine and treatment techniques, LBL patients have better odds of surviving the ordeal.

Unlike LBL, the diffuse histiocytic lymphoma type or DHL is a slow growing cancer. And because it is slow-growing the cancer is quite hard to detect. Also, there are times where the cancer reappears after treatment.

Another kind of NHL appears closer to the bodys surface. The cutaneous T-cell lymphoma or CTLC is a kind of lymphoma that affects the skin. What happens is that the white blood cells of the skin become cancerous. At first, the signs are dry, scaly skin with red or dark patches. These areas of the skin also itch a lot. But as the cancer cells continue to grow, the skin will develop highly noticeable tumors. Eventually the cancer cells enter the blood stream and spreads all over the body which soon infects other tissues and organs.

Although not common, the mantle cell lymphoma is another kind of non-Hodgkin’s lymphoma. This cancer borders on being rare since only an estimated 5% of people diagnosed with NHL have it. It seems that the cancer is more likely to occur in men 50 years old and older. The cancer starts off as a slow growing lymphoma but can suddenly become aggressive in later stages.

Doctors have made 4 classifications or stages of non-Hodgkin’s lymphoma which basically indicates how fast and how far the cancer cells have spread. Stage 1 is when the cancer cells are grouped in lymph node or organ of the body. In stage 2 the cancer has spread to two or more groups of lymph nodes or organs on the same side of your diaphragm. Stage 3 is where the cancer cells have infected organs on both sides of the diaphragm and finally stage 4 is when the different types of non-Hodgkins lymphoma have gone beyond the lymphatic system and infecting other organs like the liver, bones, and lungs.


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Knowing Your Cancer, Hodgkins disease

Hodgkin’s lymphoma or otherwise known as Hodgkin’s disease is one of two kinds of lymphoma or a cancer of the lymphatic system. Thomas Hodgkin was the first person who published documented studies of the disease hence the cancer was named after him. Hodgkin’s lymphoma is different from the other kind of lymphoma mainly through the presence of Reed-Sternberg cells in the cancer cells. These Reed-Sternberg cells can be seen through an open biopsy. In contrast, cells seen on non-Hodgkins lymphomas are mutated B-cells or T-cells.

It has been observed that Hodgkins lymphoma oftentimes begin to develop in the lymph nodes in the neck. This is again quite different from non-Hodgkins lymphoma which beings in different locations in the body. Nonetheless, since this is cancer were talking about, from the neck lymph node spreading to other lymph node groups, the lungs, spleen, and bone marrow is only natural and inevitable if no treatment is undergone. It seems also that Hodgkin’s lymphoma targets the immediate nearby lymphatic regions before leaving eventually the lymphatic system and spreading throughout other organs of the body.

According to studies, Hodgkins lymphoma is more likely to develop in young adolescents particularly those within the age range of 15 to 24 as well as those who are more than 60 years old. Again this is quite different from non-Hodgkins lymphoma which rarely happens in young people and instead is more common to people aged 60 years old and above.

In determining a diagnosis, one can actually self-diagnose at least initially. A doctors expertise is still needed, of course, for a more accurate diagnosis of the disease. The symptoms that have been reported are not that different from the other kinds of lymphoma. The presence of a painless lump in the lymph nodes in the neck, underarm, or groin, recurrent fevers, unexplained weight loss, night sweats and itchy skins are among the warning signals of developing lymphoma.

Among the usual tests your doctors would require you to undertake includes blood tests to check abnormalities in the blood counts, blood chemistry, and abnormal erythrocyte sedimentation rate (ESR), X-rays to look at the lymph nodes, computerized tomography or CT scan and magnetic resonance imaging or MRI scans of the chest, pelvis, and abdomen to see if the cancer has already spread to other parts of the body.

Other scans that could be used to properly diagnose and determine the stage of the cancer are the positron emission tomography or PET scan which scans the cancer at a cellular level and the gallium scan which looks for radioactive intake of gallium which can mean the onset of the disease. There are other tests and procedures which doctors might conduct on you all in the aid of a proper and accurate diagnosis.

Hodgkins lymphoma has several sub-types, namely nodular sclerosis (NS) which hits the lower neck, chest and collarbone, lymphocyte predominance (LP) which is made of malignant L&H cells which have a “popcorn”, mixed cellularity (MC) which has lymph nodes that are usually contain Reed-Sternberg cells and inflammatory cells, lymphocyte depleted (LD), and nodular lymphocyte predominant (NLP).

As they say, knowing is half the battle. Knowing more about Hodgkins disease is a good thing. You can contribute fully to the decision making process if you know exactly the situation you are in.


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Asking Your Doctor about Lymphoma

Lymphoma simply means cancer of the lymphatic system. However, as simple as it sounds the disease is quite complex. So it is only natural to begin asking your doctor about lymphoma right from the start. But it is essential that you ask the right questions as well. Never be shy about asking questions that you think sounds stupid. Your future health is on the line so it is imperative that you be properly informed.

We often ask our doctors what causes lymphoma. Unfortunately, the answer to this question remains to be a big fat unknown. Doctors and scientists have yet to identify the singular cause of the cancer. However, what they were able to do was identify the different risk factors involve that might affect the development of lymphoma. It seems that prolong exposure to hazardous chemicals, herbicides, pesticides and even drugs that suppress the bodys immune system have been tied to the high chances of developing cancer of the lymphatic system. Avoiding these situations would be a good life choice or at the very least if you work in the industry where handling chemicals or pesticides are necessary you should take the necessary precautions to protect our bodies from harm.

You need to ask your doctor what type of lymphoma you have. There are two kinds: the Hodgkin’s lymphoma which is immediately identifiable under the microscope due to the presence of a particular cell. This is actually the most common kind of lymphoma. The rest of the cases that dont adhere to the conditions and appearance of Hodgkins lymphoma are simply classified as non Hodgkin’s lymphoma. Even though they have similarities, the two kinds of lymphoma use slightly different treatment procedures which are why it is important that your doctors are able to identify what kind you have.

How far the disease has spread and how serious is the condition? This is another pertinent information before treatment is implemented. There are basically four stages of lymphoma development. The first stage is where the cancer cells are just in one part of your body so far. At this stage the cancer cells are isolated in at least one lymph node. The second stage is more complex for the cancer cells are in two or more lymph nodes or regions. The cancer cells are located either above or below the diaphragm. This stage is also referred to as “locally advanced disease.”

The next stage is the advance disease which is the third stage already. The cancer cells at this point are already on both sides of the diaphragm. The final stage or stage four means the cancer cells have already spread to other parts of the body.

The next series of questions would be concerning the treatment. What are the treatment recommendations and what are the procedures for the treatment. There are a number of treatment options available. Among them is biologic therapy which uses methods like monoclonal antibodies, radioimmunotherapy, interleukin 2 and vaccines that boost the bodys capability of protecting itself from lymphoma. Other treatments include the conventional chemotherapy and radiation therapy.

Asking your doctor about lymphoma means to get all the information about the disease in order for you to be prepared physically, mentally and psychologically on the next steps that you would need to undergo.


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