There are a lot of different subgroups of this disease, and depending on the type one has, the prognoses and treatments differs. The most important thing is to seek a second opinion from a lymphoma expert who can find out and identify the exact type of lymphoma that may be posing a threat to one’s health and choose the best treatment. Although some types may not need to be treated immediately, others may require more urgent treatment.
Understanding Lymphoma
It is a type of cancer that usually takes its origin in the immune cells known as lymphocytes (helps the body fight infection and diseases) located in the lymph nodes, thymus, spleen bone marrow and other body parts. When a person is down with the disease, lymphocytes start to grow out of control and entirely change.
As a routine, doctors examine a tissue biopsy under the microscope to look for any abnormalities in the lymphocytes. Other tests are carried out to examine the genetic makeup of the lymphocytes which may help to identify the subtype and best approach towards treatment.
Types of Lymphomas
There are different types, but the most common are the Hodgkin’s lymphoma and non-Hodgkin’s lymphoma, and each of them has different subtypes or subgroups. In case of the Hodgkin’s type of lymphoma, the rarest type of the disease and mostly characterized by Reed-Sternberg cells. Its subtypes are up to six, this type of cancer has some characteristics that practically stand out, but can only be observed under a microscope.
According to the World Health Organisation classification system, there are basically four types of Hodgkin’s lymphoma. They are nodular sclerosis, mixed cellular, lymphocyte rich, and lymphocyte depleted. Also, we have two types of nodular lymphocyte Hodgkin’s lymphoma which predominates, they are not so famous and only occur in 1 out of 20 people with the disease.
As for Non-Hodgkin’s lymphomas, these are more common. It has about 61 known types. Unlike its counterpart, non-Hodgkin’s lymphoma is not characterized by Reed-Sternberg cells. It may be difficult to name every type of this disease because of the number and different methods used.
Therefore, the up to date standard classification of non-Hodgkin’s defined by the World Health Organisation is based on its appearance when viewed under a microscope, the chromosomal features of the lymphoma cells, the presence of specific proteins, and whether it takes the route from the B-cells or T-cells.
Causes of lymphomas
As to the exact cause of lymphoma, till date, it is still unknown. However, there are some high-risk groups such as in people with lowered immunity because of autoimmune diseases, HIV and AIDS, or an inherited immune disorder. People who are exposed to some environmental toxins can also be at risk, smokers, individuals who have a family history of the disease. Furthermore, those who are also affected by some viruses or bacteria especially the Epstein-Barr Virus. It is more common in men, although some subtypes may be common in women; someone who has previously been treated for cancer with radiation. Even if a person should fall under any of this groups, it still does not mean one has lymphoma, as these factors may also be an indicator of other diseases.
Diagnosis of Lymphoma
These are the standard tests for lymphoma. One may not have all the tests, but when the selected ones are carried out, the doctor or doctors will let you know what has been learned regarding cancer, and suggest the best possible treatment. The doctor will begin by examining the patient’s body, especially the areas where the lymph nodes are located. The doctor will also take a medical history and ask about symptoms.
Tissue Biopsy: if a swollen lymph node is discovered, the doctor may think it is cancerous and want to confirm his suspicion by taking some tissue sample from the area for examination. The whole node may be removed, or most of the time only a part of it is taken for the biopsy, they are checking to see if this tissue sample has cancer cells in it. During the taking of this biopsy, general or local anesthesia would be given. This is for the procedure to be pain-free. If after the biopsy the doctor’s suspicion has been confirmed then further tests will be carried out to know whether or not cancer has spread and to what parts of the body, this is known as cancer staging.
Blood Test: using a needle and a syringe the doctor would take some blood from the patient’s arm, it will also be sent to a lab for other examinations, and this test will also let the doctor know how well the other organs are working, like the kidneys and the liver.
Bone marrow Biopsy: the cancer cells can also spread to the bone marrow. In this biopsy, a sample from the bone marrow is taken using a large needle; it is usually taken from the back of the hipbone. A local anesthetic and possibly some sedative will be given so that the procedure will be pain-free. The sample will then be taken to the lab and examined under a microscope to see if there has been a case of metastasis to the bone marrow.
Positron Emission Tomography (PET) scan: this provides clear and detailed pictures of the body. An injection of a glucose solution containing a small amount of a radioactive substance will be given. The scanner will detect this substance, which lets the viewer know where the glucose is being used in the body. Cancer cells show up in those areas by growing actively.
Other tests: may include gallium scan, computerized tomography (CT) scan, a magnetic resonance imaging (MRI), and a lumbar puncture (When a needle is put into the spinal cord area, and cerebrospinal fluid is taken for examination).
Can you die from Non-Hodgkin’s Lymphoma?
The causes of death at autopsy findings in people who have taken treatment for non-Hodgkin’s lymphoma at an institution over 13-years ago were reviewed. The autopsy examination showed evidence of lymphoma in about 90% of patients. The most frequent places affected were the respiratory channel, bone marrow, liver, kidney, and gastrointestinal tract (GIT). Regardless of the advances in therapy and supportive care of patients with non-Hodgkin’s lymphoma, many patients still die of the disease or from conditions related to its treatment.
Treatment of Hodgkin’s Disease
Depending on the type and the stage of cancer, including other options, treatment may include chemotherapy; radiotherapy; immunotherapy; a high dose of chemotherapy and transplantation of stem cells. The main treatments are chemotherapy and radiotherapy but as to whether these treatments are used individually or together depends on the situation. In cases where chemo and radiotherapy fail, some patients may be treated with immunotherapy or stem cell transplant.
In as much as this is a very severe disorder, there are palliative measures that can help to manage it. It is clear that for every form of any disease, the earlier it is diagnosed, the better the prognosis. Even though it is cancer we are talking about, it does not mean that it is outrightly a death sentence. There is always hope, and many advancements are being made to manage lymphoma better.
References
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