Lymphoma: what it is, main symptoms and treatment

Lymphoma is a type of cancer that affects lymphocytes, which are cells responsible for protecting the body from infections and diseases. This type of cancer develops mainly in the lymph nodes, also known as lupus, which are found in the armpit, groin and neck, leading to the formation of lumps and which can cause symptoms such as fever, night sweat, excessive tiredness and weight loss without apparent cause.

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 low immunity or who have been infected by certain viruses like HIV, Epstein-Barr or HTLV-1.

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

• Hodgkin's lymphoma, which is more rare, affects older people and affects specific body defense cells, type B lymphocytes; Non-Hodgkin's lymphoma, which is more common and usually develops from B and T lymphocytes. Check out 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 based mainly on chemotherapy, radiotherapy and bone marrow transplantation. If it is diagnosed early and if 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 sweat 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 tiredness; Itching; Malaise; Loss of appetite; Thinning without apparent cause; Shortness of breath and cough.

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 the lymphoma and become swollen and cause pain, and in addition, when a lymph node is greatly 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 tests and, if the diagnosis is confirmed, 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, cancer begins in the lymph nodes, or lingual. In addition, although some symptoms are similar, such as fever and night sweats, in leukemia it is more common to bleed and appear purple spots on the body, and in lymphoma, itchy skin occurs.

What are the causes

The causes of lymphoma are not yet 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 by the HIV virus, by the Epstein-Barr virus, which causes mononucleosis, HTLV-1, which is responsible for certain types of hepatitis, and infection by the Helicobacter pylori bacteria , 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 onset 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: they are used to evaluate blood cells and enzymes, because changes in the leukogram, such as an increase in lymphocytes, and an increase in lactic dehydrogenase (LDH) may indicate the presence of lymphoma; X-ray: provides images of parts of the body that may be affected by the lymphoma; Computed tomography : allows viewing of images of parts of the body in more detail than the X-ray, being able to detect the lymphoma; Magnetic resonance imaging : like computed tomography, it is used to detect areas of the body affected by lymphoma by means of images; Pet-scan: it is a type of computed tomography, which helps in the detection of metastasis, which is when the lymphoma spreads to various parts of the body;

It is also indicated by the doctor to perform a bone marrow biopsy that 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 the lymphoma.

How the treatment is done

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

1. Chemotherapy

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

Chemotherapy protocols are carried out every 3 or 4 weeks, because as these drugs have strong side effects, such as hair loss, nausea and vomiting, poor appetite and decreased immunity, it takes a longer period 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

Radiation therapy is a treatment used to destroy cancer cells through radiation emitted by a machine directly to the lymph node affected by the lymphoma, in which marks are made on the skin so that this radiation is administered in the same place every time.

Before starting the radiotherapy treatment, the radiotherapist, with the aid of imaging exams, makes a planning of the location of the body where the lymphoma is located and will indicate the radiation dose, quantity 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 of heat in the applied area. See what to eat to ease the effects of radiation therapy.

3. Immunotherapy

Some types of lymphoma can be treated with immunotherapy, which are drugs that help the immune system fight the 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, bortezomide and lenalidomide.

4. Bone marrow transplantation

Bone marrow transplantation is a treatment that consists of destroying diseased lymphoma cells and replacing them with healthy stem cells. Before receiving healthy stem cells, high-dose chemotherapy is required to kill all 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 that are autologous, when stem cells are received from the person himself, and allogeneic, which is when stem cells are acquired from another person. In order to receive the bone marrow from another person, it must be compatible, so before the transplant, blood tests are performed, both on the person who has the lymphoma and on the person who is going to 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 the immunity and fighting cancer cells. This treatment is still being studied and is not available in all hospitals. Find out more how the treatment is performed using the CAR-T-cell technique.

6. Surgery

In some cases, when the lymph nodes increase a lot in size, due to the lymphoma, they can reach other organs such as 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.

Can lymphoma be cured?

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

New treatments, new research and better support care for the person being treated are being developed and, therefore, better results and, consequently, increased quality of life are expected.