Malignant Lymphoma: Symptoms, Treatment- Chemo/Immunotherapy, Stem Cell Transplant
Malignant cells are those cancerous cells which can spread or metastasize to other areas of the body. Our lymph system consists of vessels, fluid and lymphoid tissue, which in turn consists of lymph nodes. These are a part of our immune system. The function of our immune system is to generate blood cells and protect our bodies from any harm from outside germs. Cancers or tumors which originate in the lymphatic system are known as lymphomas.
There are 2 main types of lymphoma, namely (1) Hodgkin's Lymphoma and (2) Non-Hodgkin's Lymphoma (NHL). Treatment comprises of chemotherapy and radiation therapy. Lymphomas can be cured in most of the patients.
Types of Malignant Lymphoma
There are 2 main types of malignant lymphoma and these 2 types metastasize and respond in a different manner to treatment. Low grade lymphoma is that lymphoma which grows at a slow rate. High-grade lymphoma is aggressive and grows fast. The following are the 2 main types of lymphoma.
1. Hodgkin's Lymphoma (Hodgkin's Disease)
The presence of an abnormal cell, Reed-Sternberg, classifies a lymphoma into Hodgkin's lymphoma. According to research, majority the lymphoma patients have Hodgkin's lymphoma. Hodgkin's lymphoma commonly begins in the larger lymph nodes, which are more centrally located, such as neck blood vessels, central chest, abdomen adjacent to the spine, underarms and groin regions. Hodgkin's lymphoma is quite easily curable. Hodgkin's lymphoma is often treated with chemotherapy and/or radiation therapy. Treatment can also be done in combination of both therapies or individually.
2. Non-Hodgkin's Lymphoma
The remaining other types of lymphomas are categorized as Non Hodgkin's Lymphoma. NHL occurs due to any injury to the lymphocyte progenitor's DNA and NHL is not an inherited disease. NHL has around 60 subtypes. Non-Hodgkin's Lymphoma is around 10 times more common than Hodgkin's lymphoma. Almost all the types of NHL are curable. NHL is commonly treated with chemotherapy, and/or radiation therapy and immunotherapy. In some cases, a stem cell transplant can also be done by way of treatment. Depending on the stage of the cancer and patient's general health, treatment can be done individually or in combination with other treatments.
Causes and Risk Factors of Malignant Lymphoma
Malignant lymphoma can occur in anyone. The exact cause of the lymphoma is not clear; however, there are certain risk factors which increase the risk of developing lymphoma.
- Adults, as well as children, can develop Hodgkin's lymphoma; however, the risk is more in late or early adult life.
- Men are at a higher risk to develop lymphoma.
- The risk of developing NHL increases with age.
- Exposure to radiation therapy from other cancer treatment can also increase the risk of developing malignant lymphoma.
- A weakened immune system also increases the risk of developing malignant lymphoma.
- Children usually do not develop NHL.
Signs and Symptoms of Malignant Lymphoma
- Swelling in the lymph nodes is the most common symptom. These lymph nodes can be found in the neck region, underarms, upper chest, abdomen and groin region.
- Night sweats.
- Itchiness of the skin.
- Weight loss.
Investigations for Malignant Lymphoma
- Physical examination
- Blood tests
- Biopsy of the lymph node helps in determining if there are cancerous cells present. A biopsy also helps in differentiating between Hodgkin's Lymphoma and Non Hodgkin's Lymphoma and also other sub-types of cancer.
Treatment for Malignant Lymphoma
Treatment depends on the lymphoma type, its stage, other medical conditions of the patient and patient's preferences. The following are the treatment options:
Chemotherapy for Malignant Lymphoma
Chemotherapy is often used for treating lymphoma. Chemotherapy uses medications or drugs to kill the cancer cells. Chemotherapy can be given either orally or intravenously or as an injection. The drug travels to the tumor via blood and destroys the cancer cells. Chemotherapy can also be used along with radiation therapy
Radiation Therapy for Malignant Lymphoma
Radiation therapy is a treatment which involves the use of high-beamed x-rays for killing cancer cells. Radiation therapy can be done before the surgery to shrink the size of the tumor or after the surgery to remove any remaining cancer. Radiation therapy is commonly used for all types of leukemia, non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma. Radiation therapy can be used alone or with chemotherapy.
In lymphoma, radiation therapy is done by a machine which targets the radiation to specific points on the body. This is known as external radiation. Radiation therapy given with seeds, wires, or catheters placed inside the body is known as internal radiation. The type of radiation therapy given depends on the stage and the type of the cancer. Side effects of radiation therapy include: Tiredness, low blood count, skin rash, nausea, vomiting or diarrhea.
Immunotherapy for Malignant Lymphoma
Immunotherapy, also known as biological therapy, is a treatment where medicines which use or enhance our immune system to destroy the cancer cells are used. In a cancer patient, immunotherapy is that process where the immune system of the body is trained to remove or destroy cancer cells. Some of the drugs used for this purpose include aldesleukin and interferon. Side effects of immunotherapy are nausea, vomiting, fever, chills and appetite loss.
Stem Cell Transplant for Malignant Lymphoma
Stem cell transplant is done for treating multiple myelomas, Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma. A stem cell transplant is a process where healthy stem cells are instilled into the body to promote the growth of new bone marrow, to curb the cancer, and to decrease the chances of a relapse.
All the different treatment modalities or therapies can be given alone or in combination with other methods.
Prognosis of Malignant Lymphoma
Starting the treatment in the early stages of disease gives a very good prognosis. Each patient has a different prognosis which depends on the stage of the cancer and patient's general health. Chemotherapy used in combination with radiation treatment is often successful; however, there are some side effects. Sometimes patient may also have remission. One of the easily curable lymphomas is Hodgkin lymphoma, particularly in kids and young adults.