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For Patient - Lymphomas Cancer

 
 

Cancer

 

CANCER : Lymphomas

 
Lymphoma Image

Lymphoma is a form of cancer that can affect the various sections of the lymphatic system. However it is commonly the lymphocyte cells and the lymph glands that are the primary sites of cancerous growth. Lymphoma is quickly becoming one of the more common types of cancer in many countries. It affects both sexes. However, men appear to be more susceptible than women. The reason for this is still to be discovered.

Lymphomas need to be classified as an exact type before they can be treated with any success however this isn't always easy as there are a large number of different types that differ only slightly in their form.

Generally lymphoma is classified as being either Hodgkin's lymphoma or non-Hodgkin's lymphoma.
Hodgkin's lymphoma was first described by Thomas Hodgkin in the 1830s and is the rarer of the two forms of the cancer. In general many cases of Hodgkin's lymphoma begin in a single lymph node in chest, neck or axilla, spreading in an orderly fashion to other lymph nodes and nearby tissues. Hodgkin's lymphoma can affect any age group and either gender however individuals that are between 15-35 and those over the age of 55 are thought to be at increased risk.

Non-Hodgkin's lymphoma means that the patient has one of 30 subtypes of lymphomas and requires further diagnostic tests in order to exactly categorize the specific sub- type. The exact subtype of non-Hodgkin's lymphoma is crucial for treatment decisions. There are a number of classification systems that are used to describe cancers. However, broadly these are classified as either:
Fast (aggressive) or slow (non-aggressive) with regards to the rate of growth.

Affecting the B-cells or T-cells of the immune system.

Non-Hodgkin's lymphoma does not seem to favour one age group or gender. However, there are a number of risk factors that can increase the chances of an individual developing the disease. These include chronic obesity, the presence of AIDS or any other immunosuppressant condition, the Hepatitis C virus and the Epstein-Barr virus.

 

STAGING (Ann Arbor classification)

The most commonly staging system for Lymphomas is as follows:

 
Stage I Involvement of a single lymph node region (I) or of a single extra-lymphatic organ or site (IE)
Stage II Involvement of two or more lymph node regions on the same side of the diaphragm (II) or localised involvement of extra-lymphatic organ or site and of one or more lymph node regions on the same side of the diaphragm (IIE).
Stage III Involvement of lymph node regions on both sides of the diaphragm (III) which may also be accompanied by localised involvement of extralymphatic organ or site (IIIE) or by involvement of the spleen (IIIS) or both (IIISE)
Stage IV Diffuse or disseminated involvement of one or more extralymphatic organs or tissues with or without associated lymph node enlargement.
 

Diagnosis

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The diagnosis is confirmed by biopsy. A biopsy of bone marrow is also taken to rule out possible involvement of bone marrow.

PET CT:

In past CT and MRI were generally used for staging and follow up. However, recent studies have shown that F-18 FDG PET CT is superior to all other modalities for staging, prognosis and follow up of intermediate and high grade lymphomas.

 

Treatment Options

The various treatment options include:
 
  • Radiation therapy
  • Chemotherapy alone or in combination with radiation therapy. At times steroids are also given along with chemotherapy.
  • Surgery
  • Stem Cell / Bone Marrow Transplantation
  • New Therapies:
    Targeted therapy like Yttrium-90 Zevalin Angiogenesis inhibitors.
Your doctors will be able to discuss various treatment options with you in detail.
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