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What
are Lymphomas?
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Lymphomas are cancers of the
lymphatic system, a network of vessels which form part of the
body's immune system, and
carry lymph, a colourless, watery fluid that contains
infection-fighting white
blood cells called ‘lymphocytes ‘, as well as draining dead
cells away from the tissues.
Dotted along the lymph vessels are groups of small,
bean-shaped lumps called lymph nodes or glands. Clusters of
lymph nodes are found under your arms, around your neck and
under your chin, |
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and throughout the pelvis, groin, abdomen and chest.
They make and store
infection-fighting
cells, especially lymphocytes.
Lymphoma results when a
lymphocyte undergoes a malignant change and multiplies,
eventually crowding out healthy cells and creating tumours.
These tumours enlarge the lymph nodes and/or grow in other sites
that are part of the immune system.
Lymphoma accounts for one in ten childhood cancers, making it the third
most common. There are two principal kinds of lymphoma -
Hodgkin's and non-Hodgkin's. Non-Hodgkin is more common in older
people, and Hodgkin’s lymphoma is more common in young adults
between 15 and 30, and adults over the age of 50.. Lymphomas are
twice more common in boys than girls. |
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Symptoms of lymphoma:
Some of the symptoms of lymphomas can be very similar to
those of leukaemia, although there may be no symptoms
until the lymphoma has spread. It can start in almost
any part of the lymphatic system and spread to almost
any other part of the
body, including
the liver, bone marrow (the spongy tissue inside the
large bones of the
body that makes
blood cells) and the spleen (an organ in the upper
abdomen that makes lymphocytes and filters old blood
cells from the blood). Hodgkin lymphoma usually has
symptoms of painless swelling of the lymph nodes (lymphadenopathy),
most frequently in the neck, people often get a similar
swelling (lymphadenopathy) if they have a simple cold.
In Hodgkin lymphoma the swelling is much larger and
firmer.
Other symptoms include: |
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| Fever for which no
cause can be found | Fatigue or extreme tiredness |
Paleness | Night sweats (usually a sign of Hodgkin's) |
Weight loss |
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Often lymphomas have spread all over the
body before the
person is aware they have a problem. |
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Lymphoma - causes and risk factors:
The causes of lymphoma have not yet been
established,
Scientists have looked at many things that may be linked
with lymphomas. They have found many
connections and risk factors but are
unable to say exactly what the causes
are. However, in Hodgkin's lymphoma,
there appears to be a connection with a
virus called the Epstein-Barr virus.
This is the virus which causes glandular
fever, and Hodgkin's is often found in
people in their 20s. However, the
incidence of glandular fever is high
among this age group - and the number of
Hodgkin's cases is very low. Genetic and
environmental factor, such as exposure
to pesticides, have also been suggested |
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Lymphoma Treatment and Recovery:
The two main types of lymphoma involve
different types of white blood cell and
it's important to get the exact
diagnosis (determined mainly by what the
cells look like under the microscope).
Each type of lymphoma needs slightly
different treatments and has different
prognoses or cure rates. Doctors will
also work out how far it has spread
around the
body.
As recently as 1950, lymphoma was almost
inevitably fatal, but these days nearly
100 per cent of teenagers with Hodgkin
lymphoma can expect to be cured.
Non-Hodgkin lymphoma is less easily
treated, with an overall cure rate of
about 75 per cent. The first thing a
doctor will do to investigate suspicions
of lymphoma is carry out a physical
examination, feeling the lymph nodes in
the neck, under the arms and in the
groin, or felt. It can be slightly
uncomfortable, but not painful. A doctor
can also feel the abdomen for unusual
swellings in the liver, which can happen
if lymphoma spreads to that organ. Blood
tests will also give a strong clue as to
both the presence of disease - and what
type it is.
The numbers of various types of
cell are counted to make sure there are
the right number, using automated
laboratory machinery, and a small sample
also examined directly under the
microscope by a consultant haematologist,
or blood specialist. Another key test is
the x-ray or CT scan, which can look for
swellings in the lymph nodes, liver,
lungs and spleen.
For lymphoma, a biopsy of lymph nodes,
normally from the neck and underarm area
is taken to check for disease. All this
information will help doctors work out
how aggressive the
cancer
is, and how far it has already spread. |
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Lymphomas are usually treated by a
combination of:
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Chemotherapy, where drugs are used
to kill
cancer
cells and shrink tumors. The aim is
to get the
cancer
into ‘remission’, which means no
evidence of
cancer
can be found on scans or blood
tests.
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Radiotherapy, where high-energy x-rays are used
to kill the
cancer
cells.
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Surgeryy
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Bone marrow transplants
are also sometimes also needed,
particularly if the first chemotherapy
treatment fails and more powerful drugs
have to be used. The bone marrow is
found at the centre of the
body's
larger bones, such as in the spine and
upper leg, producing blood cells and
helping the
body
fight
infection.
If high-dose chemotherapy is to be used,
this may permanently damage the bone
marrow, so it has to be replaced
afterwards.
Many children with lymphoma will be offered the chance to be treated as
part of a clinical trial. While they or
their family may be frightened by the
idea that they're being used as some
sort of guinea pig, they'll be very
carefully monitored by doctors during
the trial. Trials are the only way to
find better treatments. Drugs can be
given to stimulate the production of
cells vital to rebuilding the bone
marrow, which are then harvested and
replaced after the treatment. Or a donor
may have to be found whose bone marrow
is an exact match for the patient. A
close relative may be able to provide a
match, but this is far from certain. The
Anthony Nolan Bone Marrow Trust keeps a
register of 130,000 volunteers who are
all prepared to give bone marrow if they
prove a match for a patient |
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