lymphoma

Lymph cancer (lymphoma) is the uncontrolled growth of lymphocytes, the body’s defense cells. Lymph nodes are one of the body’s most important defense mechanisms, and lymph nodes are the most common sites of lymph cancer.

There are thousands of lymph nodes in our body, and they are the most important part of our immune system that allows us to resist infections and diseases. During infections, lymph nodes enlarge.

When the disease ends, it returns to its former dimensions. This is indicative of a perfectly normal mechanism. When lymphoma occurs, lymphocytes, the cells of the lymphatic system, degenerate and multiply, thereby creating more abnormal cells.

Lymphomas are basically considered in two groups, Hodgkin and non-Hodgkin (non-Hodgkin). Although the symptoms of both may be similar, the type of lymphoma is decided according to some special cells that can be found in the tests performed.

It is very important to determine the type of lymphoma in order to determine the treatment options.

What Are the Symptoms of Lymphoma?

Lymphoma may not always show symptoms in the early stages. As the disease progresses, symptoms that mimic many diseases occur and these symptoms may vary according to the stage of the disease. Sometimes a unilateral enlarged tonsil or soft subcutaneous nodules can be diagnosed as lymphoma, these lymph nodes can be detected in many parts of the body:

• Neck
• upper chest area
• underarms
• Stomach
• Groin

The diagnosis of lymphoma can sometimes be overlooked due to the non-selective nature of the early signs of the disease, and many signs and symptoms may accompany lymph node enlargement at this stage:

• Cough and shortness of breath
• tonsil swelling
• High fever
• night sweats
• Weakness
• Unexplained loss of weight and appetite
• Abdominal cramps
• Itching
• bone pain
• enlargement of the spleen
• Pain after drinking alcohol

Occupational Exposure

It is possible for people working in agriculture to be exposed to herbicides and pesticide chemicals used against weeds and insects, this exposure is associated with an increased risk of developing lymphoma.

Infectious Causes

It has been determined that diseases caused by various microorganisms are associated with the development of different types of lymphoma. Bacteria called Helicobacter pylori cause MALT (mucous-associated lymphoid tissue) lymphoma. Bacteria called borrelia burgdorferi, chlamydia psittaci, campylobacter jejuni, T cell lymphotropic virus cause adult T cell lymphoma. hepatitis C virus can cause lymphoplasmacytic lymphoma or diffuse large B-cell lymphoma, while HHV8 virus can cause primary effusion lymphoma and Castleman disease.

Apart from these microorganisms and diseases, there may be a risk of developing lymphoma in viruses such as Epstein Barr virus and cytomegalovirus, which cause long-term stimulation of lymphoid tissue.

Immune (Immune) Deficiency

Lymphoma can be seen in people with HIV infection and in people who use drugs to prevent rejection after organ transplantation (transplant), or people who have genetic immune-related diseases.

Autoimmune Diseases

Diseases in which the immune system produces antibodies against its own cells and tissues and causes damage to these structures are called autoimmune diseases. Inflammatory bowel diseases (IBD), rheumatoid arthritis and Sjögren’s syndrome are in the autoimmune disease classification. While enteropathy-associated lymphoma may occur in IBD, a risk for the development of diffuse large B-cell lymphoma may be seen in rheumatoid arthritis and Sjögren’s syndrome.

Lymph Cancer (Lymphoma) Risk Factors

Hodgkin lymphoma is more common in men than in women, although its causes have not yet been fully determined. It is more common especially in the 15-34 age range, which is called young adulthood, and 55 years and older.

Some of the identified risk factors are:

• family history
• Epstein-Barr virus (EBV) infection
• HIV infection

Non-Hodgkin Lymphomas are more common diseases with advancing age. Some Identified Risk Factors for Non-Hodgkin Lymphomas Are:

• EBV infection
• HIV infection
• HTLV (human T-cell leukemia virus) infection
• Helicobacter Pylori infection (especially in gastric lymphomas)
• HHV-8 (human herpes virus type 8) infection
• hepatitis C virus infection
• Some chemicals (especially pesticides and chemicals used in the heating-cooling industry)
• Chemotherapy drugs used to treat certain cancers
• Some genetic diseases such as Kleinefelter, Chediak-Higashi syndromes
• Some rheumatological diseases such as Sjögren’s syndrome, celiac disease, systemic lupus

However, having one or more of these risk factors does not necessarily mean that they will have lymphoma. While some individuals with many risk factors may not develop lymphoma for years, it is possible to develop lymphoma in individuals without risk factors.

Some individuals with many risk factors may not develop lymphoma for years, while individuals without risk factors may develop lymphoma.

Diagnostic Methods

If an enlarged lymph node and other symptoms indicate lymphoma, a detailed physical examination is performed after the individual’s disease and family history is taken. The neck, armpit, elbow, groin and pit behind the knee are examined for the presence of enlarged lymph nodes. There is also an examination for the presence of possible enlargement of the spleen and liver, then some tests that can be done to confirm the diagnosis and determine the spread of the cancer are as follows:

• Blood Tests
• Complete blood count and biochemical examinations (such as LDH, uric acid).
• Lung Film
• Possible lymph node size and other problems are being investigated.

Biopsy

The enlarged lymph node should be partially or, if possible, completely removed. Because needle biopsies are generally less likely to yield a healthy result, if lymphoma is suspected, the entire lymph node must be examined by a pathologist, if this is not possible, a part of it. Bone marrow biopsy can also be performed to determine the extent of the disease.

Computed Tomography

The neck, lungs and entire abdomen can be examined in detail by computed tomography.

Lymph Cancer (Lymphoma) Treatment

Among the factors affecting the treatment decision in lymphoma are the type of lymphoma, the stage of the disease, the rate of growth and spread, the age of the patient, and the patient’s other health problems.

In some types of lymphomas that progress slowly and have no symptoms, the patient is checked at regular intervals for the progression of the disease, the occurrence of symptoms, and the need for treatment. Chemotherapy, biological treatments (monoclonal antibodies) and radiotherapy can be used in slow-progressing lymphomas with symptoms.

While chemotherapy and biological (monoclonal antibodies) treatments are generally preferred in the treatment of rapidly progressing lymphoma, radiotherapy can be added to the treatment when necessary.

When the disease is resistant to treatment or when disease recurrence (relapse) develops after treatment, the treatment modalities used are chemotherapy, biological treatments, radiotherapy, high-dose therapy, stem cell or bone marrow transplants, and Car T Cell therapy. Car-T Cell therapy is currently an approved method of treatment for B-cell Lymphoma. This treatment is based on changing the genetics of T cells, the main element of our cellular immune system, to transform our immune system cells, which do not recognize cancer, into cells that recognize cancer and fight them.

After completion of lymphoma treatment, patients are kept under close follow-up for recurrence for up to 5 years, more frequently in the first 2 years.

Lifestyle changes such as avoiding harmful habits such as smoking and alcohol, regular exercise and consuming healthy foods are recommended for the prevention of lymphomas.

Morale Is Very Important in Lymph Cancer

Since the patient has a positive perspective and believes that he will get better, it will help the treatment of lymphoma, so morale is also important for the doctor. Although morale alone is not effective in defeating lymphoma, it allows the patient to adapt to the treatment process. The more the patient adheres to the treatment of lymphoma and the more he believes that he will recover and survive, the more naturally his chances of success increase.