Non Hodgkin's Lymphoma example essay topic

Lymphoma Lymphoma or lymphatic cancer is a very serious and life threatening disease. In this country there is an estimated 63,900 new cases, 7,100 of which are Hodgkin's lymphoma as opposed to non-Hodgkin's lymphoma. Since around the 70's the occurrence of non-Hodgkin's lymphoma has almost doubled while the occurrence of Hodgkin's disease has declined. (Steen, 1993) Lymphoma is the name given to a cancer that infects the lymphatic system. In a case of lymphoma the lymphatic system has cells that multiply and cannot be stopped. There are two main types of lymphoma, Hodgkin's and non-Hodgkin's.

Non-Hodgkin's lymphoma is called lymphoma and Hodgkin's type lymphoma is called Hodgkin's disease. Hodgkin's disease is different from non-Hodgkin's disease in that Hodgkin's disease has a Reed-Sternberg cell present in the areas infected with the cancer. Hodgkin's disease occurs mainly in people between 15 and 40 or over 55. Non-Hodgkin's type cancer is much more common than Hodgkin's disease. Non-Hodgkin's lymphoma is a group of over 29 types of lymphoma. These are classified by the US National Cancer society as aggressive or fast multiplying or indolent, slow multiplying.

(Lymphoma Information Network) The lymphatic system protects the body from agents that could cause disease like bacteria or viruses. Within this system, that consists of organs such as the spleen and tonsils, there are organs that destroy foreign agents, those organs are called lymph nodes. The lymphatic system works as follows; the bone marrow produces blood cells including white blood cells. White blood cells are the cells that find and destroy disease-causing agents. Both B and T cells change a great deal to defend the body from pathogen. It is while the B cells are transforming that cancers can infect them.

(Lymphoma Information Network) What causes Hodgkin's disease is not known, but the symptoms are well known and somewhat easy to detect. One's lymph nodes in the neck, armpit or chest begin to swell. The swelling should be painless to touch, not sore or tender, if it were sore it would most probably be caused by an infection of the lymph nodes. To diagnose Hodgkin's is a relatively simple procedure, it determines whether or not one has Hodgkin's disease and what stage the disease is in. If the lymph nodes in the armpit or neck are en flamed then the procedure is simple, however if it is only the nodes in the chest a or a less common thoracotomy is required. This involves opening the chest, or in the case of thoracotomy the neck, so that the entire lymph may be taken out.

To test the stage of the disease the following tests are available depending on preference and the position of the lymph nodes. A CT scan or Ultrasound shows lymph nodes in the stomach area, abnormalities in the liver or spleen problems. A lympho graph can detect pelvic and abdominal problems, bone marrow biopsy test the bone marrow as the Hodgkin's disease often spreads to the marrow. A laparotomy involves the surgeon opening one's abdomen to see the organs.

At times the spleen is removed as it is often infected with Hodgkin's disease and it being gone often helps with radiotherapy. Laparotomy is less frequent as scanning type tests are more often used. Liver biopsy tests the liver, this is only necessary in certain circumstances. A gallium scan entails an injection of gallium, and because of the way Hodgkin's disease takes up gallium parts of the nodes which are otherwise difficult to see are visible. Blood tests are often done as well and new methods of testing are being developed. In any of these cases if a Reed-Sternberg cell is found it is sure that it is Hodgkin's disease.

(Buckman, 1995) There are two main types of treatment used in Hodgkin's disease, radiotherapy and chemotherapy. They are used alone and in conjunction with one another. Radiotherapy is often used to treat the disease when only one or two groups of nodes carry the disease. More recently chemotherapy has been used as well. (Cancerbacup) Radiotherapy uses high energy rays to destroy cancer cells. This does do damage to normal cells but that is minimized.

Treatment is given usually on a daily basis, but only during the week. One will have to have their skin marked so that the radiographer can position you correctly. This test consists of lying under a large X-ray or CT scanner machine called a simulator. Then you are bombarded with high dose X-rays or other energy. Radiotherapy has adverse and unwanted side effects as nausea, tiredness and hair loss.

Nausea can be treated by anti-emetics which make one feel somewhat better. Also appetite loss often accompanies nausea. Hair loss usually only occurs in the areas being treated and will grow back once the therapy is over. Also tiredness is a side effect. One has to get a great deal of rest as well as stay somewhat active in order recover from the treatment. These side affects will all gradually fade after the treatment is ended.

(Cancerbacup) Chemotherapy is the second major treatment used. Chemotherapy is cy toxic drugs used to kill the lymphatic cancer cells. The drugs are administered intravenously or by way of the mouth. Several drugs are given for a few days, then a few weeks with no drugs.

That allows your blood count and body to recover from the drugs and prepare for the next dose. The treatment lasts several months. Some people have a 'central line'; inserted into them. The central line is a tube of plastic inserted into a large vein that then comes out onto the chest. The plastic tubing makes it easier for the drugs to be given and samples to be taken. Not all drugs have the same side effects and the effects vary from person to person.

For the time when the treatments are being given the bone marrow function decreases. This often causes anaemia, bruising or bleeding and infection. The amount that one's blood count drops is reduced varies on the type of chemotherapy as well as the dose, and also if the drugs are used in conjunction with other drugs. The most common side affects of chemotherapy are sickness, like nausea and vomiting, the tissue in one's mouth becomes sore and food tastes a little odd and hair loss.

Hair loss is unfortunately very common. The hair does grow back rather quickly once the treatment is over, however. If by some chance a person has a relapse, something called a cell-stem transplant is done. In this, uninfected cells from one's bone marrow are taken and frozen. Then after intense chemotherapy, which often kills the cells, the bone marrow is replaced. (Cancerbacup) Non-Hodgkin's lymphoma is the cancerous growth of B and T-cells.

The symptoms of lymphoma are swollen lymph nodes in the neck, armpit and groin. Other symptoms include sweating heavily during the night, temperatures that come and go, loss of weight and itching. Lymphoma is classified under the newly created REAL classification system. REAL stands for Revised European-American classification of Lymphomas. This takes into perspective how the cancer spreads or grows instead of what it looks like under a microscope. Since this is a new system it is still under debate and not all centers for cancer use it.

Non-Hodgkin's lymphoma are split into two main groups. Slow growing or low grade and fast growing or high grade. Each grade is treated differently. A doctor will give someone's lymphoma a name by the look of the cells, though really the names don't tell you anything important. The names tell the doctors what grade the lymphoma is and how to treat them. When a doctor looks at a cell he is looking for whether the cells are follicular or grouped together, diffuse or spread out, large or small.

The names of the main types using REAL classification are as follows. Low grade consists of small cell lymphocytes, follicular, mantle cells, diffuse, smaller cells, follicular center lymphoma, and diffuse, mixed cells. High grade consists of large, diffuse B cells, peripheral T cells, lymphoblast ic B and T cells and immune blast ic, large cells. Unfortunately low grade lymphoma usually isn't curable, though it is responsive to treatment. (Institute of Cancer Studies at the University of Birmingham) Lymphoma is diagnosed by taking tissue from an inflamed area and looking at it under a microscope. It is treated much in the same way as Hodgkin's disease, with radiotherapy and chemotherapy.

Lymphoma however can be treated in very different ways than Hodgkin's disease. Observation is one method in which a slow growing lymphoma is simply watched until it affects or is going to affect an organ. If a relapse occurs a cell-stem transplant is done. (Mayo Health Clinic)

Bibliography

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web cancer help / public /specific / lymphoma /treat / which. html Lymphoma Information Network. October 3.1999.
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