Getting to Know Lymphatic Cancer and Its Treatment

By: dr. I Made Chandra Ari Kumara, Sp.B, Subsp. Onk (K)

Lymph cancer, also known as malignant lymphoma, is a malignant tumor disease that attacks the body's lymphatic system. The lymphatic system is a complex network that plays an important role in the body's defense against infection and disease. The lymphatic system includes the lymph nodes, spleen, thymus glands, and bone marrow.

How Does Lymph Cancer Occur?
Lymph cancer occurs when lymphocyte cells, which are an important part of the immune system, grow uncontrollably and become malignant. These abnormal lymphocyte cells form tumors in the lymph nodes and can spread and damage other parts of the body.

Types of Lymph Cancer:
There are two main types of lymph cancer:

Hodgkin's lymphoma: This type is characterized by the presence of abnormal cells called Reed-Sternberg cells.

Non-Hodgkin's lymphoma: This type includes a variety of cancers that do not have Reed-Sternberg cells.

Hodgkin's lymphoma:
Hodgkin's lymphoma is a type of cancer that attacks the immune system, specifically the lymph nodes. This cancer usually appears in the lymph nodes in the neck, but can spread to other parts of the body.

Who is at risk?

Hodgkin's lymphoma is more common in young adults aged 20-40 years, and also in people over the age of 55 years.

Characteristics of Hodgkin's Lymphoma:
This cancer is characterized by enlarged lymph nodes in the neck, which are not painful, and involve a chain of nearby lymph nodes. Examination of a biopsy preparation finds abnormal cells called Reed-Sternberg cells. These cells look under the microscope as large, odd-looking, two-lobed cells with two nuclei appearing in a background of non-malignant inflammatory cells.

Risk Factors:
Several factors can increase a person's risk of developing Hodgkin's lymphoma, such as:

Family history: Having a family member who has been diagnosed with Hodgkin's lymphoma can increase the risk.
Epstein-Barr Virus Infection: This virus can cause mononucleosis and is associated with an increased risk of Hodgkin's lymphoma.
Weakened immune system: People with weakened immune systems, such as those with HIV, are at higher risk of developing Hodgkin's lymphoma.
Non-Hodgkin's Lymphoma:
Non-Hodgkin's lymphoma is a type of cancer that attacks the lymphatic system, with the most common complaint being an enlarged and symptomatic lymph node mass, either in the central or peripheral parts of the body, such as the neck, armpits, groin. Spread outside the lymphoma is often found, such as the tonsils, lungs, liver, kidneys and bone marrow. B symptoms are often found, such as persistent fever without cause, excessive night sweats, weight loss.

Causes of Non-Hodgkin Lymphoma:
The exact cause of non-Hodgkin lymphoma is unknown, but several factors may increase a person's risk of developing the disease, including:

Chromosomal mutations or translocations: These genetic changes can cause lymphocyte cells to grow uncontrollably.
Toxins: Exposure to certain chemicals, such as pesticides and herbicides, may increase the risk.
Infections: Some infections, such as the Epstein-Barr virus and Helicobacter pylori, have been linked to an increased risk.
Weakened immune system: People with weakened immune systems, such as those with HIV, are at higher risk of developing non-Hodgkin lymphoma.
Chronic inflammation: Long-term inflammation in the body, such as inflammatory bowel disease, may increase the risk.
Who is at Risk?
Non-Hodgkin lymphoma is more common in people over the age of 65–75.

What are the current treatments for lymphoma?

● Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells.

Most chemotherapy drugs are given through a vein either in the peripheral or central vein. In the case of more specific types of lymphoma such as classic Hodgkin's, a combination of chemotherapy and radiation therapy is needed.

Chemotherapy treatment has several side effects on patients such as hair loss, mouth ulcers, nausea, vomiting, diarrhea, anemia, decreased white blood cells, etc.

● Radiotherapy

Radiation therapy uses X-rays, to destroy cancer cells in a specific area. It is often used after chemotherapy or for lymphomas that are limited to one area of ​​the body.

Side effects of radiation therapy include fatigue and sunburn-like reactions on the skin at the location where the radiation is directed. Other side effects depend on where the radiation is directed. Radiation to the neck can cause dry mouth and damage the thyroid.

● Bone marrow transplant

Treatment involves placing bone marrow stem cells

healthy cells into the body. These cells replace cells that have been damaged by chemotherapy and other treatments. A bone marrow transplant may be an option if Hodgkin lymphoma comes back or doesn’t respond to other treatments.

● Targeting therapy

Targeted therapy uses drugs that target specific molecules on cancer cells, such as proteins that help cancer cells grow and survive. For non-Hodgkin lymphoma, targeted drugs can be used alone, but are often combined with chemotherapy. This combination can be used as an initial treatment and as a second treatment if your lymphoma comes back.

● Supportive therapy

Therapies that aim to support the main therapy, also known as supportive care or palliative care, play an important role in treating lymphoma. They aim to improve a patient’s quality of life by managing symptoms, reducing the side effects of treatment, and addressing emotional and psychological needs.

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