What Are the Different Alternative Treatments for Lymphoma?

Lymphoma that has undergone malignant changes is called lymph adenocarcinoma, also known as lymphoma. According to the "WHO Pathological Classification Standard for Lymphatic Tumors of the World Health Organization", currently known lymphomas have nearly 70 pathological types, which can be roughly classified into Hodgkin's lymph Tumors and non-Hodgkin's lymphomas.

Lymphoma

Lymphocytic adenocarcinoma occurs when lymphocytes undergo malignant transformation

The distribution of lymphocytes, lymph nodes, and lymph tissues throughout the body determines that lymphoma is a systemic disease. When there is more than one lesion, in addition to hair, nails, and cornea, all parts of the body that have lymphoid tissue and lymph nodes may be violated, including blood and bone marrow. Therefore, after the diagnosis of lymphoma is clear, a comprehensive assessment and examination of the location, size, and size of the systemic lesion should be performed for two purposes: staging of the disease: the same type of lymphoma, if the staging is different, the treatment principle , Treatment course and prognosis often also have large differences; retain the basic data at the beginning of the onset, to facilitate the evaluation of the efficacy of the treatment plan after treatment, decide whether to continue the original treatment or adjust the dose or replace the more effective plan. Different lymphoma types and different locations of the disease require different examination items, but generally include superficial lymph node B-ultrasound (at least including bilateral neck, submandibular, supraclavicular, axillary and inguinal lymph nodes), chest enhancement CT examination, abdominal / pelvic enhanced CT examination or B-ultrasound, bone marrow aspiration smear or biopsy. Sometimes nasopharyngeal, gastrointestinal, and respiratory endoscopy may be needed, or lumbar puncture to check the cerebrospinal fluid to determine whether the central nervous system has been violated, and chemotherapy injections if necessary.

In addition, routine examinations of hemogram, liver and kidney function, blood glucose, blood lipids, lactate dehydrogenase, 2 microglobulin, red blood cell sedimentation rate, electrocardiogram or echocardiography, and viral hepatitis, HIV, syphilis and other infections are required. These programs are mainly to determine whether the patient's physical condition can tolerate chemotherapy. Do important organs such as the heart, lungs, liver, and kidneys have serious functional defects, and do you need other medical treatment to escort them? Do chemotherapy drugs and doses need to be adjusted? Are there any adverse factors affecting the prognosis? Therefore, after patiently obtaining the pathological diagnosis and before the initial treatment, there are still a lot of waiting items for lymphoma patients, which costs a lot and waits a long time, but this is also an important content and process of correct diagnosis. Safe and smooth progress is directly related to the necessary prerequisites for the correct choice of treatment.

Patients can be assured that there is no significant difference in treatment and prognosis between most types of lymphoma between stage I and II, and between stage III and IV. Therefore, wait for 1 to 2 weeks for a comprehensive examination before chemotherapy Is safe. Of course, patients with severe symptoms may develop very quickly and belong to the type of highly aggressive lymphomas, such as Burkitt's lymphoma, lymphoblastic lymphoma, etc., which need to be treated as soon as possible.

Patients with malignant tumors whose recurrence rate has achieved complete remission after chemotherapy or combined radiotherapy do not completely eradicate tumor cells. This complete remission is only a clinically successful initial treatment. In fact, many tumor cells may remain in the body at this time. It is just difficult to detect with the commonly used CT, B-ultrasound, PET / CT and hematology tests. For example, Hodgkin's lymphoma and diffuse large B-cell lymphoma, although highly effective in initial treatment and with a high rate of complete remission, still recur in about one-quarter to one-third of cases. The recurrence rate of peripheral T-cell lymphoma is even higher. Most indolent lymphomas are basically impossible to completely cure with current treatment methods, and they may recur sooner or later.

With the great improvement in the treatment effect of lymphoma, many patients can survive for a long time, even marry and give birth. On the surface, there is no difference from the general population, but long-term complications and quality of life cannot be ignored for patients with long-term survival. Important issues, such as secondary tumors, cardiovascular disease, infertility, and psychological disorders.

The incidence of secondary tumors in patients with lymphoma 10 years after treatment is significantly higher than that in the general population. Patients with first-line regimen combined with radiation therapy have a higher probability of developing secondary tumors. Lung cancer and breast cancer are the most common secondary tumors, and patients should have an X-ray or CT scan every year. Female patients should self-examine their breasts regularly and have a breast health examination every year. Patients undergoing chest or axillary radiotherapy should be screened annually for breast magnetic resonance imaging 8 to 10 years after the end of treatment or after the age of 40 years.

Some antitumor drugs and mediastinal radiotherapy can produce cardiotoxic effects, survivors have a significantly increased risk of developing symptoms or fatal heart disease, and most patients also have other risk factors for heart disease. Therefore, patients with abnormal blood pressure and dyslipidemia should be actively monitored and treated. Patients with symptoms of progressive fatigue or chest pain should undergo a cardiovascular examination. For pregnant women, cardiac function monitoring should be performed due to a significant increase in cardiac stress.

About 50% of patients with long-term survival of lymphoma can be associated with thyroid dysfunction, especially in women who have received cervical and superior mediastinal radiotherapy. The most common is hypothyroidism, hyperthyroidism and benign and malignant thyroid nodules are more common and related to radiation dose. Therefore, patients with lymphoma after treatment should be tested annually for thyroid function, and those with abnormalities should be routinely given hormone replacement therapy, and may even need to take medication for life.

Pelvic radiotherapy and alkylating agents, procarbazine chemotherapy have great toxic and side effects on gonads, especially in adolescent patients, which are more sensitive and fragile, which can lead to hypogonadism and infertility.

Therefore, it is recommended that surviving patients with lymphoma visit the specialized tumor hospital regularly for a lifetime.

The exact etiology of lymphoma has not been fully discovered at present, and it is generally accepted that certain infectious factors may be related to the pathogenesis of certain types of lymphoma. For example, human immunodeficiency virus (HIV) -infected patients most often suffer from lymphoma, which is 60 to 100 times more common than the general population; Hodgkin's lymphoma, Burkitt's lymphoma, and nasal NK cell lymphoma May be related to EB virus infection; HTLV-1 virus is closely related to adult T-cell lymphoma / leukemia; Helicobacter pylori is a possible cause of gastric MALT lymphoma; Hepatitis C virus is associated with splenic lymphoma; Related to the occurrence of ocular appendix lymphoma.

Immunity abnormalities, autoimmune diseases, long-term application of immunosuppressive drugs after organ transplantation, and aging are likely to be important reasons for the significant increase in the incidence of lymphoma in recent years. Radiation, pesticides, herbicides, hair dyes, heavy metals, benzene and other physical factors and chemicals may also be related to the incidence of lymphoma. Lymphoma has not been found to have a very obvious genetic predisposition and familial aggregation.

Although there may be more than one lymphoma patient in some families, it has not yet been found that lymphoma has a very obvious genetic tendency and familial aggregation, which is a completely different concept from familial breast cancer and colon cancer. In addition, as mentioned above, although the cause of lymphoma is likely to be related to some bacterial viruses, the mechanism of tumorigenesis is very complicated. Infection is only one of the external factors. At present, no lymphoma has the tendency to be transmitted and the group has not been found. Sex. Therefore, as relatives of patients with lymphoma, the risk of developing lymphoma is not significantly higher than that of the general population.

However, if you have received large doses and multiple courses of chemotherapy, especially some drugs that affect reproductive function, it is recommended that patients avoid fertility during treatment; for the health of the child and the well-being of the family, it is also recommended to consider fertility 3 years after the end of treatment .

Reducing environmental pollution, maintaining good living habits, timely treatment of certain chronic inflammatory diseases of the body, and improving the body's immune function may not only reduce the incidence of lymphoma, but also the common principles of reducing the incidence of other malignant tumors.