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What is it about ?
Lymphomas are malignant tumors of the lymphatic system. This is a very heterogeneous group of diseases, both in terms of symptoms and prognosis. Lymphomas can be subdivided into two major groups: Hodgkin lymphomas (or Hodgkin lymphomas) and non-Hodgkin lymphomas.
What is their frequency?
Hodgkin lymphomas affect about 2 in 100,000 people. The majority are young adults. Non-Hodgkin lymphoma affects about 20 in 100,000 people each year, with the average age of patients at onset of the disease being 60 years. The number of non-Hodgkin lymphomas is on the rise, but survival is improving slightly. Hodgkin lymphomas have also experienced a slight increase in recent decades, but there has been a marked improvement in terms of survival.
How to recognize them?
Hodgkin lymphoma often starts with the swelling of one or more lymph nodes. It is very often a lymph node located above the collarbone. Other symptoms can also develop due to the pressure exerted by the swollen nodes on the surrounding tissues or organs. The disease spreads from the neck to the rib cage, then to the abdominal cavity. At a later stage, the malignant cells can spread to the spleen, bone marrow and liver. Other symptoms, known as B symptoms, are less common: fever, night sweats, unexplained weight loss.
Non-Hodgkin lymphomas produce less characteristic symptoms. Manifestations depend on the location of the lymph nodes and affected organs. Many people do not have any symptoms when they are diagnosed. In this type of lymphoma, the B symptoms mentioned above only occur in 1 in 4 people. At the time of diagnosis, only the lymph nodes are affected in half of the cases. And, in 20% of patients, other organs are also affected, most often the stomach, skin, bones, brain, intestines or thyroid. The main suspicious signs are swelling of the lymph nodes in the elderly, persistent sore throat that does not improve with antibiotics, and sudden swelling of a lymph node.
How is the diagnosis made?
Any lymph node that has grown and that does not decrease after a month is suspect: the doctor takes a piece of tissue for analysis (biopsy). Blood testing usually provides little information, but it is important for assessing the condition of organs and the feasibility of treatment. Once the diagnosis is made, the extent of the disease is determined by an imaging test. Imaging is important to know the prognosis and to know which treatment is best suited. The more localized the disease, the better the prognosis and the greater the chances of recovery.
What can you do ?
If you discover a swollen node and it does not deflate after a few weeks, it is advisable to see your general practitioner.
What can your doctor do?
Hodgkin lymphoma
If the lymphoma is limited and does not cause any symptoms, treatment consists of chemotherapy for 2 to 4 months, possibly followed by radiation therapy to the affected areas. In the presence of metastases or B symptoms, treatment consists of chemotherapy for 6 to 8 months. Here too, radiotherapy can optionally be administered subsequently to the affected areas. After treatment, a PET scan can assess the effectiveness of the treatment. More than 95% of people with localized Hodgkin lymphoma are permanently cured. The average 5-year survival is 90% among people with metastasized Hodgkin lymphoma. In the presence of a localized tumor, it sometimes happens that only symptomatic treatment is given to limit the adverse effects of the tumor. In this case, close monitoring of the disease is very important.
Non-Hodgkin lymphoma
There are different types of non-Hodgkin lymphoma. The type will determine the possible chemotherapy options and outlook. In some cases, adding a stem cell transplant to chemotherapy can positively influence the prognosis. Life expectancy is very variable.
Regular
The risk of relapse of Hodgkin lymphoma is highest during the first 2 years after the onset of the disease, but a relapse is still possible after 10 years. Aggressive tumors usually do not recur after 3 years from the start of treatment.
It is essential to detect a recurrence as soon as possible. Therefore, follow-up will initially be scheduled every three months. A physical exam, discussion of symptoms, imaging tests and blood tests are often scheduled for follow-up.
In addition to being attentive to the return of symptoms, it is also important to monitor the possible consequences of the treatment. If radiotherapy has been administered, the consequences depend on the irradiated area: decrease in thyroid function in the event of radiotherapy to the neck, early menopause in the event of radiotherapy to the belly, etc.
There is also an increased risk of developing other cancers in the irradiated area. Early detection of breast cancer in women irradiated in the breast region is therefore particularly indicated.
Chemotherapy can also lead to complications. It strongly depends on the type of chemotherapy given. Leukemia and fertility problems can sometimes result.
Removing my spleen (removal of the spleen) results in reduced resistance to infection. In this case, vaccinations are necessary to reduce the risk of serious infections: vaccination against pneumococci, vaccination against meningococcus and annual vaccination against influenza.
Want to know more?
- Chemotherapy – Foundation against cancer
- Radiotherapy – Foundation against cancer
- Receiving a stem cell transplant – canadian cancer society
- Flu – Vaccination-Info.be
- Meningococcal meningitis and septicemia – Vaccination-Info.be
- Meningitis, pneumonia and pneumococcal septicemia – Vaccination-Info.be
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