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Non-Hodgkin’s Lymphoma
- Non-Hodgkin’s lymphoma is cancer of the lymph nodes.
- It begins in the lymphatic system in the white blood cells called lymphocytes. When these cells become abnormal, they don’t protect the body from infection or disease.
- They also grow without control and may form lumps of tissue called tumors.
- Non-Hodgkin’s Lymphoma ranks 12th in prevalence across all cancer types and constitutes 2.8% of the total annual cancer patients.
- Death rate is 12% of the total affected patients the 9th most common cancer to cause death and the 5 – year survival rate is 17.73%.
- NHL is also described by how quickly the cancer is growing, either “indolent” or “agressive”.
- Indolent and agressive NHL are equally common in adults while in childern agressive NHL is more common.
- Types of NHL
– B-Cell Lymphoma
About 90% of people in Europe and the US with lymphoma have B-cell lymphoma.– T-Cell Lymphoma
About 10% of people with lymphoma have T-cell lymphomas and are more frequent in Asia.– NK-cell Lymphoma
Less than 1% of people with lymphoma are NK-cell lymphoma. - Some sub types of lymphoma cannot easily be classified as indolent or aggressive.
- For example, mantle cell lymphoma (see below) has both indolent and aggressive NHL features.
Causes
- In most cases, cause cannot be ascertained but a weak immune system is commonly seen.
- There is sudden growth of numerous abnormal lymphocytes, that is white blood cells.
- Lymphocytes have a life cycle where old lymphocytes die, and they are replaced by new cells.
- In non-Hodgkin’s lymphoma, lymphocytes continue to grow and divide and the excess lymphocytes are amassed into the lymph nodes, causing them to swell.
Signs and Symptoms
- Swelling of lymph nodes, which may or may not be painless.
- Fever.
- Unexplained weight loss.
- Sweating (often at night).
- Chills.
- Lack of energy.
- Itching etc.
Investigations / Screening
- Physical examination and history – examine the enlargement of lymph nodes in the neck, underarm and groin.
- Biopsy – Tissue is usually taken from the lymph nodes of the neck, under arm, or in the groin. Biopsy for non-Hodgkin’s lymphoma is usually taken from a lymph node. • A bone marrow aspiration and biopsy is usually done to find out if lymphoma cells are present in the bone marrow.
- PET Scan / MRI / CT Scan – A CT scan can be used to measure the tumor’s size. Sometimes, a special dye is introduced by an injection or a pill called a contrast medium is given before the scan to provide better detail on the image PET Scan is used for understanding the spread of the disease and the response to treatment.
- Chest X ray- to see if it has spread to the lungs.
- Biomarkers Investigations.
- Other Tests – Lumbar Puncture (also called a spinal tap), to find out whether lymphoma cells are in the fluid (cerebrospinal fluid, or CSF) surrounding the brain and spinal cord.
Treatment
- To plan personalised treatment for each individual patient as every individual is different even if they have the same type of cancer.
- To improve health related quality of life (QOL) in all types and stages of cancer patients.
- To plan for partial or total regression of tumour depending on the nature of tumors.
- To increase overall survival (OS) of patients.
- To increase disease free survival (DFS) where complete resection of tumour is achieved.
- To provide a treatment option to patients who are refractory to conventional treatments like chemotherapy / radiotherapy / immunotherapy etc.
- To reduce the rate of growth of the tumor in recurrent and advanced staged cases.
- To increase progression free survival in advance cases.
- To reduce impact of symptoms related to progression of disease.
- To improve confidence of patients.
- To provide palliative support in end-of- life cancer cases.
- To add happiness and extension of life to cancer patients.
- To compliment other therapies like chemotherapy, radiotherapy in a synergistic way.
- To reduce severity or adverse effects of other conventional treatment. This reduces incidence and frequency of hospitalization.
- It is pertinent to note that Rasayu Cancer Clinic does not claim or blame anything while communicating any aspect to cancer patients.
- Rasayu Cancer Clinic focuses on Ayurveda fundamental based therapies.
- Rasayu Cancer Clinic believes in continuous improvement in service and science.
- Rasayu Cancer Clinic always advocates patient centric approach which leads to long and happy life of cancer patients.
- Every patient has a right to choose the therapy.
- Rasayu Cancer Clinic never imposes Rasayana therapy on patients but helps them to take the right decision, hence making patients/ relatives well aware about the disease and possible outcomes along with its risk benefit and cost benefit ratios.
- Rasayu Cancer Clinic is well connected with global updates in cancer care and therapies, through advisors and collaborations with national and international institutes.
NHL is usually treated with ;
Chemotherapy
1. The most commonly used combination is called CHOP.
2. It combines four medicines: cyclophosphamide, doxorubicin, vincristine, and prednisone.
3. Chemotherapy treatment uses medicine to weaken and destroy cancer cells at the original cancer site and any cancer cells that may have spread to other parts of the body.
4. Adverse effects of chemotherapy in non Hodgkins lymphoma – Click Here
5. While destroying cancer cells, it destroys fast dividing normal cells, which further creates multiple side effects.
5. Side effects of Chemotherapy in NHL – Click Here
6. Side effects of Chemotherapy – Click Here
7. Adverse drug reactions (ADRs) of Chemotherapy – Click Here
Radiation Therapy
1. High-energy x-rays, electrons, or protons are used to destroy cancer cells.
2. Radiation treatment for NHL is usually external-beam radiation therapy, which is radiation given from a machine outside the body.
3. A radiation therapy has a certain number of treatments given over a specific frame depending on the type of lymphoma.
4. It is most commonly used to people who have localized lymphoma and its surrounding areas, or to people who have a lymph node that is particularly large, usually more than 7 to 10 cm across.
5. It alleviates pain when used in low doses in advanced cases.
6. General side effects from radiation therapy may include fatigue and nausea. And localized symptoms like mild skin reactions, dry mouth, temporary hair loss, or loose bowel movements.
7. Long term side effects of radiotherapy – Click Here
Targeted Therapy
1. Targeted therapy uses monoclonal antibodies in medicine that is injected into the body so these antibodies can attach to cancer cells and destroy them.
2. It attacks the cancer specific genes, proteins, or the tissue environment that contributes to cancer growth and survival.
3. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells.
4. Targeted Therapy Side Effects – Click Here
5. Adverse effects of chemotherapy in non Hodgkins lymphoma – Click Here
Immunotherapy
1. Efficacy of the treatment is still not clear as per the National Library of Medicine, since there is a need for improved biomarkers.
2. Cost of this treatment is high and many times does not fit into cost benefit ratio.
3. Side effects – Click Here
4. Risk and Benefits of Immunotherapy – Click Here
Stem cell transplantation
1. This is a technique that replaces defective or damaged cells that are affected by cancer.
2. Chemotherapy often destroys healthy cells in the blood and bone marrow, patients who have certain types of chemotherapy may need stem cell transplants.
Rasayu Cancer Clinic Rasayan Treatment Protocol – To know more please click here
Rasayu Therapy is recommended for those :
- Who voluntarily opted for this treatment as their first choice.
- Who are disenchanted with the past treatments.
- Who do not see any other options of treatments.
- Who are looking for personalized treatment plan.
- Who desire a convenient home-based oral therapy which is easy for consumption.
- Who are susceptible to acquire hospital borne infections/ complications, hence not willing to be hospitalised.
- Who are looking for favourable risk benefit ratio.
- Who desire to improve Quality of Life benchmarks based on global standards and monitored regularly.
- Who wants to be involved in decision making for choice of treatment.
- Who are willing to be involved in monitoring the efficacy of Rasayana Therapy.
- Who believe in the transparency of the process by conducting regular investigations by biochemical parameters/ hi tech imaging techniques like PET scan etc.
- Who are looking for professionals being sensitive to the patient, the care givers and the family.
- Who desire to take even with other treatments including Chemotherapy / Radiotherapy.
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