What is lymphoma?
cancer of immune system
primarily affects lymphatic system (they are the highway of the body)
what is lymphoma classified by?
- degree of cell differentiation
- origin of predominantly malignant cells
what broad categories of lymphoma are important?
- Hodgkin Lymphoma
- Non- Hodgkin lymphoma (WORSER)
Lymphoma can originate in?
Lymph nodes
spleen
thymus gland
tonsils
adenoids
bone marrow
digestive tract
How do you stage lymphomas?
Based on the diaphragm
STAGE ONE:
Earliest stage, cancer only involves single lymph node group
Stage 2:
several lymph nodes either above or below the diaphragm
stage 3:
several lymph nodes both above and below the diaphragm
stage 4:
widespread beyond lymph nodes and slpeen; spread to one or more organs
(THE WORST CASE SCENARIO)
Hodgkin Lymphoma characterstics:
develops from abnormal b cells
RARE
5 subtypes
HIGH CURE RATE VERY TREATABLE
s/s of hodgkins:
firm painless enlargement of 1 + lymph nodes fatigue weakness NIGHT SWEATS weight loss enlarged painless lymph nodes
what are the two common age groups for hodgkins?
16-34
and 55 and older
risk factors of hodgkins?
EBV: MONO
HIV
weakened immune system
family history
Non-Hodgkin characteristics?
develop from abnormal b or t cells
has 60 subtypes
cure rate varies
MORE prevelant in 50 -70 age group
WAY HARDER TO TREAT
risk factors for non hodgkins?
viral infections
autoimmune
infection with h pylori
exposure to chemicals
s/s of non hodkins:
same as hodgkins
EXCEPT NO REED-STERNBURG
may have CNS involvement (neuropathy , headache)
what types of non hodgkins are there?
low grade or indolent: slow growing lifelong disease
intermediate grade: moderately aggressive
high grade: aggressive and poor prognosis
Diagnostic testing for HL and NHL
cbc
cxr
ct scan
lymph node biopsy to identify type of cell and pattern (b vs t cells)
shows reed sternberg cells in HL only
bone marrow biopsy
NHL treatment:
based on type and stage, prior treatment, ability to tolerate therapy
Options:
watchful waiting ( only in NHL low grade stage)
chemotherapy
radiation
combo of radiation/ chemo in later stages
stem cell transplant
how can we manage lymphoma?
Fatigue: balance acvitity w rest
Nutrition: monitor weight, fluids and food intake
Risk for infection: myelo suppression
body image: weight loss alopecia sterility
hopelessness: support groups ACS family planning options
Treatments for lymphoma?
surgery
chemo
photodinaic therapy: use of drugs that come active when exposed to light
biological therapy: monocolal antibodies, growth factors, vaccines
radiation
