Lymphoma: symptoms, signs, treatment, prognosis

Lymphoma is a malignant disease that affects the lymphatic system. More precisely, we are talking about a group of diseases, because there are several of them - and they differ in different features.

The lymphatic system itself is a complex system whose vessels cover all internal organs. It also includes lymph nodes, which form lymphocytes, which are very important for our immunity. This system has several key functions. The barrier cleanses the lymph and traps particles undesirable for the body (for example, dead cells). The transport function delivers nutrients to the organs, and the immune function helps fight viruses, bacteria, and any harmful cells.

If lymphoma develops, lymph cells begin to divide uncontrollably, tumors appear, which, without timely treatment, threaten the patient with death.

What is lymphoma?

Lymphoma is a lesion of the immune system and internal organs, in which altered cells accumulate, disrupting tissue function.
The tumor develops in the lymphatic system, which helps us fight infections and other diseases. The lymph circulating in it washes all the cells of the body and delivers the necessary substances to them, taking away waste. In the lymph nodes located throughout its network, dangerous substances are neutralized and removed from the body. The lymphatic system complements the circulatory system and helps fluids move throughout the body. Unlike blood, the speed of which is set by the “pump” - the heart, lymph slowly circulates on its own.

Why does lymphoma occur and how to recognize it?

September 15 is World Lymphoma Day. This day is held on the initiative of the World Lymphoma Society, which calls for active assistance to patients with this disease. Currently it has more than seven thousand members. The tasks of this community include information propaganda and explanatory work with the world society, increasing awareness of the symptoms of lymphomas in order to increase the early detection of the disease, as well as preventing the development of lymphomas.

The problem of lymphoma is dealt with by oncologists and hematologists, since this disease is classified as a malignant neoplasm. So what is it?

Lymphoma is a heterogeneous group of diseases of the lymphatic tissue, characterized by enlarged lymph nodes and/or damage to various internal organs, in which there is an uncontrolled accumulation of “tumor” lymphocytes.

A lymphocyte is a white blood cell that is the main component of the body's immune system. In lymphoma, as a result of unlimited division of “tumor” lymphocytes, their descendants populate the lymph nodes and/or various internal organs, causing disruption of their normal functioning.

The term “lymphoma” refers to a large number of different types of disease, significantly different from each other in their manifestations and approaches to their treatment.

All lymphomas are divided into two main groups:

1. Hodgkin's lymphoma or lymphogranulomatosis (HL); 2. Non-Hodgkin lymphomas (NHL).

Lymphogranulomatosis or Hodgkin's lymphoma most often affects people of two age groups: about 20 and from 50 to 60 years. Lymphoma affects people of all ages, from early childhood to old age. The life expectancy of patients varies widely depending on the clinical and immunomorphological variants of lymphomas. The incidence of lymphomas has been steadily increasing in recent years.

Causes of lymphoma

The exact causes of lymphoma are not known. Several factors are associated with an increased risk of developing lymphoma. These are risk factors such as:

1. Age. In general, the risk of non-Hodgkin's lymphoma (NHL) increases with age. Hodgkin's lymphoma in older adults is associated with a poorer prognosis.

2. Infections:

• HIV infection; • infection with the Epstein-Barr virus (EBV) (the etiological factor of mononucleosis); • Helicobacter Pylori infection (caused by a bacterium that lives in the digestive tract); • infection with hepatitis B virus and hepatitis C virus.

3. Medical conditions that suppress the immune system : HIV infection, autoimmune diseases, use of immune suppressive therapy (often after organ transplantation), immunodeficiency diseases (severe combined immunodeficiency).

4. Exposure to toxic chemicals while working in agriculture and other activities with toxic chemicals, such as: pesticides, herbicides, benzene, use of hair dye.

The presence of these risk factors does not mean that a person will actually develop lymphoma. In fact, most people with one or more of these risk factors do not have lymphoma. Symptoms and signs

Often the first sign of lymphoma is painless swelling in the neck, arm or groin, and an enlarged spleen. An enlarged lymph node sometimes causes other symptoms by pressing on a vein or lymphatic vessel (swelling of an arm or leg), a nerve (pain, numbness, or tingling), or the stomach (early feeling of fullness). An enlarged spleen can cause abdominal pain or discomfort. It must be remembered that lymphoma can be asymptomatic.

Symptoms of tumor intoxication (B-symptoms):

1. Fever above 38C for at least three days in a row without signs of inflammation; 2. Profuse night sweats; 3. Losing 10% of body weight over the past six months; 4. Itching (25% of patients develop itching, most often in the lower extremities, but it can occur anywhere, be localized or spread throughout the body).

These symptoms are nonspecific. This means that they can be caused by a huge variety of conditions not related to lymphomas. For example, they may be signs of the flu or another viral infection, but in such cases the symptoms may not last very long. With lymphoma, symptoms persist for a long time and cannot be explained by an infection or other disease.

Making a diagnosis or assessing the extent of the disease

Stage I (at the onset of the disease). Lymphoma is found in one area of the lymph nodes or in one area of an organ outside the lymph nodes.

Stage II (locally advanced disease). Lymphoma is found in two or more lymph nodes located on the same side of the diaphragm, or in the same area of lymph nodes and nearby tissues or organs.

Stage III (progressive stage). Lymphoma affects two or more areas where lymph nodes are located, or one lymph node and one organ on opposite sides of the diaphragm.

Stage IV (widespread or diffuse). Lymphoma that has spread beyond the lymph nodes and spleen has spread to another site or organ, such as the bone marrow, bones, or central nervous system. To determine the prognosis of patients with lymphoma, a special international prognostic index (IPI) was developed.

The following unfavorable prognostic factors are identified:

1. Age (over 60 years old); 2. Stage of the disease (III-IV); 3. General condition of the patient; 4. Number of extranodal lesion zones (outside the lymph node) (more than 1); 5. Increased levels of lactate dehydrogenase (LDH) in the blood serum.

Treatment of lymphomas

All types of antitumor therapy are used to treat lymphomas. Surgical treatment is considered indicated only for single primary lymphomas of the gastrointestinal tract. Attempts at radical removal of lymphomas affecting peripheral lymph nodes, mediastinum, skin, tonsils and other organs and tissues are impractical.

Radiation therapy is an effective treatment for lymphomas. Local relapses in the irradiated area are rare. However, radiation therapy for lymphomas as a stand-alone treatment is rarely used. Radiation therapy is used mainly in combination with chemotherapy (CT) as the final stage of treatment.

Chemotherapy is a universal method of treatment, used for all immunomorphological variants, stages and localizations of lymphomas. Tumor lymph nodes show sensitivity to almost all available antitumor drugs.

How does lymphoma develop?

Oncology begins with the appearance in the body of just one altered cell of the immune system. In total, there are 2 main types:

B lymphocytes
: produce antibodies - proteins that protect the body from bacteria and viruses. This is where most lymphomas form.
T lymphocytes
, one part of which destroys germs and abnormal cells, and the second helps to increase or slow down the activity of the immune system.

Almost all abnormal cells are identified and destroyed by our immune system, but some of them manage to survive. They gradually multiply, spread throughout the body, create tumors, accumulate in internal organs and disrupt their functioning.

The disease can occur in any area where lymphatic tissue is located, the main areas of which are:

Lymph nodes
are small, pea-sized organs that are collections of cells of the immune system, including lymphocytes. There are more than 500 of them in the human body.
The spleen
, located under the lower ribs on the left side of the body. It produces lymphocytes, stores healthy blood cells and filters out damaged ones, and destroys microbes and foreign substances.
Bone marrow is
the spongy tissue inside certain bones. Here new blood cells are formed, including some lymphocytes.
The thymus, or thymus gland, is
a small organ located behind the upper part of the sternum in front of the heart. It is where some lymphocytes mature and develop.
Tonsils, or tonsils, are
collections of lymphatic tissue in the back of the throat. These organs help produce antibodies, proteins that prevent inhaled or ingested microorganisms from multiplying.
Digestive Tract:
The stomach, intestines and many other organs also contain lymphatic tissue.

Diagnosis of kidney cancer

For primary diagnostics aimed at identifying a specific type of cancer, many tests and studies are carried out today. They are also necessary to detect metastasis - the spread of malignant cells from the primary site to other tissues or organs.

Factors that may be taken into account by a physician when choosing a diagnostic algorithm:

type of cancer suspected;
existing signs and symptoms of the disease;
age and general health;
results of previous medical studies.

The following tests may be used to diagnose kidney cancer, in addition to a physical examination:

Blood and urine tests. Your doctor may recommend a blood test to check your hemoglobin and red blood cell levels. A urine test is used to look for blood, bacteria, or cancer cells. These tests can indicate the presence of kidney cancer, but they cannot be used to make a definitive diagnosis.
Biopsy. Removing a small amount of tissue for examination under a microscope. Typically, a biopsy is performed as an outpatient procedure using local anesthesia. Other tests may suggest the presence of cancer, but only a biopsy can provide an accurate diagnosis. After collecting the material, the pathologist analyzes the sample(s) and writes a report on the pathohistological examination. It is used by the attending physician to decide on further diagnostic and treatment tactics.

A biopsy followed by histological examination is the most accurate and informative method to determine the presence of cancer and its type. If a biopsy is not possible, other tests may be needed to make a definitive diagnosis.

The pathology report reflects the type of cells causing the cancer, which is important for treatment planning. The oncologist must have pathological findings before recommending systemic therapy, which involves the use of drugs that affect the entire body.

In some cases, to plan surgical treatment, the oncological surgeon may need the results of a kidney tumor biopsy. However, if imaging studies show a solid and growing tumor, the surgeon may remove it first, and the final type and stage of the tumor is then determined by a pathologist.

The situation of each patient is individual; during a consultation at the Rassvet clinic, you can discuss with the oncologist the need for a biopsy before starting treatment.

Is lymphoma cancer?

Official medicine in Russia and some other countries refers to cancer as malignant tumors - life-threatening neoplasms that develop in epithelial cells contained in the skin or mucous membranes and lining the internal surface of organs.
Lymphoma is not a cancer, but an oncological disease. It is formed from lymphocytes, and its cells are also able to divide uncontrollably, accumulate in tissues, disrupting their work, and create additional foci of disease in various parts of the body.

Prevention of lymphoma

Since the main causes of lymphoma have not been identified, preventive measures regarding this disease are extensive. It is worth undergoing timely examinations with key specialists. In case of infectious diseases, you must carefully follow the recommendations of doctors. If you notice some concerns about your condition, going to the doctor should not be postponed indefinitely. Don't forget about personal hygiene, proper nutrition and exercise. Physical activity and fresh air have never harmed anyone.

Types of lymphomas

Doctors distinguish 2 main classes of them:

Hodgkin's lymphoma, or lymphogranulomatosis
: Most often starts in the lymph nodes of the upper body - in the chest, neck or armpits. It usually spreads to various lymph nodes through the lymphatic vessels, but in rare cases, in later stages it enters the bloodstream and spreads to other parts of the body, such as the liver, lungs or bone marrow. This diagnosis is made when special cells are identified in the body - Berezovsky-Reed-Sternberg, which are modified B-lymphocytes.
TO non-Hodgkin's lymphomas
include all other types of the disease - there are about 30 of them. Each of them has its own special characteristics: the location of the primary tumor, the structure and speed of development.

Most common types of kidney cancer cells

Today, more than 30 different types of kidney cancer cells are known.

Clear cell carcinoma. This type of cancer accounts for about 70-80% of cases. Clear cell carcinoma cells range from slow-growing (grade 1) to fast-growing (grade 4). Particularly effective treatments for clear cell kidney cancer are targeted therapy and immunotherapy.

Papillary cancer. Papillary kidney cancer occurs in 10-15% of patients. This type of cancer is divided into 2 subtypes: type 1 has a relatively low grade and a favorable prognosis; type 2 is characterized by a high degree of malignancy and a pronounced tendency to metastasize.

Localized papillary kidney cancer is often treated with surgery. Locally advanced metastatic papillary kidney cancer - targeted drugs (inhibitors of blood vessel growth). The use of immunotherapy to treat metastatic papillary cancer is still under investigation.

Chromophobic type. Occurs in 4-5% of cases. This is another unusual and different type of cancer. It may have indolent (slow) tumor growth. The tumor has aggressive growth and a low tendency to metastasize. Clinical trials are currently underway to find the most effective treatments for this type of cancer.

Oncocytic type. Occurs in 2-5% of cases. This is a slow-growing type of kidney cancer that rarely (or does not) metastasize.

Ductal type. Ductal carcinoma occurs in 1-2% of cases. This type of cancer is more often diagnosed in people between 20 and 30 years of age. It begins in the collecting ducts of the kidney and, due to its connection with the pyelocaliceal system, is closely associated with transitional cell carcinoma. Ductal carcinoma is difficult to treat, even with a combination of systemic chemotherapy and surgery.

Sarcomatoid type. Each tumor subtype of kidney cancer (clear cell, papillary, chromophobe, etc.) may have highly disorganized features when examined microscopically. Pathologists often describe these types as “sarcomatoid.” This is not a separate tumor subtype, but the identification of sarcomatoid elements indicates a very aggressive form of kidney cancer. There is promising research into the effectiveness of immunotherapy treatments for people with sarcomatoid types of kidney tumors.

Medullary type. This is a rare and very aggressive form of kidney cancer. It most often occurs in people of the Black race and is associated with sickle cell anemia (hereditary hemoglobinopathy). Combinations of chemotherapy with blood vessel growth inhibitors are considered effective treatment options based on some scientific evidence. Clinical trials are currently underway to determine the best treatment.

Angiomyolipoma. A benign tumor that has a unique appearance on CT scans and when viewed under a microscope. Treatment usually involves surgery or (if the tumor is small) active surveillance. Significant bleeding is rare and is more common in pregnant and premenopausal women. An aggressive form of angiomyolipoma, epithelioid, can in rare cases grow into the renal vein, inferior vena cava, and spread to nearby lymph nodes or organs (for example, the liver).

The oncology department of the Rassvet Clinic conducts high-precision histological, immunohistochemical and molecular genetic studies. Accurate determination of the cell type of a kidney tumor allows for proper treatment planning.

Causes of lymphoma development

Doctors and scientists do not know exactly why the disease begins to develop in the human body. They only know about the factors that increase the likelihood of developing each type of cancer.

For Hodgkin's lymphomas

they look like this:

Epstein-Barr virus
, which causes infectious mononucleosis - damage to lymphoid tissue, including adenoids, liver, spleen and lymph nodes. In some patients, parts of the virus are found in Berezovsky-Reed-Sternberg cells, but in most patients there are no signs of it.
Age
: Diagnosis can be made at any age, but it is most common in 20-year-olds and people over 55.
Gender
: The disease is more common among men than among women.
Heredity and family history
: The risk is increased for siblings and for identical twins. Identical twins develop from a single egg fertilized by a single sperm. They come in only one gender, have the same genes and are extremely similar in appearance. owners of Hodgkin's lymphoma. The reason for this is not exactly known - perhaps the whole point is that members of the same family suffer the same infections in childhood, or have common inherited gene changes that increase the likelihood of developing this type of oncology.
Weakened immune system
. The chances of receiving this diagnosis increase in people with HIV infection and disorders of the immune system, which develop, among other things, due to the use of drugs that suppress it, which is often required after an organ transplant.

List of such factors for non-Hodgkin's lymphomas

looks different:

These include exposure to radiation
, including doses received during radiation therapy used to treat other types of cancer.
Various substances
, including herbicides and insecticides that kill weeds and insects, as well as chemotherapy drugs.
Age
: as a rule, the older the person, the higher his risks - in most cases the disease occurs at the age of 60+, but some types also occur in younger people.
Malfunctions of the immune system
affect the chances of developing all types of lymphomas.
Some viruses
can influence the DNA of lymphocytes, which encrypts all the information about our body, and convert them into cancer cells.
Infections that constantly stimulate the immune system and force our natural defenses to work harder also increase the risk of receiving a serious diagnosis.
Having close blood relatives - parents, children, brothers or sisters - with this diagnosis also increases the likelihood of developing the disease.
Some studies have shown that breast implants, especially those with a rough surface, may cause anaplastic large cell lymphoma. It develops on the skin, lymph nodes, or scar tissue formed at the site of the incision.

Classification of non-Hodgkin's lymphomas

The most commonly used is the European-American classification developed within the World Health Organization (WHO).

According to this classification, NHLs are divided depending on their cellular identity.

Diffuse large B-cell lymphoma accounts for 31% of the total number of lymphomas. This lymphoma occurs most often after age 60 and grows rapidly. At the same time, 40-50% of patients can be completely cured.

Follicular lymphoma , which accounts for 22% of total NHL. This type of lymphoma is usually diagnosed around age 60 and is characterized by slow growth. Long-term (5-year) survival of patients ranges from 60-70%. Over time, follicular lymphoma can develop into a fast-growing diffuse lymphoma.

Chronic lymphocytic leukemia/small cell lymphocytic lymphoma. These related diseases account for 7% of the total number of lymphomas. They are characterized by slow growth, but are difficult to treat. However, patients with these diseases can live for 10 years. Sometimes it is possible to transform them into fast-growing lymphomas.

Mantle cell lymphoma (6%) most often affects men around 63 years of age. Although this type of lymphoma does not grow very quickly, only 20% of patients live for 5 years.

Extranodal marginal zone B-cell lymphomas—MALT lymphomas (8%). The average age of patients is about 60 years. Often found in the stomach, it is characterized by slow local growth. It can be cured well in the early stages.

Nodal marginal zone B-cell lymphoma (2%). Characterized by slow growth. Many patients with early stages of the disease can be completely cured.

Splenic marginal zone B-cell lymphoma occurs in elderly patients, most often males. Often, treatment is not prescribed until severe symptoms appear as a result of an enlarged spleen.

Primary mediastinal B-cell lymphoma (2%) occurs in the mediastinum mainly in women aged 30-40 years and is characterized by rapid growth. 50% of patients can be cured.

Burkitt's lymphoma and Burkitt-like lymphoma (2%) occurs in 90% of cases in men aged about 30 years. Characterized by rapid growth. With intensive chemotherapy, 50% of patients can be completely cured.

Lymphoplasmacytic lymphoma (Waldenström's macroglobulinemia) accounts for 1% of the total number of NHLs. The disease is characterized by a slow progression, but it cannot be completely cured. However, most patients live more than 5 years.

Hairy cell leukemia is a very rare disease and is detected in older people. Characterized by slow growth. Some patients do not need treatment.

Primary central nervous system (CNS) lymphoma can affect both the brain and spinal cord. Previously, this tumor was considered very rare, but now it is detected more often in patients with AIDS. 30% of patients live 5 or more years.

T-lymphoblastic lymphoma/progenitor cell leukemia (2%). This disease can be considered lymphoma or leukemia. The difference depends on the number of tumor cells in the bone marrow. If less than 25% of tumor cells are detected, a diagnosis of lymphoma is made, and more than 25% - leukemia.

75% of patients are men, and the remaining 25% are women. The average age of patients is 25 years. If the bone marrow is not affected, then the probability of cure is high, and if it is involved in the process, the probability of cure does not exceed 20%.

Peripheral T-cell lymphomas (7%) are divided into several types:

Cutaneous T-cell lymphoma (mycosis fungoides, Sezary syndrome) accounts for less than 1% of all lymphomas and is detected at the age of 50-60 years. The 5-year survival rate of patients ranges from 5 to 58%, depending on the rate of tumor growth.

Angioimmunoblastic T-cell lymphoma is characterized by rapid growth and a poor prognosis.

Extranodal T-cell lymphoma of natural killer cells , nasal type, occurs in all age groups. The outcome of the disease depends on the degree of spread of the tumor process.

T-cell lymphoma with enteropathy occurs in people who are sensitive to gluten, a protein in wheat flour. The prognosis (outcome) of the disease is unfavorable.

Subcutaneous T-cell panniculitis-like lymphoma grows slowly at first but can become a fast-growing tumor over time. Chemotherapy is only partially effective.

Anaplastic large cell lymphoma, T/0-cell (2%) occurs more often in young people. Chemotherapy can cure many patients.

Symptoms and signs of lymphoma

As a rule, in the early stages this type of oncology does not manifest itself in any way, and its owner feels well and is not aware of the disease - almost all of its symptoms appear later, in advanced stages.

One of the most common signs is the appearance of swelling in the neck, armpits, groin, or above the collarbone.

, which is an enlarged lymph node. Typically, such a tumor does not hurt, but over time it often increases, and new lumps appear next to it or in other areas of the body.

Lymphomas that begin to develop or grow in the abdominal cavity can cause swelling

or
abdominal pain, nausea,
and
vomiting
. Such sensations occur due to enlargement of the lymph nodes or internal organs, such as the spleen or liver, or the accumulation of large amounts of fluid.

An enlarged spleen can put pressure on the stomach, causing loss of appetite.

and
a feeling of fullness after a small amount of food
.

Enlarged thymus Thymus, or thymus gland -

a small organ located behind the upper part of the sternum in front of the heart.
It is where some lymphocytes mature and develop. or lymph nodes in the chest may put pressure on the trachea, which carries air to the lungs. This leads to coughing
,
difficulty breathing, pain
or
heaviness in the chest
.

Brain lesions can cause headaches, weakness, personality changes, and problems with thinking

and
seizures
.

Other types of the disease can spread to the tissues surrounding the brain and spinal cord, causing the patient to see double and have a numb face

and
speech deteriorates
.

Lymphomas of the skin often appear as itchy red bumps

or
cones
.

In addition, symptoms may include:

weight loss;
chills;
night sweats;
elevated temperature;
severe fatigue;
bloating;
frequent or severe infections;
Easy bruising or bleeding.

Symptoms of kidney cancer

Often, kidney cancer is discovered during an X-ray or ultrasound examination performed for another reason. In the early stages, kidney cancer does not cause pain. Often, symptoms of the disease appear when the tumor becomes large and begins to affect nearby organs.

People with kidney cancer may experience the following symptoms. Sometimes patients show none of these changes. In other cases, the symptom may be caused by a disease other than cancer.

Symptoms of kidney cancer:

blood in urine;
pain or pressure in the side or lower back;
tumor formation on the affected side determined by palpation;
swelling of the ankles and feet;
high blood pressure;
anemia - low level of red blood cells;
fatigue;
loss of appetite;
unexplained weight loss;
fever that lasts for a long time and is not associated with a cold, flu or other infection;
in men, the rapid appearance of enlarged veins around the testicle is called a varicocele (a varicocele, especially around the right testicle, may indicate the presence of a large kidney tumor).

If you are concerned about any changes in your health, or observe the above symptoms, sign up for a consultation at the Rassvet clinic. We will help you find out the cause of your problem, make the correct diagnosis and prescribe the necessary treatment.

Once a cancer diagnosis has been made, symptom relief remains an important part of cancer care and treatment. Palliative or symptomatic therapy often begins soon after diagnosis and continues throughout the treatment period. Be sure to tell your healthcare provider about the symptoms you experience, including any new symptoms or changes.

Diagnosis of lymphoma

Most patients see a doctor because they have certain signs of illness or feel unwell. Specialists begin the examination with an examination and questioning about family diagnoses, possible risk factors and other health problems. Then the lymph nodes and other parts of the body that contain lymphatic tissue are examined, including the spleen and liver. After which a number of studies are prescribed:

Blood tests
: measure the levels of various cells in the blood, detect bone marrow damage, evaluate kidney and liver function, and detect infections and other problems.
Biopsy
is the removal of a piece of suspicious tissue and its transfer to a laboratory for examination. Depending on the course of the disease, doctors may need to biopsy lymph nodes, bone marrow, cerebrospinal fluid, pleural fluid, which is found in the chest, or peritoneal fluid, which is found in the abdomen.
Computed tomography
- allows you to identify foci of the disease in the abdominal cavity, pelvis, chest, head and neck.
Magnetic
resonance
imaging, MRI
, creates a detailed image of soft tissue. The method is usually used to study the spinal cord or brain.
X-ray
– helps detect enlarged lymph nodes in the chest or bones.
Ultrasound, ultrasound
- used to study enlarged lymph nodes or various organs, such as the liver, spleen or kidneys.
Positron
emission
tomography, PET
, can detect lymphomas in enlarged lymph nodes, even those that appear normal on CT. In addition, it can be used to determine whether the disease is treatable.

In the oncology department, a complete diagnosis of lymphoma is carried out - quickly, without queues and loss of precious time, using the most modern equipment. Our specialists guide the patient “from” to “to” – from examination to any treatment.

Kidney cancer screening

Screening is used to look for cancer before any symptoms or signs appear. Scientists have developed and continue to develop many tests that can be used to screen the human body for certain types of cancer.

General goals of cancer screening:

reduce the number of people who die from the disease or eliminate death from cancer altogether;
reduce the number of people who develop the disease.

More details

Screening.
Identifying hidden diseases and predispositions For kidney cancer, there are currently no approved and proven screening tests to detect the disease at an early stage. In selected cases, individual screening programs are recommended for people at high risk of kidney cancer. For example, patients with a family history of kidney cancer are sometimes offered a CT scan, magnetic resonance imaging, or ultrasound.

If you are at increased risk of renal cell cancer, the oncologist at the Rassvet Clinic will select individual monitoring and treatment tactics for you.

Lymphoma stages

Immediately after detecting the disease, doctors determine its stage - find out how far it has spread and what tissues it has damaged. This information is extremely important for specialists, since it allows not only to understand the patient’s prognosis, but also to select the most appropriate treatment for him.

Stages of Hodgkin lymphoma:
I
: Changed cells are found in only one group of lymph nodes or one lymphoid organ, such as the tonsils.
II
: they are present in 2 or more groups of lymph nodes located on one side of the diaphragm, or have spread from one damaged lymph node to an adjacent organ.
III
: lymphoma cells are present in the lymph nodes on both sides of the diaphragm;
or not only in the lymph nodes above the diaphragm, but also in the spleen. IV
: The disease has spread to at least one organ outside the lymphatic system, such as the liver, bone marrow, or lungs.

Stages of non-Hodgkin's lymphomas:
I
: altered cells are found only in 1 group of lymph nodes or one lymphoid organ, for example, tonsils;
or in 1 area of one organ outside the lymphatic system. II
: they are present in 2 or more groups of lymph nodes on 1 side of the diaphragm;
either in the lymph nodes and 1 area of an adjacent organ, or in another group of lymph nodes on the same side of the diaphragm. III
: lymphoma cells are present in the lymph nodes on both sides of the diaphragm;
or they are present in both the lymph nodes above the diaphragm and the spleen. IV
: The disease has spread to at least one organ outside the lymphatic system, such as the liver, bone marrow, or lungs.

Remission and prognosis for lymphoma

A patient is considered to be in remission if the size of the tumor has decreased by half or more (partial remission) or if it cannot be detected (complete remission). For some types of lymphoma, such as aggressive lymphoma, a period of remission of 5 years or more may be considered a completely cured disease. However, remission does not always mean that the cancer has been cured. Indolent lymphomas are not usually considered cured because these cancers can recur even after a long period of remission.

In foreign practice, the International Prognostic Index (IPI) is used, which was first developed to help doctors determine the prognosis for patients with rapidly growing (aggressive) lymphomas. However, this score is also used to predict most other types of lymphoma.

The index depends on 5 factors:

patient's age;
stage of lymphoma;
whether the lymphoma is located in organs outside the lymphatic system;
how well the patient can perform normal daily activities;
the level of lactate dehydrogenase in the blood, which increases with the number of lymphomas in the body.

After studying all these factors, the doctor can establish tentative prognoses for the treatment of lymphoma. However, it is important for patients to remember that the earlier the disease is diagnosed, the more effective its treatment will be.

Lymphoma treatment

Treating lymphoma is not an easy task.
To solve it, you need not just one doctor, but a whole team of professionals - a chemotherapist, radiologist, surgeon, oncologist, hematologist and others. The oncology department has all the necessary specialists - world-class doctors who conduct a full diagnosis of the disease and any necessary therapy. With us, you don’t have to retake tests, redo studies and ask the question “what to do next?”
We fully guide the patient and give him a clear action plan, following which he gets the best possible result. Several methods are used to combat this type of cancer:

The main one is chemotherapy

– drugs that destroy altered cells. They are taken in pill form or injected into a vein, enter the bloodstream and spread throughout the body. Treatment is carried out in cycles, each lasting several weeks, followed by a period of rest during which the body recovers.

Bone marrow transplantation

or stem cells from which blood cells are formed. The procedure allows higher doses of chemotherapy, sometimes along with radiation, to be given, which helps kill the lymphoma more effectively. Transplantation is possible not only with donor material, but also with your own material, collected several weeks before the intervention.

Radiation therapy

– destruction of altered cells using radiation. This method is suitable for most patients, and works especially well if the disease has affected a small amount of tissue. It is used both independently and in combination with chemotherapy.

Immunotherapy

– drugs that help a person’s own immune system better recognize and destroy abnormal cells. There are several types used for lymphomas. These include:

monoclonal antibodies are proteins designed to attack a specific substance on the surface of lymphocytes;
Immune checkpoint inhibitors - drugs that prevent altered cells from masquerading as healthy ones;
T-cell therapy: removal of immune cells from the patient’s blood and modification in the laboratory, their reproduction and return to the body, where they find and destroy foci of the disease.

Surgery

: Often used to obtain samples of suspicious tissue and determine its type, but rarely for therapy itself. In rare cases, operations are prescribed for lesions of the spleen or other organs that are not part of the lymphatic system - for example, the thyroid gland or stomach.

Genetic diseases and kidney cancer

Although kidney cancer can run in families, hereditary kidney cancer is rare, occurring in about 5% of cases. Only a few specific genes have been found to increase this risk. Many genes are also associated with specific genetic syndromes.

Knowing whether a specific genetic syndrome runs in a family can help a patient and their doctor develop an appropriate cancer screening plan and, in some cases, determine the best treatment options. A genetic mutation can only be detected through genetic testing.

Genetic diseases that increase the risk of developing kidney cancer:

Hippel-Lindau disease (VHL syndrome). People with VHL syndrome have an increased risk of developing several types of tumors. Most of these tumors are benign. However, 40% of people with this disorder develop clear cell kidney cancer.
Hereditary papillary RCC (pRCC). A genetic disorder that increases the risk of developing type 1 papillary cell carcinoma of the kidney. People with pRCC syndrome have an increased risk of developing more than 1 kidney tumor and tumors in both kidneys. Hereditary pPPCC is suspected if two or more close relatives are diagnosed with type 1 papillary cell renal cancer.
Burt-Hogg-Dubé syndrome (hybrid oncocytoma - chRCC, BHD syndrome). BHD syndrome is a rare genetic disorder associated with multiple noncancerous skin tumors, lung cysts, and an increased risk of noncancerous and cancerous kidney tumors, particularly chromophobe or oncocytic kidney cancer. People with BHD may also develop clear cell or papillary types of kidney cancer.
Hereditary leiomyomatosis and renal cell carcinoma (HLRCC syndrome - Hereditary leiomyomatosis and renal cell carcinoma). HLRCC is associated with an increased risk of developing type 2 papillary cell carcinoma of the kidneys and skin nodules (leiomyomas), which occur primarily in the arms, legs, chest, and back. Women with HLRCC often develop uterine leiomyomas, or, less commonly, malignant uterine leiomyosarcoma.
Tuberous sclerosis (Bourneville-Pringle disease, TS). A genetic disease associated with changes in the skin, brain, kidneys and heart. People with TS also have an increased risk of developing renal angiomyolipoma or kidney cancer.
Other genetic conditions may also be associated with an increased risk of developing kidney cancer. Research to identify other genetic causes of the disease is ongoing.

Folk remedies and prevention

Hospital treatment is absolutely necessary

It is not possible to cure lymphoma with folk remedies. They only serve as supportive and strengthening therapy. Before taking any medication, be sure to consult your doctor. Uncontrolled use of herbs and infusions can significantly worsen your condition. Sea buckthorn juice has a healing effect. It soothes and restores the gastric mucosa. Sometimes it is recommended to mix vodka and vegetable oil and take it orally. A decoction of birch buds can also help the digestive system. Drops from Djungarian aconite can be consumed in limited quantities. It is used both internally and externally.

Preventive measures are the same as for stomach cancer. It is impossible to prevent the occurrence of lymphoma 100%, since it is impossible to accurately determine the causes of its occurrence. You can only reduce the risk factors that can lead to this disease. For example, it is recommended to avoid negative environmental influences such as radiation and polluted air. If you live in an ecologically unfavorable area and it is not possible to move, you need to periodically give your body a rest by going out into nature or to a village with a more favorable environment.

According to research, agricultural workers are at increased risk of developing lymphoma because they are exposed to pesticides, which is very dangerous for the body. With reduced immunity, the risk also increases. This is especially true for AIDS patients and people who have undergone organ transplants. During transplantation, therapy with immunosuppressants is carried out. Poor nutrition, consumption of carcinogens, and vegetables with pesticides also increase the chances of developing stomach lymphoma. The higher the quality of food, the less likely it is that the stomach will suffer from certain diseases.

Stages of the disease

Like any other oncology, lymphoma goes through 4 stages of its development. The first one is initial. Here we are talking about damage to one lymph node in one area. This is the same stage when the tumor affects one organ without affecting the lymph nodes.

In the second stage, two or more lymph nodes located on the same side of the diaphragm are affected. Here the clinical picture of the disease begins to appear.

At the third stage, the oncological process is characterized by two or more nodes on both sides of the diaphragm. We are also talking about this diagnosis when there is damage to the lymph nodes and damage to one organ. The symptoms here are pronounced.

The fourth stage is a state when tumor cells have spread throughout the body. A severe development of the situation is a process when organs that are far from the original site of tumor development are affected.

How to recognize

One of the first signs that appears quite often is enlarged lymph nodes. Doctors are primarily concerned about the cervical, axillary and inguinal areas. Moreover, they can be distinguished from those enlarged due to ARVI: in this situation, the nodes are painless and do not decrease in size over time, even with the use of special treatment, including antibacterial therapy.

If internal organs are affected, there may be a feeling of fullness in the abdomen, breathing problems, a feeling of bursting pain in the lower back, pressure in the face or neck.

In addition, signs of lymphoma development include weakness, increased body temperature, and sweating. Unjustified weight loss is also noted; a person begins to suffer from digestive problems.

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Types of Hodgkin's lymphoma

The disease has several types, each of which develops in a specific way and requires different treatment approaches.

Classic lymphogranulomatosis

It develops in Reed-Berezovsky-Sternberg cells, which are modified B lymphocytes. They are contained in small quantities in the affected lymph nodes. They are surrounded by many normal immune cells, which cause edema - an increase in the size of the organ due to the accumulation of fluid. In developed countries, it accounts for more than 9 out of 10 all diagnoses and has 4 subtypes:

Nodular sclerosis
is most common in adolescents and young adults, but can occur at any age. It usually starts in the lymph nodes of the neck or chest.
Mixed cell
variant - mainly observed in HIV-infected people, as well as in children and the elderly. It can appear in any area of the body, but is usually found in the upper half of the body.
Lymphoid depletion
is not common, most cases affect the upper body and is rarely detected in more than a few lymph nodes.
Rich in lymphocytes
- usually develops in the elderly and people with HIV infection. Typically affects the lymph nodes of the abdomen, spleen, liver and bone marrow. More aggressive than other species - it grows faster and is less treatable.

Nodular type of lymphoid predominance

Hodgkin's lymphoma - accounts for about 5% of all diagnoses. Its Berezovsky-Reed-Sternberg cells are modified and visually different from those found in the classic form of the disease. It usually begins in the lymph nodes in the neck and armpit, affects people of different genders and ages, develops more slowly and requires a special approach to therapy.