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Lymphoma or lymph node cancer is a collective name for cancer diseases that occur in cells in the body’s lymphatic system. The prognosis varies but many can get rid of the disease.

Most people who get lymphoma are 65 years of age or older. Children and young adults can also get lymphoma. Here you can read about lymph node cancer in children.

What is lymphoma?

Lymphoma is cancer in the part of the immune system called the lymphatic system. Cancer occurs in cells called lymphocytes. There are two types of lymphocytes:

  • B lymphocytes protect against bacteria.
  • T lymphocytes protect against viruses and fungi.

Many different types of lymphoma

There are many different types of lymphoma. They are divided into three groups:

  • Hodgkin’s lymphoma
  • Rapidly growing
  • . Also called high-grade lymphoma.
  • Slow-growing lymphoma. Also called low malignant lymphoma.

Forecasts may vary

The prognosis may vary depending on the type of lymphoma you have. How you feel otherwise also affects.

The treatment can be demanding and may take several months. Many people can get rid of the disease even if it has spread in the body.

Slow-growing lymphomas are more difficult to get rid of, but usually only need to be treated when you have symptoms. Most people can live a good life long with the disease.

How common is lymphoma?

Lymphoma is one of the most common cancers in most countries. Every year, thousands of people get some form of the disease.

Symptoms of Lymphoma

The most common symptom of lymphoma is that one or more lymph nodes swell in the body.

You may also feel tired, have a fever, sweat or lose weight involuntarily.

Swollen lymph nodes are not always visible but they can be felt. For example, it can hurt or feel uncomfortable in the chest or stomach if you have swollen lymph nodes there. You can cough and get short of breath if you have swollen lymph glands that press on the airways.

When and where should I seek care?

If you have symptoms that you think may be due to lymphoma, contact a health care provider. Wait until it becomes every day if it is a weekend. You can contact many receptions by logging in.

Investigations

The doctor does a body examination and examines the stomach and lungs, among other things. Swollen lymph nodes may need to be examined in various ways. You can read more here. 

The lymph nodes are examined

A cell sample from the swollen lymph node can show if it contains cancer cells. The doctor takes the test with a thin needle that is inserted into the lymph gland. It takes a minute. Most people think it feels like a little stick.

Tissue tests respond to what kind of cancer it is

A tissue sample is needed if the cell sample shows that there are cancer cells. The tissue sample can provide more information than a cell sample. It goes as fast as a cell sample but is taken with a slightly coarser needle. You get local anesthesia. Sometimes the doctor needs to use an ultrasound image to control the needle correctly.

Operation of a lymph node

The doctor usually removes an entire lymph node if it is in a place in the body that is easily accessible. You are anesthetized before the operation, which takes about an hour.

Where in the body is the disease?

The lymphatic system is scattered throughout the body. Therefore, the doctor needs to find out where in the body the disease is if you have lymphoma. Your symptoms of lymphoma and the type of lymphoma you have the effect on which examinations may be needed. Here are examples:

  • blood sample
  • computer tomography
  • bone marrow sample
  • PET Camera Survey. 

You are offered an investigation according to a standardized course of care

You are offered an examination according to a standardized course of care if the doctor suspects you may have lymphoma. Standardized care processes are a way of organizing the investigation so that it goes as quickly as possible. Among other things, there are times set for the examinations you may need.

The doctor who writes the referral will tell you why you should be examined according to a standardized course of care and what it means.

It is often quick to get calls for examinations in a standardized course of care. It is good if you are clear about how the staff most safely reach you so that you do not miss any time.

Treatment varies

The type of treatment for lymphoma you receive depends on the type of lymphoma you have.

Treatment of fast-growing lymphomas 

Rapidly growing lymphomas are usually treated with cytostatic drugs in various combinations. Most people receive six to eight courses in a total of three to five months.

Rapidly growing B-cell lymphoma is most common. It is often treated with both cytostatics and antibodies.

Radiation therapy can also be given to fast-growing lymphomas. Sometimes radiation therapy can replace some cytostatic remedies.

Treatment of slowly growing lymphoma

Slow-growing B-cell lymphoma is the most common. It is treated with antibodies, sometimes with the addition of cytostatic drugs.

You usually only need treatment when you get symptoms. In between, you are called to checks about every three months. Then the doctor can start giving treatment in good time when needed.

Treatment of Hodgkin’s lymphoma 

Treatment varies depending on whether the disease is detected at an early stage or when the disease has spread.

Hodgkin’s lymphoma detected early is treated intensively with cytostatic drugs for two to four months. Then you get radiation treatment to the areas where the disease started. The combination of cytostatics and radiotherapy means you need less of each part. It reduces side effects.

Hodgkin’s lymphoma that has spread in the body is treated intensively with cytostatic drugs for about six months. Sometimes you also get radiation treatment.

Treatments if you get the disease back 

Most people can receive treatment even if the disease recurs, but it may be with other drugs or combinations of treatments than you first received. Some receive stem cell transplantation. Read more in the chapter Stem cell transplantation.

Chemotherapy

Cytostatic drugs are a collective name for drugs that inhibit cancer cells in various ways. There are about 20 different cytostatic drugs used in the treatment of lymphoma.

Usually, one treatment involves combining two to six different drugs.

You get the treatment in a number of cures. A cure means that the treatment lasts for one or more days. The cure is repeated every two to three weeks.

You are examined by an x-ray during the treatment period. It is to see that the treatment works. Otherwise, you may change treatment.

Cytostatics can be given in different ways

Most often you get cytostatic drugs directly into the blood with a drop or syringe. The treatment takes a few hours. Most people can go home afterward.

Some treatment takes a few days to receive. Then you need to be hospitalized while the treatment is in progress.

Other cytostatic treatments are in the form of tablets. Then you can take care of the treatment yourself.

Side effects of cytostatic drugs

You can get side effects of cytostatic drugs. How difficult the side effects become depends, among other things, on the types of cytostatic drugs you receive and how many treatments you need.

It is common for blood levels to be affected so that you feel tired and more susceptible to infections. You may also feel sick, lose your hair or feel tingling and numbness in your fingers and toes.

Most side effects can be prevented and alleviated. Often they go over when the treatment is complete. Read more in the text on cytostatics treatment.

It is important that you tell if you have, for example, a fever, sore throat or cough, which can be symptoms of an infection. Then you may need treatment with antibiotics.

Antibodies

There are various drugs with antibodies that attach to the cancer cells so that the immune system can find and destroy them. The antibodies can also prevent cancer cells from growing and dividing.

You get antibodies as a drop in the blood or as a syringe in the subcutaneous tissue.

You can be treated with antibodies alone or with cytostatics.

You can get antibodies after the end of cytostatic therapy. Then you will receive treatment every two to three months for a total of two years.

Side effects of antibodies

The first time you get a drip with antibodies, it is common for you to have a fever, chills, muscle aches or palpitations. Side effects can be prevented with medicines you take before treatment. 

It is uncommon but sometimes you can get an infection. Then you get treatment for it.

Radiotherapy

Radiation treatment destroys the cancer cells. Healthy cells are also affected, but they have a greater ability to recover between radiation events. This is why the treatment is often divided into several small doses.

It is common for you to receive about 10 to 15 treatments in two to three weeks. Sometimes a few treatments may be enough. Each treatment usually takes 15 minutes.

Side effects of radiation therapy

Radiation therapy can sometimes cause side effects that may come while you are receiving treatment or when the treatment is complete. The side effects you may have to depend on where on the body you received radiation treatment, and what total dose you received.

You can read more in the text Radiation treatment about various side effects and how they can be relieved and prevented.

Operation

It is unusual to need surgery if you have lymphoma.

The spleen may need to be removed if the disease causes it to grow very much so that it pressures and feels uncomfortable in the stomach. The operation usually causes problems to decrease or disappear completely.

Other organs can replace the spleen

The spleen is important for the immune system, especially when you are young. Later in life, for example, the liver and bone marrow can replace the spleen. Everyone who gets the spleen removed needs to be vaccinated against certain types of bacteria that can cause pneumonia.

Stem cell transplantation

Stem cell transplantation is a method used if you need intensive treatment with cytostatic drugs to remove all cancer cells.

The body must be strong enough to receive the treatment. The treatment is stressful and the risk of complications is great.

Pregnancy and breastfeeding

Avoid pregnancy if you are being treated for cancer, regardless of your gender. Some treatments can be harmful to a fetus.

Talk to your doctor before starting treatment if you want to try to get pregnant or use your sperm in pregnancy when you are finished.

Treatment for cancer if you are already pregnant

You can be examined and receive treatment even if you are pregnant. Sometimes care may need to be adapted in different ways.

Radiation examinations and treatments need to be replaced by other methods, or done later, or in a way that protects the fetus.

You can operate. You can receive cytostatic treatment after pregnancy in week 14.

Pregnancy does not affect the disease. Cancer cannot be transmitted to the fetus.

It is only if the cancer is growing rapidly or if it is early in pregnancy that the doctor sometimes recommends that you abort the pregnancy. It is you who decides.

Talk to your doctor if you want to breastfeed.

Treatment needs to be followed up

When the treatment is complete, you will be given checks so the doctor can see that the disease is gone. The doctor also wants to know how you feel so that you can get help if, for example, you have any side effects of the treatment.

It is different from what investigations are done. It depends on what lymphoma you have had and what treatment you have received.

It varies how often and for how long the checks are needed. Checks are common three to four times a year for the first two years, as relapse is most common. Some may end the checks after two years. Others need to continue for up to five years, but then the checks can be carried out at longer intervals. 

Relapse means that the disease has returned.

Slowly growing lymphoma is checked out life

Most who receive treatment for a slowly growing lymphoma usually feel as usual afterward.

You still need to continue with life-long controls so you can get treatment again if needed.

It may be enough to check once or twice a year, but it varies.

Contact your healthcare provider if you experience any symptoms again

It is important that you contact the healthcare provider yourself if you experience new symptoms of lymphoma between the checks or after the checks have ended. Contact a health care center if you no longer have contact with a particular physician.

What does lymphoma depend on?

The causes of lymphoma are largely unknown, but there are things that can increase the risk of getting sick:

  • to be over 60 years
  • the decreased immune system, for example, due to immunosuppressive therapy
  • rheumatoid arthritis or any other inflammatory disease
  • certain types of herbicides, solvents or dyes that you may have come into contact with, for example at work.

How is life affected by lymphoma?

Life can feel different, no matter how it goes with the disease and the treatment. You always have the experience of what you have been with.

It is common for it to feel painful for periods of time. It usually gets better, although it can take time. Some feel vulnerable and worried long after treatment is over.

So you can keep the energy

You feel better and can do more if you take care of yourself. Move. Choose a physical activity that you enjoy and feel you can handle.

Try to eat well and rest just fine. Rather rest often than long.

Save the energy for the things you enjoy doing. Spend time with people who feel good to you.

Different from sick leave

Most people who receive intensive cytostatic treatment need to be on sick leave. It is common to be able to continue working if you receive other treatments. The employer is obliged to make it easier for you to return to work after sick leave.

Relieve side effects

Talk to your doctor or contact nurse if you have, for example, side effects of the treatment. Often there is good help to be had.

Be involved and influence your care

You have the right to be involved in your care whenever possible. The healthcare staff should tell you what treatment for lymphoma options are available. They should make sure you understand what the different options mean, what side effects are available and where you can get treatment. That way you can help decide which treatment is right for you.

You decide on the care plan

You can make a care plan together with the contact nurse, the doctor and other staff. The care plan should answer questions that are important to you. Here you can read more about the contact nurse and the care plan.

New medical assessment

You can get a new medical assessment if you are unsure if you are receiving the care and treatment that is best for you. You will then see another doctor, usually at another specialist clinic. Ask your doctor if you want to know more about how to get a new medical assessment.

Getting a cancer message

There are many ways to respond to a cancer message. You may need plenty of time to talk to your doctor and other healthcare professionals about what the message means.

If possible, please let a relative accompany you. The related person can act as a support and help to remember what has been said.

You have the right to understand

You can ask to have the information written down so you can read it peacefully. Ask questions if you don’t understand. You have the right to receive interpreting assistance if you have a hearing impairment.

In many hospitals, there are special nurses called contact nurses who can provide support and also help with various practical things.

For many, it usually feels easier when treatment has begun and they know what is going to happen. 

You can get support in several places

The contact nurse or the hospital’s curator can help you if you need to talk more or have questions.

You can contact Cancer Counseling, the Cancer Foundation or, for example, a patient association. The Blood Cancer Association is a patient association for people with, for example, lymphoma, and for relatives.

Here you will find contact information and read more about how you can get advice and support in cancer.

Children also need to know

A minor child has the right to receive information and support based on his or her own needs if a relative is ill. It is the responsibility of care. If you want to tell the child yourself, you can get help with what you have to say.

Often it is good to make children as involved as possible, regardless of age. That doesn’t mean you have to tell everything.

Support if you are related

It can feel difficult to be close to someone who is sick. It is common to want to support while you have a strong concern and feel bad.

If you have other people in your area, try letting them support you. It can be family members, friends or acquaintances. Often it will be easier for them to help you if you tell them how it feels and shows if you are worried or sad.

You can get help from the contact nurse or a curator at the hospital if you are close and need supportive calls.

Muhammad Nadeem

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