Rare, but in many cases curable, Hodgkin’s lymphoma has an incidence of three cases per 100,000 people in Brazil, per year.
It originates from the lymphatic system, which is part of the body’s immune and defense system, and the tumor usually shows up in the neck and chest. In advanced stages, there may be manifestations in the abdomen and bone marrow. The information comes from Agência Brasil.
Lymphoma mainly affects adolescents and young adults, but it can also occur in older people.
An early diagnosis promotes the chances of a cure, because this type of lymphoma evolves over a period of several months, as explained by Ricardo Bigni, head of the hematology service of the National Cancer Institute José Alencar Gomes da Silva (Inca) , who cares for approximately 70 patients with Hodgkin lymphoma each year.
Treatment requires intravenous chemotherapy. Radiation therapy may also be prescribed by the doctor, in special cases, to enhance the effects of chemotherapy. “In general, a supplement is made, for certain types of cases”. Some patients need to take oral supportive medications.
“We manage to minimize the intensity of the treatment depending on the stage of the disease,” said Bigni. In patients with more advanced disease, treatment lasts an average of six months. In previous cases, healing may be achieved in shorter periods, “as appropriate”.
Hodgkin lymphoma usually arises from the lymph nodes, and the main symptom that usually appears is a bulge, or lump, which is an enlarged lymph node in medical jargon.
“It can appear in any area of our lymph nodes. Therefore, it can appear in the neck, armpits, inguinal area and even in the lymphoid organs that are in our chest and abdomen,” says the doctor. Roberto Magalhães, from the hematology department of the Federal University of Rio de Janeiro (UFRJ).
Other symptoms, called B symptoms in medical terminology, may be associated with the tumor. One is the unexplained loss of at least 10% in weight in six months. “This weight loss is something important. It is strange and must be studied.
Other symptoms include a persistent fever in the evening, but no other flu-like symptoms; night sweats which eventually cause the person to change bedding and body itching.
Diagnosis of the disease requires multidisciplinarity. If a suspicious lump appears, a biopsy is needed. A pathologist specializing in hematology is responsible for the diagnosis, and if it is confirmed that it is Hodgkin’s lymphoma, the patient is referred to a hematologist to initiate treatment.
It is up to the hematologist to verify the stage or degree of the disease. “The disease can be very localized; it can only take one area of the lymph nodes and it can involve an organ outside the lymph nodes, like the spleen or the liver, ”he says.
To make this assessment, the hematologist uses imaging techniques, in charge of a radiologist who can perform a tomography to find out which organs have been affected. “Sometimes it is necessary to include a bone marrow biopsy because sometimes this site where blood is produced can be affected,” says Roberto Magalhães.
Heals 5 years later
The hematologist of the UFRJ explains that after the treatment it is still necessary to monitor the patient’s progress. “We do not say that the patient is cured, under hemotherapy, when he has been in complete remission for five years”.
During these five years, the patient must undergo imaging examinations every six months for the first two years, followed by annual examinations. If the disease returns, Roberto Magalhães informed that there is still an option to treat it with an autologous bone marrow transplant. “There are curability rates in at least 50% of cases. “
The hematologist admitted that there are challenges for treatment in the area of old drugs disappearing from the shelves, which can greatly harm SUS patients who lack the resources to access the more modern and sophisticated drugs that are emerging. .
no specific cause
Magalhães says that there are no studies that prove the causes of the emergence of these lymphoid tumors and lymphomas. “There is no specific cause. It is genetic and environmental factors that people are exposed to that can generate this, but there is no rule ”.
Studies show the association of Hodgkin’s lymphoma with the mononucleosis virus, but that doesn’t mean that everyone who has had mononucleosis will have lymphoma, Magalhães pointed out. “There are several factors. The genesis of lymphoma is multifactorial “.