Lymphoma is a group of malignant tumors originating from lymph nodes or other lymphoid tissues. It occurs in people aged 31 to 40 and older than 50 years old and can be divided into two categories: Hodgkin’s lymphoma (HL for short) and non-Hodgkin’s lymphoma (NHL for short). Clinically, it is characterized by painless, progressive lymphoid tissue hyperplasia, especially superficial lymph node enlargement, mostly in the neck, axillae, inguinal region (inner thigh root), often accompanied by liver and spleen often enlarged, and in the advanced stage, cachexia, fever and anemia. Generally speaking, HL has a better prognosis and is one of the most potentially curable malignancies; whereas NHL develops more rapidly, is prone to distant metastases and is relatively difficult to treat.
I. Does the obvious enlargement of lymph nodes necessarily mean lymphoma, and what diseases should be excluded?
Since the main characteristic manifestation of lymphoma is swollen lymph nodes, does it necessarily mean that swollen lymph nodes are lymphoma? Many patients may have this question. It should be clarified that swollen lymph nodes are not uncommon in clinical practice, and it can be a manifestation of various physiopathologies.
1.Benign enlargement
It includes enlargement caused by various infections, connective tissue diseases and allergic reactions, etc. It is often clinically benign and can be completely recovered within a certain period of time.
2.Malignant enlargement
It includes malignant tumors originating from lymph nodes and lymph node metastasis of other malignant tumors, with a malignant clinical course and continuous progressive enlargement of lymph nodes.
3. Enlargement between benign and malignant
Such as vascular primitive immune cell lymphadenopathy and vascular follicular lymph node hyperplasia, which are often benign at the beginning and can develop into malignant. In addition, for enlarged lymph nodes, the same differences in texture exist between diseases. By touching them with the hand, lymphomas may start out as more clearly granular and movable, but may develop into masses (fused lymph nodes), hard and less mobile. Many benign lymph node enlargements, on the other hand, generally do not have such changes. Therefore, for middle-aged and elderly people who have progressive enlargement of lymph nodes or even lumpy changes, they should be especially alert and go to a specialized hospital in time.
What are the main treatment methods for lymphoma?
The current treatments for Hodgkin’s disease include chemotherapy, radiotherapy, biotherapy, surgery and hematopoietic stem cell transplantation. For early stage patients, radiotherapy is particularly effective and can shrink the enlarged lymph nodes and improve the symptoms in a relatively short time. This can be followed by combination chemotherapy. The classic regimens are COPP regimen (cyclophosphamide, vincristine, methylphenidate, prednisone) and ABVD regimen (adriamycin, bleomycin, vincristine, azulenemide). Treatment of non-Hodgkin’s lymphoma depends heavily on the pathological staging. Combination chemotherapy is the treatment of choice, such as COP regimen (cyclophosphamide, vincristine, prednisone), CHOP regimen (cyclophosphamide, vincristine, adriamycin, prednisone), etc. The role of rituximab (melphalan) is more prominent in patients with drug resistance or relapse, and can be combined with melphalan on top of the CHOP regimen, i.e. R-CHOP. in addition, autologous hematopoietic stem cell transplantation has become an effective treatment for this disease and is indicated for refractory relapsed types.
Why is there a significant increase in blood sugar during chemotherapy? What can be done?
Many patients with lymphoma find that their blood sugar rises significantly during chemotherapy, but they do not have a history of diabetes, so they become worried and think that their disease has deteriorated. It should be clear that many chemotherapy regimens for lymphoma involve prednisone (glucocorticoid), and one of the side effects of this drug is that it can cause a mild increase in blood sugar, causing fluctuations and even reaching the blood sugar standard for diabetes. Patients do not need to be overly concerned about this, because with the end of the chemotherapy course and the withdrawal of hormones, blood glucose returns to its original level, and there is generally no need to take glucose-lowering medication specifically. For patients with a history of diabetes, it may be difficult to tolerate the discomfort and possible risks associated with high blood sugar, and the doctor may adjust the dosage of hormones appropriately during chemotherapy. Patients can also eat some foods that can lower blood sugar for dietary therapy, such as: pumpkin, oats, buckwheat, yam, etc.
Do you still need radiotherapy after chemotherapy? What is the effect?
Whether radiotherapy is needed after chemotherapy varies from case to case and cannot be generalized.
Chemotherapy is the application of chemical drugs (including endocrine drugs) to treat malignant tumors. After entering the body, anticancer drugs are quickly distributed to the whole body, which can kill both local tumors and distant metastatic tumors, so chemotherapy is a kind of systemic treatment. The effect of chemotherapy depends on the type of tumor and disease condition, some can be cured, more often inhibit the growth and spread of tumor. Radiotherapy is a treatment method to irradiate tumors with various kinds of energy rays to inhibit and kill cancer cells. Chemotherapy followed by radiotherapy can improve the cure rate of cancer, but both chemotherapy and radiotherapy can cause adverse reactions, which can be treated with traditional Chinese medicine.
V. What are the adverse effects of radiotherapy? Can Chinese herbal medicine reduce the symptoms?
Radiotherapy is one of the three major treatment methods for cancer. It is a treatment method that irradiates tumors with various kinds of rays of different energies to inhibit and kill cancer cells. Radiotherapy can be used alone or in combination with surgery and chemotherapy as part of a comprehensive treatment to improve the cure rate of cancer. The most important side effects of radiotherapy are causing bone marrow suppression, peripheral blood leukocyte and platelet reduction leading to infection and bleeding, and the possibility of inducing other cancers as a long-term complication of radiotherapy. In the treatment of lymphoma, chemotherapy is used to eliminate the evil and attack the tumor, while Chinese medicine is used to support and cultivate the root, which can reduce the toxic side effects of chemotherapy, enhance the body’s immune function and improve the quality of life. During the chemotherapy period, Chinese medicine generally focuses on nourishing Yin and clearing heat, generating fluid and moistening dryness, clearing dryness and saving lung, nourishing Yin and cooling blood, and nourishing liver and kidney, etc. If vomiting, mouth sores, night sweats, palpitations, diarrhea, etc. occur, the medicine can be adjusted flexibly.
What other organs are often invaded by lymphoma?
In many cases, in addition to observing the changes in the size of lymph nodes at the primary site, doctors are more concerned about the occurrence of distant metastases when evaluating the efficacy of lymphoma treatment. The lymphatic system, like blood vessels, is distributed throughout the body and circulates to all organs and tissues. Therefore, especially for lymphomas that occur in the lymph nodes themselves, the chance of lymphatic metastasis is greatly increased. In particular, they are found in mediastinal, hilar, and aortic lymph nodes, and as the disease progresses, the enlargement of lymph nodes in different areas causes corresponding organ compression symptoms, such as respiratory distress, pneumonia, and jugular vein anger. Severe cases may invade retroperitoneal lymph nodes, as well as liver, spleen, bone and bone marrow, resulting in functional abnormalities of the corresponding organs and even directly threatening the patient’s life. Once metastasis of distant organs occurs, it also means that the disease is not well controlled and the prognosis is mostly poor.
How effective is the current treatment for lymphoma and is the survival period long?
Combining the patient’s age, condition and pathological type of lymphoma, the combination of chemotherapy regimen and radiotherapy can generally lead to complete remission in most patients, but some patients whose disease is still not controlled after multiple chemotherapy sessions need to change their chemotherapy regimen or add other treatments, or choose autologous hematopoietic stem cell transplantation. Generally speaking, HL is relatively easy to treat, has a better prognosis, has better sensitivity to radiotherapy, and many patients can achieve long-term disease-free survival, while NHL progresses more rapidly, has more complications, and is relatively tricky to treat.
Is there any good dietary treatment for lymphoma?
Elderly people suffering from lymphoma should eat more food with anti-malignant lymphoma effect and take dietary supplements to medicine supplements: such as field chicken, taro, etc.; if there are swollen lymph nodes, water chestnuts, taro, walnuts, snails, lamb belly, etc.; if there is fever, tofu dregs, figs, barley, mung beans, etc.; night sweating can choose pig heart, oats, tofu skin, etc. In addition, sheep bone porridge (sheep bone 1000g, japonica rice 100g, fine salt, 2 white onions, 3 slices of ginger) is more suitable for patients with liver and kidney yin deficiency after radiation therapy for malignant lymphoma; minced meat with wolfberry and pine nuts (minced meat 100-150g, wolfberry 100g, pine nuts 100g) is suitable for those with yin deficiency and internal heat after radiation therapy for malignant lymphoma; yam and wolfberry sanqi soup (sanqi 17g, Chinese yam 32g, Chinese wolfberry 26g, cinnamon flesh 25g, pork ribs 300g) is more suitable for malignant lymphoma masses that increase rapidly and have dark purple spots on the tongue.