Lymphoma

Lymphoma is a type of cancer that affects the lymphatic system, specifically the lymphocytes, which is a subgroup of white blood cells.

The excessive proliferation of lymphocytes and distribution in the body then leads to swelling of the lymph nodes and other health problems, which is why it is also known as lymph node cancer or lymph gland cancer.

Below we take a closer look at the two subtypes, discuss possible therapies and provide an overview of the most important questions.

Hodgkin’s lymphoma, also known as Hodgkin’s disease, is a subtype of lymph gland cancer that often occurs in younger patients around the age of thirty.
It is characterised by the presence of Reed-Sternberg cells, which become visible on microscopic examination of the tumor tissue.

Important risk factors are genetic predisposition, smoking, EBV (Epstein-Barr virus) and HIV infection.

Treatment usually involves chemotherapy and radiotherapy, which contributes to good treatment results and a 5-year survival rate of over 90%, even in advanced cases.

Non-Hodgkin’s lymphoma (NHL) is a group of lymph gland cancers that tend to occur at an older age. In contrast to Hodgkin’s lymphoma, it lacks the characteristic Reed-Sternberg cells.

There are more than 30 different NHLs. The classification is based on the type of lymphocyte involved: B lymphocytes (B cells) or T lymphocytes (T cells), whether it is aggressive (fast-growing) or benign and indolent (slow-growing) and other factors.

The risk factors include genetic predisposition, EBV infections, immunodeficiency and autoimmune diseases.

Depending on the subtype of NHL, the treatment approaches and therapy prospects can vary considerably. In most cases, the chances of recovery are high, but there are also cases in which treatment is no longer possible.

Below, we will take a closer look at the subtypes of Non-Hodgkin’s Lymphoma.

B-cell lymphoma is the most common subtype, accounting for 85% of all NHL. It arises from B lymphocytes and can be further subdivided into various subgroups, ranging from less malignant to highly malignant.

It is characterised by painless or painful swelling of the lymph nodes, fever and fatigue and is usually treated with chemotherapy.

The most common B-cell lymphoma is diffuse large B-cell lymphoma (DLBCL), accounting for about 30% of all NHL. DLBCL is very aggressive and can spread quickly.

Symptoms can be night sweats, fever, weight loss, fatigue and (painful) swelling of the lymph nodes of the neck, underarms or groin.

Treatments for DLBCL can be targeted therapy, surgery of the tumor, chemotherapy and radiation therapy.

One subtype of B-cell lymphoma is mantle cell carcinoma. It is a rare malignant tumor that arises from the mantle zone of lymphatic tissue. It starts as a slow-growing disease that turns into a rapid and aggressive tumor.

In addition to the classic symptoms of lymphatic cancer, anaemia and swelling of the liver and spleen also occur and the tumor often spreads to the digestive tract, bloodstream, bone marrow or nervous system, which leads to further symptoms.

The average age of onset is just under 65 years and the five-year survival rate is only around 60 % due to aggressive growth.

Another very aggressive B-cell lymphoma is Burkitt’s lymphoma.

It is rather rare in adults, accounting for only 2% of all NHL. In children however, Burkitt’s Lymphoma is very common, accounting for almost 30% of all NHL.

In early stages, the prognosis is usually favourable and the treatment of choice is chemotherapy.

In advanced cases, however, a cure is more difficult.

T-cell lymphomas account for the remaining 15 % of all NHL. It originates from the T-cells of the immune system.

They usually show non-specific symptoms such as increased susceptibility to infections, fatigue and weakness, which is why misdiagnosis is more common and treatment is delayed.
As the disease progresses, painless swelling of the lymph nodes and weight loss also occur.

Chemotherapy is also the treatment of choice, and radiotherapy and stem cell transplants are also used as supportive measures.

A subtype of T-cell lymphoma are cutaneous lymphomas, which affects the skin.

They are very rare and are usually discovered late, as there are no typical skin changes. Some patients experience skin dryness and redness.

If the lymphoma does not spread to other organ systems, the prognosis is usually good, even if it is discovered late.

Benign lymphomas are a group of lymphoma types that are considered non-malignant or non-aggressive. They are often referred to as indolent or slow-growing lymphomas.

In contrast to malignant lymphomas, they spread more slowly and are less likely to cause noticeable symptoms. However, they can change into a more aggressive lymphoma over time.

Asymptomatic courses or mild symptoms such as enlarged lymph nodes, fatigue or mild infections are typical.

The exact diagnosis and treatment depend on the type of benign lymphoma. There are several subtypes, including follicular lymphoma, MALT lymphoma and marginal zone lymphoma.

Treatment can range from close monitoring without immediate therapy to targeted therapies such as radiotherapy or chemotherapy, depending on whether and to what extent the lymphoma is affecting the patient’s well-being.

Follicular lymphoma is the most common type of indolent NHL. It is a B-cell lymphoma commonly found in the bone marrow or lymph nodes.

Follicular lymphoma is characterised by swelling of the lymph nodes, diffuse pain, neurological deficits and an increased tendency to bleed. However, it can grow so slowly that the patient may not experience any symptoms.

Moreover, follicular lymphoma can transform into a more aggressive form of a B-cell lymphoma, the diffuse large B-cell lymphoma (DLBCL).

This is also treated with targeted therapy, chemotherapy and radiotherapy.

Malt lymphoma is another indolent B-cell lymphoma that spreads to the mucous membranes of the body and consequently affects organs such as the digestive tract, lungs, eyes and salivary glands. This causes corresponding problems there.

Symptoms therefore include abdominal pain, coughing and breathing difficulties, dry mouth and swelling of the eyes.

If diagnosed early enough, the treatment prospects are very good.

Marginal zone lymphoma is also an indolent B-cell lymphoma and accounts for just under 10% of them.

Depending on the location of the lymphoma, different symptoms such as digestive complaints, non-specific pain and fatigue occur.

Treatment differs depending on the subtype and should be discussed with your doctor.

Classic symptoms of lymphoma include swelling of the lymph nodes, fever, night sweats, weight loss and abdominal pain.

However, diffuse symptoms such as fatigue or susceptibility to infections can also be the result of lymphoma and should be investigated.

If symptoms persist over a longer period of time and have no recognisable cause, a medical examination should be carried out.

Lymphoma is diagnosed using biopsies, imaging techniques and blood tests.

Lymphomas can cause various changes in the blood count, including changes in the number of leucocytes, erythrocytes and lymphocytes. Markers for kidney and liver function can also be altered if the tumor affects the corresponding tissue.

Overall, no general statements can be made and the changes always depend on the tumor, the staging and the general health of the patient.

The treatment of lymphomas is multifactorial and always depends on the individual case, the type and stage of the lymphoma.

Radiotherapy and chemotherapy are frequently used, while newer methods rely on immunotherapy and antibody therapy. Psychosocial support also plays a crucial and supportive role for the patient.

Below, we will take a look at the most common treatment approaches and discuss some of the possible advantages and disadvantages.

Chemotherapy uses drugs that slow down cell growth and lead to the death of tumor cells.

It is often used in combination with radiotherapy to achieve the best treatment results.

It is often the treatment of choice due to good treatment success.

Radiotherapy is a frequently used form of treatment for lymphomas. It involves exposing the tumor cells to high-energy radiation, which causes mutations to occur in the cancer cells and weakens them.

It is often combined with chemotherapy to improve the treatment outcome.

Immunotherapy aims to utilise the patient’s own immune system to fight cancer. For this purpose, the cancer cells are marked and subsequently recognised and broken down by the immune system.

The advantage is that the therapy works in a very targeted manner, and it’s therefore said to have fewer side effects than chemotherapy and radiotherapy. However, the side effects can also be severe, depending on the individual.

To date, there is no suitable immunotherapy for every subtype of lymphoma, which is why it must always be decided on an individual basis which therapy is most suitable.

Antibody therapy is part of immunotherapy and relies on specific antigens that bind to cancer cells and thus block signalling pathways or damage the tumor cells in other ways, leading to their death.

Here too, the advantage is that there are said to be few side effects.

A variety of complementary medicine can be used to support the conventional treatment. Complementary medicine encompasses a variety of therapies and approaches that can be used alongside conventional treatment to alleviate symptoms, improve well-being and enhance the quality of life of cancer patients.

Hyperthermia, also known as fever therapy, is based on the heat treatment of cancer cells. It is a complementary treatment method that has been used successfully for some cancers.

In this therapy, the patient’s body temperature is raised to stimulate the body itself to destroy cancer cells or increase the sensitivity of the cancer cells to conventional therapy such as radiotherapy or chemotherapy.

This significantly improves the outcomes of conventional therapy. In combination with chemotherapy, chemotherapy can be administered in lower doses, resulting in fewer side effects.

Combination of hyperthermia and bortezomib results in additive killing in mantle cell lymphoma cells

Local tumor hyperthermia in combination with radiation therapy. 1. Malignant cutaneous lesions

Hyperthermia in Cancer Therapy

Status of Clinical Hyperthermia

Local hyperthermia and radiation therapy in the treatment of superficially located lymphomas and recurrent Hodgkin’s disease

However, as not every cancer at every stage is suitable for this therapy, it is important that patients work with their oncologist to determine whether fever therapy might be a suitable addition to their conventional treatment and to weigh up the potential risks and benefits. How hyperthermia can be used depends largely on the type of lymphoma. If you have any further questions, you should contact your doctor.

Mistletoe therapy is used for lymphomas outside the scope of conventional medicine, as there are insufficient studies available. However, there are many published individual cases, experience reports and some studies that show a supportive effect of mistletoe therapy for lymphomas.

Complete Remission and Long-term Survival of a Patient with a Diffuse Large B-cell Lymphoma Under Viscum album Extracts After Resistance to R-CHOP: A Case Report

Durable Regression of Primary Cutaneous B-Cell Lymphoma Following Fever-inducing Mistletoe Treatment: Two Case Reports

[Favorable long-term outcome with mistletoe therapy in a patient with centroblastic-centrocytic non-Hodgkin lymphoma]

Treatment responses to Viscum album Pini (Iscador® P) in non-Hodgkin’s lymphoma. Exploring a new therapeutic route.

The use of medicinal plants and herbs to relieve symptoms and promote recovery has long been recognised in many cultures. Some herbs can help to strengthen the immune system, reduce inflammation and alleviate the side effects of cancer treatments.

A balanced diet plays an important role in supporting the immune system and overall health of cancer patients. Nutritional therapists can create personalised nutrition plans tailored to the specific needs and challenges of cancer.

If you are interested in any of these therapies, you should contact your doctor or an experienced integrative doctor.

Life expectancy and chances of cure are highly individual and depend on the subtype, the stage, the general health of the patient and the treatment method.

In many cases, a complete recovery is possible, but there are also situations in which palliative treatment is used.

The life expectancy and chances of recovery from Hodgkin’s lymphoma (HL) are generally very good, especially with early diagnosis and treatment.
Hodgkin’s lymphoma is one of the most treatable types of cancer and the prognosis has improved considerably in recent decades thanks to advances in diagnostics and therapy.

In the early stages, the cure rate is over 90%.

The life expectancy and chances of a cure for non-Hodgkin’s lymphoma (NHL) vary significantly depending on the specific type of lymphoma, the stage of the disease and other individual factors.

There are subtypes that have a very good prognosis. However, in other cases, a complete cure is very difficult. In such cases, the aim is to live as long as possible without symptoms.

The diagnosis of lymphoma often poses many questions for those affected and can quickly become overwhelming.

We would therefore like to provide answers to the most important questions below.

The information listed contains relevant topics and serves to improve understanding.