Hodgkin's Lymphoma
Hodgkin's Lymphoma, a type of lymphoma is also known as Hodgkin's Disease started from the lymph nodes in the chest, armpits and neck. It was named under Thomas Hodgkin, for first to describe the abnormalities of the lymph system in 1832. Hodgkin's lyphoma, is invasive and tends to spread orderly from one lymph node group to another. It is not a common disease with approximately 800 and 7000 of new cases reported every year in Canada and US accordingly and mostly occurs to young adults and after the age of 45.
Types of Hodgkin's lymphoma
1. Nodular sclerosis Hodgkin's lymphoma (NSHD)
It is the most common type of Hodgkin's lymphoma, accounted for 60% to 80% of all cases originated from the lymph nodes of the chest, including the upper diaphragm and abdominal muscles that control breathing just under the lung.
2. Mixed cellularity Hodgkin's lymphoma (MCHD)
It is another type of Hodgkin's lymphma, accounted for 15 - 30% of all cases and tends to affect the lymph nodes of the abdomen, the neck and armpits and men than women with all ages.
3. Lymphocyte depletion Hodgkin's lymphoma (LDHD)
It is a rare type of Hodgkin's lymphoma accounted less than 1% of all cases and occurred more often in the undeveloped world. Most of the time it is detected without enlarged lymph nodes in the neck, armpits or groin. The disease is classified to 2 subtypes
a. Nodular lymphocyte predominant Hodgkin's lymphoma (nLPHD)
b. Diffuse lymphocyte predominant Hodgkin's lymphoma (dLPHD)
4. Lymphocyte-rich classic Hodgkin's lymphoma (cLRHD)
It is also another rare type of Hodgkin's lymphoma, accounted for approximate for 5% of all cases and tends to occur in the age group of 45+ years of age and more in men than women. It is most common to be detected with an enlargement of lymph nodes in the neck, chest or armpits, other lymph nodes and organs.
5. Etc.
Symptoms
1. Enlarge lymph node
Painless enlargement of one or more lymph nodes in the neck and shoulders and chest are often as a result of the malignancy of lymph node cells.
2. Pain
In the later stage of Hodgkin's lymphoma, lymph nodes in the abdomen may cause pain in the spleen, leading to tenderness and fullness in the abdomen.
3. Fatigue
4. Enlargement of the spleen and of liver
They may be due to infection in the advance stage of the diseases and are presented in about 30% and 5% of all cases accordingly.
5. Pain followed by drinking alcohol
May be due to swelling of the involved nodes or increased pressure in diseased marrow that leads to bone pain.
6. Back Pain
Often happens to the lower back in advance stage patients.
7. B symptoms
The presence or absence of B symptoms is used to determine the stage of Hodgkin's lymphma
letter A in any stage means no B symptoms are present while letter B indicates otherwise.
a. Weight loss
Unintentional loss of 10% of your body at the onset of Hodgkin's lymphoma
b. Unexplained fever
Happened several times with no explained cause.
c. Night sweat
Night sweat required to change cloth at night.
8. Itchy skin
Itchy skin in the affect area of lymph nodes.
9. Etc.
Causes and risk factors
A. The causes of Hodgkin's lymphoma still unknown, but researchers suggested the theories below
1. Infection
According to this theory, Hodgkin's lymphoma seems to spread from one lymph node group to another, consistent with an infection from an agent such as Epstein-Barr viru.
2. Virus
This theory suggest that infection with the Epstein-Barr virus may trigger Hodgkin's lymphoma as study found that the Epstein-Barr virus is present in as many as 50 percent of all cases of Hodgkin's lymphoma.
3. Weakened immune system
One theory suggested that Epstein-Barr virus reduces the immune response of the killer T-cells by preventing them from multiplying. Other studies have suggested that EBV may even cause a mutation in the p53 gene, causing the cancer cell's to grow relentlessly and uncontrollably. Further research is required to confirm these theories.
4. Etc.
B. Risk factors
1. Weakened immune system
May be due to weakening of B cells and killer T-cells in the immune system.
2. Prolonged use of human growth hormone
Researchers took a hard look at the lifetime medical records of the children who were treated with the human growth hormone between 1959 and 1985 and suggested that taking the old form of hGH significantly increased risk of cancer, especially colon cancer and Hodgkin's lymphoma.
3. Age
As we mentioned above, young adult are people most at risk of Hodgkin's lymphoma.
4. Gender
Men is more more likely to develop Hodgkin's lymphoma
5. Epstein-Barr virus or human herpesvirus 4
People infected with this type of virus are more likely to develop Hodgkin's lymphoma than are people who haven't.
6. Geography
Hodgkin's lymphoma is most common in the United States, Canada and northern Europe but less in Asian countries.
7. Exposure to exotoxins
There is a link that exposure to exotoxins such as Orange agent and Hodgkin's lymphoma as some of the veterans who fought the Vietnam war are died as the result of the disease.
8. Etc.
Diagnosis and tests
1. Biopsy
Biopsy is the procedure of taking a sample or removing an entire lymph node.from one or more sample from cancerous areas with a thin needle and viewed by specialist(pathologist) under microscope to determine types of malignant cells.Hodgkin's Lymphoma, a type of lymphoma is also known as Hodgkin's Disease started from the lymph nodes in the chest, armpits and neck. It was named under Thomas Hodgkin, for first to describe the abnormalities of the lymph system in 1832. Hodgkin's lyphoma, is invasive and tends to spread orderly from one lymph node group to another. It is not a common disease with approximately 800 and 7000 of new cases reported every year in Canada and US accordingly and mostly occurs to young adults and after the age of 45.
Types of Hodgkin's lymphoma
1. Nodular sclerosis Hodgkin's lymphoma (NSHD)
It is the most common type of Hodgkin's lymphoma, accounted for 60% to 80% of all cases originated from the lymph nodes of the chest, including the upper diaphragm and abdominal muscles that control breathing just under the lung.
2. Mixed cellularity Hodgkin's lymphoma (MCHD)
It is another type of Hodgkin's lymphma, accounted for 15 - 30% of all cases and tends to affect the lymph nodes of the abdomen, the neck and armpits and men than women with all ages.
3. Lymphocyte depletion Hodgkin's lymphoma (LDHD)
It is a rare type of Hodgkin's lymphoma accounted less than 1% of all cases and occurred more often in the undeveloped world. Most of the time it is detected without enlarged lymph nodes in the neck, armpits or groin. The disease is classified to 2 subtypes
a. Nodular lymphocyte predominant Hodgkin's lymphoma (nLPHD)
b. Diffuse lymphocyte predominant Hodgkin's lymphoma (dLPHD)
4. Lymphocyte-rich classic Hodgkin's lymphoma (cLRHD)
It is also another rare type of Hodgkin's lymphoma, accounted for approximate for 5% of all cases and tends to occur in the age group of 45+ years of age and more in men than women. It is most common to be detected with an enlargement of lymph nodes in the neck, chest or armpits, other lymph nodes and organs.
5. Etc.
Symptoms
1. Enlarge lymph node
Painless enlargement of one or more lymph nodes in the neck and shoulders and chest are often as a result of the malignancy of lymph node cells.
2. Pain
In the later stage of Hodgkin's lymphoma, lymph nodes in the abdomen may cause pain in the spleen, leading to tenderness and fullness in the abdomen.
3. Fatigue
4. Enlargement of the spleen and of liver
They may be due to infection in the advance stage of the diseases and are presented in about 30% and 5% of all cases accordingly.
5. Pain followed by drinking alcohol
May be due to swelling of the involved nodes or increased pressure in diseased marrow that leads to bone pain.
6. Back Pain
Often happens to the lower back in advance stage patients.
7. B symptoms
The presence or absence of B symptoms is used to determine the stage of Hodgkin's lymphma
letter A in any stage means no B symptoms are present while letter B indicates otherwise.
a. Weight loss
Unintentional loss of 10% of your body at the onset of Hodgkin's lymphoma
b. Unexplained fever
Happened several times with no explained cause.
c. Night sweat
Night sweat required to change cloth at night.
8. Itchy skin
Itchy skin in the affect area of lymph nodes.
9. Etc.
Causes and risk factors
A. The causes of Hodgkin's lymphoma still unknown, but researchers suggested the theories below
1. Infection
According to this theory, Hodgkin's lymphoma seems to spread from one lymph node group to another, consistent with an infection from an agent such as Epstein-Barr viru.
2. Virus
This theory suggest that infection with the Epstein-Barr virus may trigger Hodgkin's lymphoma as study found that the Epstein-Barr virus is present in as many as 50 percent of all cases of Hodgkin's lymphoma.
3. Weakened immune system
One theory suggested that Epstein-Barr virus reduces the immune response of the killer T-cells by preventing them from multiplying. Other studies have suggested that EBV may even cause a mutation in the p53 gene, causing the cancer cell's to grow relentlessly and uncontrollably. Further research is required to confirm these theories.
4. Etc.
B. Risk factors
1. Weakened immune system
May be due to weakening of B cells and killer T-cells in the immune system.
2. Prolonged use of human growth hormone
Researchers took a hard look at the lifetime medical records of the children who were treated with the human growth hormone between 1959 and 1985 and suggested that taking the old form of hGH significantly increased risk of cancer, especially colon cancer and Hodgkin's lymphoma.
3. Age
As we mentioned above, young adult are people most at risk of Hodgkin's lymphoma.
4. Gender
Men is more more likely to develop Hodgkin's lymphoma
5. Epstein-Barr virus or human herpesvirus 4
People infected with this type of virus are more likely to develop Hodgkin's lymphoma than are people who haven't.
6. Geography
Hodgkin's lymphoma is most common in the United States, Canada and northern Europe but less in Asian countries.
7. Exposure to exotoxins
There is a link that exposure to exotoxins such as Orange agent and Hodgkin's lymphoma as some of the veterans who fought the Vietnam war are died as the result of the disease.
8. Etc.
Diagnosis and tests
1. Biopsy
2. Thoracotomy
Thoracotomy is the process of surgery by making of an incision into the chest wall, if cancerous lymph node found in the chest to study the condition of the lungs and surrounding area.
3. Stages testing
To determine the stage of the cancer
a. Blood tests
In Hodgkin's lyphoma, blood lest is important. In case, surgery is necessary to determine the affects of cancer to the function of bone marrow. A sample of blood is drawn from your vein to determine the number of red blood cells and the amount of hemoglobin, white blood cells and platelets.
a. Blood tests
In Hodgkin's lyphoma, blood lest is important. In case, surgery is necessary to determine the affects of cancer to the function of bone marrow. A sample of blood is drawn from your vein to determine the number of red blood cells and the amount of hemoglobin, white blood cells and platelets.
b. Chest X-ray radiographs
A chest X-ray radiograph (X-ray) is impotant for your doctor to visualize tissues, organs and bones that lie beneath the skin of the chest cavity to see any swollen lymph nodes in the chest and if cancer has spread to the lymth nodes in the lung.
c. Computed tomography (CT) of abdomen and Liver
A CT scan generates a large series of two-dimensional X-ray images taken around a single axis of rotation, to create a three-dimensional picture of the inside of abdomen and the liver in details.The pictures are viewed by your doctor to see the extent of the tumors abnormalities, such as spreading of cancer to the nearby structure and lymph nodes.d. Bone marrow biopsy
e. Lymphangiogram
A lymphangiogram is a special x-ray used to chech for any abnormal cells growth or cancerous cells in the lymph nodes and lymph vessels.f. Liver biopsy
It is a procedure to examine a sample withdrawn from the liver to view inder microscope for nay sign of cancerous cells by either percutaneous, transvenous, and laparoscopic.
g. Positron emission tomography (PET)
The important test for your doctor to determine the location of the cancer. In the procedure, by using the injection a small amount of radioactive glucose into the vein to reveal the location as glucose is become concentrated around cancer cells.h. Etc.
Stages of Hodgkin's lymphoma and treatments according to stage of a patient
1. Stage I
Cancer is found only in a single lymph node region or a single extra lymphatic site (only one area or organ outside of the lymph nodes).
2. Stage II
Cancers found in two or more lymph node sites and on the same side of the diaphragm or one lymph node area and a contiguous extra-lymphatic site
3. Stage III
Cancers found in lymph node areas on both sides of the diaphragm and may have spread to a contiguous extra-lymphatic organ or site, and may include the spleen.
Stage IV
Cancer have spread over a large area, one or more extra-lymphatic organs.
Prevention
A. How to avoid
Researcher found that taking vitamin C supplement, containing soldium ascorbate can induce a flare-up of Hodgkin's symptoms.
2. Meats
Diet high in meats is associated with the increased risk of Hodgkin's lymphoma and worsen the symptoms.
3. Antioxidants
Taking fruits and vegetables enhances the body immune system in fighting against forming of free radical and free radical caused of cancer due to high amount of antioxidants in them.
4. Avoid alcohol
Alcohol not only can exhibit the symptoms but damages the liver, thus suppresing parts of immune system in fighting against diseases.
5. Avoid infection and inflammation
Even though infection or inflammation may not be accepted as a standard cause of Hodgkin's lymphoma, but since the theories are built in some kinds of evidences, it may be right in futher clincal trials. According to the American Cancer Society, there is a slight increased risk of developing Hodgkin's disease in those who have first contracted infectious mononucleosis.
6. Smoking
If you can for a optimal health.
7. Etc.
B. Diet
1. Pomegranate
Pomegranate not only is rich in antioxidants such as Polyphenol, which protects the cells from oxidation and contains substances which demonstrate the antibacterial and antiviral effects, but it also contains phytochemincals such as catechins, gallocatechins, and anthocyanins which demonstrates inhibition of cancer cells in some studies.2. Cruciferous vegetables
Cruciferous vegetables beside contain high amount of phytochemical which is useful in may study in treating estrohen related cancers, it also contain Indole-3-carbinol, a chemical compoud needed for our body to enhances DNA repair, and act as an estrogen antagonist to slow the growth of cancer cells.
3. Leafy greens
4. Vegetables and fruits with different colors
Flavoinoids are pigments of the plant to either to attract pollinator animals or to protect the plant against organisms that cause plant disease. In vitro, high experimental concentrations demostrate the stronger antioxidant abilities than those of vitamin C and E. In study, researcher found that flavonoids could also induce mechanisms that may kill cancer cells and inhibit tumor invasion.5. Etc.
C. Nutritional Supplements
1. Resveratrol
Resveratrol is produced naturally by several plant when under attack by bacteria or fungi. In rat study, researchers found that resveratrol demonstrated anti-cancer, anti-inflammatory effects. There has been many animal studies of resveratrol of the anti-cancer activity, but no human clinical trials for cancer have been reported.2. Vitamin D
Researcher found that levels have been found to be lower in Non Hodgkin's lymphoma and to be protective in Hodgkin's lymphoma.
3. Flavonoids
In vitro, high concentrations of flavonids demonstrate the stronger antioxidant abilities than those of vitamin C and E. In study, researcher found that flavonoids could also induce mechanisms that may kill cancer cells and inhibit tumor invasion.
4. Vitamin A,C,E
Vitamin A,C and E are considered as one of the powerful antioxidants that show scavenging effect in free radical cause of alternation of DNA of cell.
5. Selenium
Selenium is another powerful antioxidant in preventing the free radical cause of DNA mutation of cells. In a laboratory study reported in May 2006 issue of "Annals of Oncology" researchers found that two selenium compounds, methylseleninic acid and selenodiglutathione, may provok cell death in cells from human lymphoma cancers.
6. Eicosapentaenoic acid (EPA)
Study found that Eicosapentaenoic acid (EPA) found in fish oil induces cell death in lymphoma cells.
7. Soy extracts
In some studies, researchers found that genistein, found in soy extracts, induces cell death in lymphoma cells (Baxa DM and Yoshimura FK in 2003).
8. Etc.
Treatments
A. Conventional medicine
Types of the cancer, stage and B symptoms are all taken into consideration to determine the best treatment for a patient
1. Radio therapy
a. Radiation may be used for stages II, III, and IV to kill any cancer cells remaining in the body. By using high-energy x-rays or other types of radiation, radiation therapy kills the cancer cells and keep them from growing or regrowing.
c. Side effects
c.1. Fatigue
c.2. Chest pain
c.3. Heart problem
c.4. Short of breath
c.5. Skin discoloration or pinkness, irritation.
c.6. Etc.
2. chemotherapy
a. Chemotherapy is most use to treat with advance stage of cancer combined with radio therapy, as it has spread to a distant parts of the body by using drugs taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.
3. High-dose therapy for recurrence
a. Drugs used in High-dose chemotherapy therapy are stronger than normal conventional dosage with an objective of killing the recurred cancer cells.
b. Side effects
a. Bone Marrow Destruction
b. Infection
c. Diarrhea
d. Nausea and Vomiting
e. Alopecia
f. Pain
g. Anemia
h. Etc.
B. Herbs
1. Devil's Claw
Devil's claw, a sprawling perennial herb, is an herbal remedy that may benefit symptoms of lymphoma cancer, according to a study published in the journal "Current Oncology" in August 2009conducted by K.S. Wilson, M.D.
2. Asparagus Cochinchinensis
Asparagus, is a flowering perennial, a genus Asparagus, belonging to the family Asparagaceae. In rat study, researchers found that astragalus extracts possess cytostatic properties, inhibiting tumor growth and were shown to delay chemical-induced hepatocarcinogenesis.Researcher found that levels have been found to be lower in Non Hodgkin's lymphoma and to be protective in Hodgkin's lymphoma.
3. Flavonoids
In vitro, high concentrations of flavonids demonstrate the stronger antioxidant abilities than those of vitamin C and E. In study, researcher found that flavonoids could also induce mechanisms that may kill cancer cells and inhibit tumor invasion.
4. Vitamin A,C,E
Vitamin A,C and E are considered as one of the powerful antioxidants that show scavenging effect in free radical cause of alternation of DNA of cell.
5. Selenium
Selenium is another powerful antioxidant in preventing the free radical cause of DNA mutation of cells. In a laboratory study reported in May 2006 issue of "Annals of Oncology" researchers found that two selenium compounds, methylseleninic acid and selenodiglutathione, may provok cell death in cells from human lymphoma cancers.
6. Eicosapentaenoic acid (EPA)
Study found that Eicosapentaenoic acid (EPA) found in fish oil induces cell death in lymphoma cells.
7. Soy extracts
In some studies, researchers found that genistein, found in soy extracts, induces cell death in lymphoma cells (Baxa DM and Yoshimura FK in 2003).
8. Etc.
Treatments
A. Conventional medicine
Types of the cancer, stage and B symptoms are all taken into consideration to determine the best treatment for a patient
1. Radio therapy
a. Radiation may be used for stages II, III, and IV to kill any cancer cells remaining in the body. By using high-energy x-rays or other types of radiation, radiation therapy kills the cancer cells and keep them from growing or regrowing.
c. Side effects
c.1. Fatigue
c.2. Chest pain
c.3. Heart problem
c.4. Short of breath
c.5. Skin discoloration or pinkness, irritation.
c.6. Etc.
2. chemotherapy
a. Chemotherapy is most use to treat with advance stage of cancer combined with radio therapy, as it has spread to a distant parts of the body by using drugs taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.
3. High-dose therapy for recurrence
a. Drugs used in High-dose chemotherapy therapy are stronger than normal conventional dosage with an objective of killing the recurred cancer cells.
b. Side effects
a. Bone Marrow Destruction
b. Infection
c. Diarrhea
d. Nausea and Vomiting
e. Alopecia
f. Pain
g. Anemia
h. Etc.
B. Herbs
1. Devil's Claw
Devil's claw, a sprawling perennial herb, is an herbal remedy that may benefit symptoms of lymphoma cancer, according to a study published in the journal "Current Oncology" in August 2009conducted by K.S. Wilson, M.D.
2. Asparagus Cochinchinensis
3. Turmeric
5. Myrrh
Myrrh is the dried oleo gum resin of a number of Commiphora species of trees, genus of Commiphora, belonging to family Burseraceae. In some studies, researchers found that some constituents in myrrh, have been shown to be inhibitors of certain cancers.
6. Etc.
C. Chinese Herbs
1. Fu Zi
Fu Zi is also known as Aconite Root. The ht, acrid and toxic herb has been used in TCM as inflammatory, anti cancer and heart stimulating agent and to treat pain and cold in chest and abdomen, profuse sweating, muscle spasm, etc. as it tonifies kidney yang, disperses cold, warms channels and assists heart yang by enhancing the functions of heart, kidney and spleen channels. In some preclinical studies, Fu Zi found to demonstrated anti cancer effect, but none of the chemicals have been evaluated in clinical trials.
2. Ru Xiang
Ru Xiang is also known as Bible Frankincense. The acrid, bitter and warm herb has been used in TCM to spastic muscle, carbuncles, gum bleeding, gingivitis, rheumatoid arthritis, cirrhosis of liver, etc. as it invigorates blood, dispels blood stasis, alleviates pain, promotes movement of qi by enhancing the functions of heart, liver and spleen channels. In some test-tube studies Ru Xiang is suggested to use in support of of patients suffered from cancers.
3. Di Long
Di Long also known as earth worm. The salty and cold herb has been used in TCM as diuretic, antipyreticn sedative and anti-convulsion agent and to treat high fever, spasms, painful joints due to arthritis and paralysis, etc. as it clears heat, disperses wind, calms dyspnea and promotes circulation by enhancing the functions of stomach, bladder, liver, lung and spleen channels. In mice study, researchers found that fibrinolytic enzyme (EFE), is a complex protein enzyme showed suppression of tumor growth property with sarcoma 180 and Ehrlich ascites tumors.
4. Wu Ling Zhi
Wu Ling Zhi is also known as Trogopterus Dung. The sweet, warm and cold herb has been used in TCM to treat painful menses, pain due to absence of menses, postpartum infection and pain, angina, uterine bleeding, etc. as it moves blood, calms pain, clears blood accumulation and stops bleeding by enhancing the function of liver channels. A report from China Journal of Chinese Materia Medica 2006-07 showed that Radix ex Rhizoma Ginseng and Trogopterus Dung inhibit the proliferation and induce the apoptosis of tumor cell.
6. Ma Qian Zi
Ma Qian Zi is also known as Nux Vomica. The bitter, cold and bitter herb has been used in TCM to treat tuberculosis, cervical erosion, difficulty in swallowing, rheumatoid arthritis, cancer, depression, migraine, menopausal syndrome, etc. as it promotes circulation in channels circulation, dissolves nodules, dissolves edema and calms pain by enhancing the functions of liver and spleen channels. In vitro, researchers at the Nanjing University of Chinese Medicine examined the effect of each of Nux Vomica four alkaloids: brucine, brucine N-oxide, isostrychnine and strychnine found that nux vomica extract was effective in slowing the spread and kill liver tumor cells.
7. Etc.
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