A brief discussion on the early diagnosis and treatment of lymphoma

The "lymphoma" that people often talk about should strictly be called "lymphoma", which is a malignant tumor. Lymphoma is divided into two categories: Hodgkin's and non-Hodgkin's lymphoma. Lymphoma is a common cancer, and most lymphoma patients are non-Hodgkin's lymphoma. From the perspective of clinical practice, the number of lymphoma patients in my country has increased year by year in recent years. The 2009 Second Global Breast Cancer and Lymphoma Academic Symposium revealed that the incidence of lymphoma patients in my country has risen from the 11th to the 9th place among the top ten most common tumors in men, and from the 13th to the 10th place in women. Therefore, "early diagnosis and early treatment" of lymphoma is very important. "Talking about cancer and changing color" is the psychology of most people. When people talk about suffering from lymphoma, they feel that the shadow of death has descended. Everyone knows that Luo Jing, a famous announcer of CCTV, was diagnosed with lymphoma and died of the disease in just over 8 months. In fact, highly malignant lymphomas only account for about two-thirds of all lymphoma patients.

At present, medical science has made great progress. Many lymphoma patients can achieve long-term survival or even cure after regular treatment. For example, diffuse large B-cell lymphoma is a highly malignant and common non-Hodgkin's lymphoma, accounting for 1/3 of lymphomas. After combined treatment with anti-CD20 monoclonal antibodies and chemotherapy, more than half of the patients have the possibility of being cured. However, some patients are refractory.

We have realized from our clinical work that there are some misunderstandings in the current diagnosis and treatment of lymphoma.

First, some patients do not take their condition seriously, or do not have time to go to the hospital for treatment due to busy work, which delays their condition. Recently, there was a young patient in our hematology ward, Xiao Jiang, a 15-year-old girl. She started coughing half a month before hospitalization, but she did not have symptoms of a cold, such as fever, runny nose, etc. Her parents did not pay attention to it. Because the child had to go to school, they gave her "antiviral oral solution" orally, treating it as a common cold. However, after taking the medicine, Xiao Jiang still coughed and even worsened, and sometimes she was a little short of breath. The parents sent the child to the local health center to get penicillin for anti-inflammatory. The condition worsened again, and a chest CT scan revealed a lump. Later, she came to our hospital and was diagnosed with malignant lymphoma. This example reminds us to seek medical treatment early.

The early symptoms of lymphoma are mainly swollen lymph nodes, which are painless and itchy. They are often found in the neck, armpits, groin and other places. About 60% of lymphoma patients first find swollen lymph nodes in the neck. At first, there are only one or a few swollen lymph nodes, and then the number of swollen lymph nodes increases slowly. Unexplained fever is also one of the early symptoms. Some patients with highly malignant lymphoma may quickly develop high fever, jaundice and other symptoms, which are a manifestation of the serious condition.

Another early symptom worth paying attention to is night sweats. In layman's terms, it means that you sweat after waking up from sleep. This sweating is not caused by hot weather. Symptoms such as low fever and night sweats are easy to be ignored. Lymphoma can also invade other parts of the body. If it occurs in the stomach, small intestine or large intestine, there may be gastrointestinal symptoms such as abdominal distension, blood in the stool, vomiting, and abdominal pain; if it invades the bone marrow, it may cause anemia symptoms such as pale complexion; if it occurs in the chest cavity, there will be coughing and shortness of breath, like Xiao Jiang's condition.

Another important misunderstanding requires the joint attention of patients and doctors. We found that many lymphoma patients did not go to the hematology department or cancer hospital when they were diagnosed. Some patients often went to the ENT department, ophthalmology department, surgery department, etc. because of lumps found in the neck, eyes, abdomen, etc. Some of these patients were discharged after undergoing surgery to remove the lumps in these departments. The key is that these patients no longer go to the hematology department or cancer hospital for postoperative treatment after being discharged.

You should know that surgery cannot cure most lymphomas! Chemotherapy and immunotherapy are necessary to cure lymphoma. Some patients delay follow-up treatment because they are afraid of chemotherapy, thus losing the chance of cure. What a pity!

In fact, many lymphoma patients can be cured through chemotherapy and immunotherapy. We have analyzed the situation of lymphoma patients in detail and noticed that many patients only received chemotherapy once after surgery or did not receive chemotherapy at all. These patients have a very short survival time and have lost the best treatment opportunity in vain.

Special reminder to patients: Once you have lymphoma, you must go to a specialist (hematology or cancer hospital) for chemotherapy. It takes about 6-8 courses of chemotherapy or chemotherapy combined with immunotherapy to have hope of cure. Generally speaking, lymphoma patients who have achieved complete remission through chemotherapy or chemotherapy combined with immunotherapy should be reviewed every 3-6 months to prevent recurrence of the disease.

In addition, many patients choose Chinese medicine for treatment because they are afraid of chemotherapy. Chinese medicine has a certain anti-tumor effect and is good for improving the patient's immune function and resistance. But it cannot cure lymphoma. Therefore, Chinese medicine can only be used as an auxiliary treatment, but not as the main treatment.

Medical science is developing rapidly. In recent years, scientists have conducted gene chip analysis and research on lymphoma and discovered some new targets for treating lymphoma. In other words, there are new methods for treating lymphoma. We have achieved good results in treating refractory lymphoma by combining proteasome inhibitors with chemotherapy, which has significantly improved the cure rate of lymphoma. Looking to the future, with the development of science, the dawn of conquering lymphoma has emerged.