There are a considerable amount of various diseases that jeopardize human health every day, but continuous medical research and laboratory investigations allow diagnosing and managing them accordingly. However, there are cancer-related afflictions that demonstrate a high level of mortality and morbidity due to specific properties of cancer cells that complicate their diagnosis and treatment. Medical scientists continue searching more efficient and less damaging medications and curing methods to combat various cancers, including lymphatic cancer or lymphoma. It is one of the most prevailing oncological conditions, which affects millions of people throughout the world. This research paper will provide a basic understanding of cancer and the structure of cancerous cells. Furthermore, it will scrutinize lymphoma in various aspects, indicating its stages, risk factors and genetic changes. Simultaneously, the paper will acquaint with different treatment modalities efficient for managing the disease.
Cancer may affect any organ of the human body. It is an oncological medical condition caused by erratic and uncontrollable cell division and growth that eventually develops into a malignant tumor. The human body consists of certain tissues, which in turn are built of millions of cells. Every tissue has its special cellular texture with strictly-ordered cells in it. Old or affected cells are replaced by the new ones when required. Normally, cell growth and division is connected with the formation of new cells in response to the body’s needs. The damage of cellular texture accompanied with sequential cell division causes malignant diseases. Uncontrollable division of mutated cells facilitates the formation of lumps and masses of tissues that are called tumors. Tumors can significantly interfere with various systems of the body such as nervous, digestive, urinary, and circulatory due to their rapid development. Additionally, the hormones released by the tumors substantially impair body functioning. There are two types of tumors: benign and malignant. Benign tumors are characterized by constrained growth and unchangeable location. They primarily do not affect nearby tissues and remain localized in the original place. Unlike benign cells, malignant ones are more dangerous due to their ability to infiltrate into healthy tissues and travel all over the body, affecting lymphatic and blood systems. Cancer is frequently associated with the development of metastasis or metastatic spread, which is the process of cancer cells shifting from the starting location and lodging into other tissues and parts of the body, where abnormal cells can start an uncontrollable growth cycle.
There are various types of cancer due to the variety of cancer cells. However, it is a well-known fact that malignancies originate from normal cells that undergo multiple severe mutations, which transform them into cancerous cells. Normal cells traditionally have certain a strict proliferation, pass signals to stop it, produce “substances called adhesion molecules” that provide their fine location and go through apoptosis, the programmed death of cells; and cancer cells do the opposite (Eldridge). Malignant cells stop responding to many different “signals controlling cellular growth and death” (“Essential of Cell Biology”). Abnormal cells spring from adjoining tissues and start their rapid multiplication and growth that cause critical disturbances in the cell programming. A damaged cell program leads to immortality of cancer cells. They demonstrate an ability to multiply even if they it is not required. Furthermore, damaged cells fail to respond to “self-termination signals” that command to stop growing or die, so-called apoptosis, at cell’s senescence or damage (Bailey). The damaged cells are prone to overcrossing their boundaries, penetrating the nearby tissues. Such invasiveness complicates surgery on cancerous tumor removal. Unlike normal cells, cancerous ones experience a deficit of special adhesion molecules that are responsible for sufficient stickiness of cells. Such deficiency allows them shifting and floating inside the body and consequently damaging other organs and tissues. Additionally, malignant cells learned how to “restore their telomeres,” a specific chromosome’s structure responsible for the cell’s lifespan, which enables them to achieve immortality. Specific gene mutations result in impossibility of cells’ self-destruction. Furthermore, they are hardly detectable due to their ability to hide among normal cells and shape their properties. Due to such abilities, cancer cells manage to “evade detection or inactivate the immune cells” (Eldridge). They undergo gene and chromosome mutations that impair relevant cell reproduction. Malignant cells can induce normal cells to create their own blood vessels for delivering oxygen and nutrients to the tumor. Moreover, they consume a large amount of glucose required for rapid division and growth. Thus, malignant cells possess properties that allow them surviving under any circumstances. Uncontrollable growth, invasiveness, propensity to metastatic spread, and immortality are also distinctive peculiarities of cancerous cells.
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As it has already been specified, there are a great variety of cancers that may impair any organ or system of the body, and the blood system is not an exception. One may be aware of such illnesses as leukemia and lymphoma that disrupt the functioning of the entire blood system. Lymphoma or lymphatic cancer is a dangerous disease that severely damages cells and organs of the blood system and can substantially reduce a person’s life expectancy. The disease affects lymphocytes, the cells of the immune system and consequently compromises the entire immune system. They comprise approximately 25% of white blood cells and include B and T cells. B cells participate in the antibody response, and while T cells are responsible for cellular immunity. The mutagenesis of lymphocytes and their further transformation into malignant ones signify lymphatic cancer. Multiplication and gradual accumulation of altered lymphocytes inside the body promote further spread of lymphomas. Oncologists report that “the cellular misadventures in blood-forming cells or lymphocytes and aberrations of normal cell process” may provoke “oncogene formation and inadequacies in DNA repair mechanisms” and lead to the most severe blood cancerous afflictions (Lichtman).
Lymphoma is one of the most common blood cancers in the USA. It is the seventh most frequent cancer in adults and the third one among cancers in children. Non-Hodgkin’s lymphoma is diagnosed more frequently than Hodgkin’s type. In 2016, 81,080 people were expected to be diagnosed with lymphomas, and 21,270 people could die from the disease. Approximately 800,000 patients live with the disease in the USA. The represented statistics shows the growing incidence and high mortality rates of the illness.
There is a great variety of lymphomas, such as Hodgkin’s, non-Hodgkin’s, Birkitt’s, T-cell and B-cell lymphomas, lymphoproliferative lymphomas, and others. However, Hodgkin’s and non-Hodgkin’s lymphomas are the most frequent ones. According to the American Cancer Society, Hodgkin’s lymphoma affects lymphatic tissues or lymph nodes, and Non-Hodgkin’s type of lymphatic cancer is “cancer that starts directly in cells called lymphocytes.” Essential impairments in the lymphocytes’ DNA ignite the development of the stated disease. “The altered DNA in the lymphocyte produces a cancerous change” that can lead to the “uncontrollable growth of the cancerous lymphocyte” (Walter). Unchecked multiplication of the damaged B-lymphocytes, or so-called Reed-Sternberg cells, that hugely affect the lymphatic or reticuloendothelial systems identify Hodgkin’s lymphoma. Non-Hodgkin’s lymphoma primarily damages B or T-cells that may penetrate into lymphoid tissues, including lymph nodes or any other organ of the body. Thus, different kinds of lymphoma substantially damage various lymphocytes and lymphatic tissues. The disease may spread to other organs as a result of mutagenesis.
Lymphomas usually have four stages, and each of them signifies the spread of the illness from one starting spot to another site of the body. The first or the early stage of the disease indicates the damage of a single lymph node or a single lymphatic site. It simultaneously shows if cancer affects “a single extra-lymphatic site without involving any lymph nodes” (Bonander). The second stage identifies localized progressing of the disease that afflicts two or more lymph nodes that are placed on the same side of the diaphragm. In this phase, lymphoma can move close to any tissue or lymphatic organ. The third stage is the advanced stage of the disease, when cancer severely affects two or more lymph nodes, or can damage one lymph node or organ located on both sides of the diaphragm. The distinguishing feature of the third stage is the involvement of “the spleen or extra-lymphatic extension” into mutation (Bonander). Finally, the fourth stage indicates the spread of lymphoma beyond lymph nodes and spleen to another site or organ. In the last stage, cancer can infiltrate liver, bone marrow, bones or the central nervous system. “Diffuse or disseminated involvement of one or several extra-lymphatic organs” with or without damaging lymph nodes specify the fourth and the most dangerous stage of lymphoma (Bonander). The present classification is helpful for choosing adequate therapy that would be efficient for a particular stage. There are lots of factors associated with the significant risk of acquiring a lymphoma; however, the exact causes of lymphomas remain unknown. Nevertheless, medical researchers managed to define specific risk factors that may influence the incidence of lymphoma. It is evident that people of different age can develop the symptoms of lymphoma. It is also a fact that the elderly are more prone to this medical condition. Children are at risk of having lymphomas if they experience some “immune deficiency disorders” or have contracted a specific virus (Fayed). The presence of such infections as Helicobacter pylori infection, T-cell leukemia virus, Epstein-Barr virus, Kaposi’s sarcoma-associated herpes virus, and Hepatitis C are the causative agents peculiar for a certain kind of lymphoma. Patients affected by some autoimmune disorders or suffering HIV/AIDS are susceptible to lymphomas of any kind due to the vulnerability of their immune system. There are also definite genetic and environmental risk factors that increase the risk of developing lymphoma. Radiation, pollution, chemical and viral exposure relate to environmental causes of lymphoma. The presence of a lymphoma-afflicted person in the family also increases the probability of developing the same disease in the future. Patients who undergo chemotherapy or radiation therapy or receive immunosuppressive medication after transplantation are also at risk of developing lymphoma. Furthermore, belonging to a certain sex or race can be an alternative triggering factor for some types of the disease. Thus, age, compromised or depressed immune system, exposure to specific viruses and infections, chronic diseases, chemical and radiation exposure, living in the polluted areas are the most predominating factors that predispose the development of lymphatic cancer.
During their maturation, lymphocytes go through the differentiating process that specifies responsibilities of lymphocytes inside the immune system. If this process is disturbed, lymphatic malignancies can occur. Malignant cell transformation implicates the interfered regulating mechanism of genes functioning and the damage of genome stability. The deficit of immune response, such as imbalance of cytokines production and genetic impairments connected to T-cell receptor immunoglobulin rearrangement may contribute to lymphoma development. Genetic abnormalities related to lymphatic cancer can be divided into 2 categories: proto-oncogenes activation and deactivation of genes responsible for malignancy suppression. The main mechanism of proto-oncogenes activation in lymphatic tumors is chromosome translocation. Proto-oncogene is frequently placed on one of the partner chromosomes near the recombination spot. The proto-oncogene is anatomically intact but its expression regulation is defected. At Non-Hodgkin’s lymphoma, proto-oncogene frequently dislocates to the immunoglobulin gene locus and comes under control of heterological elements that regulate gene expression on the partner chromosomes. It results in the constant proto-oncogene expression. Lymphoma rarely occurs due to translocations. On the contrary, it can appear in case of place and time factor coincidence. Considering multifactor nature of lymphoma, genetics came to a conclusion that amalgamation of genes responsible for predisposition to lymphomas forms a network of interlinked elements. Furthermore, the result of such interconnection and interaction on the protein level predestinates biochemical susceptibility of a human being to blood cancers, including lymphoma. The presence of genetic polymorphism explains the variability of malignant progression. Thus, various genetic alterations can lead to mutagenesis and development of such blood cancer as lymphoma.
Lymphomas can spread to distant sites of the body. However, metastasis is not very common in lymphoma; that is why “the notion of metastatic lymphoma becomes a little more complicated” (Bonander). Metastatic lymphoma rarely forms a tumor in the body remotely. Such tumor is frequently disclosed in the lungs, spleen or in the central nervous system.
Since all kinds of lymphoma are equally dangerous, the appropriate treatment is rather crucial for achieving recovery. Lymphoma is considered one of the most curable cancer diseases, particularly in case of early diagnosis. The scrutinized affliction primarily involves a broad usage of chemotherapy and radiation therapy. Chemotherapy appears to be the most frequent and efficient treatment modality involved in the lymphoma medical management. It is aimed at destroying malignant cells, preventing their further reproduction, and shrinking tumors. Chemotherapy medicines are used for attacking cells that divide rapidly. However, this kind of treatment may produce adverse effects due to the capability of specific drugs to destroy not only cancerous cells but also “harm normal, noncancerous cells as well” (LymphomaInfo). Lymphoma patients can take either a single drug or a combination of them, which depends on the severity of the disease. As stated above, radiation is also a medical tool to treat lymphoma. John Walter in his booklet “Hodgkin Lymphoma” clarifies the purpose of the applied therapies: radiation therapy concludes in “targeting the evident Hodgkin’s lymphoma cell masses while chemotherapy is meant for killing lymphoma cells” (Walter). High doses of X and gamma rays or other alternative types of ionizing can destroy malignant cells and shrink tumors. For some kinds of lymphoma, oncohematologists frequently utilize a combination of chemotherapy and radiation therapy if the usage of the one of the stated curing methods is insufficient and does not demonstrate any improvements. Lymphoma treatment may involve surgical intervention if tumor removal is required. The complicated cases of lymphatic cancers require bone marrow or stem cell transplantation, which implicates wiping out the entire immune system, including the bone marrow that produces blood cells, and transplantation of a healthy bone marrow. Additionally, there are such treatment modalities as immunotherapy and radioimmunotherapy. At immunotherapy “the body’s immune system is trained to attack and remove tumor cells” (“Immunotherapy”). The combination of monoclonal antibody therapy and radioactive isotopes specifies radio-immunotherapy, which is mostly designed either for refractory or relapsed lymphomas. Any treatment therapy can be highly efficient in case of a comprehensive and early diagnosis.
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Medical treatment largely depends on the type of lymphoma and its stage. Furthermore, health care providers must consider the patient’s health condition, his or her age, the location of the malignant tumor, and physical maturity. These factors are important for developing treatment planning that can be efficient for recovery or long-term remission. Practically all therapies involved in the lymphoma medical management are aggressive and can badly affect the immune system of the lymphoma-affected patient. Therefore, it is crucial to take all necessary precautions to prevent any infections or viruses and avoid any suspicious contacts that can deteriorate the patient’s condition. Any treatment modality can be associated with certain adverse effects. Chemotherapy as well as radiation therapy may cause various complications or even other secondary cancers that can occur after treatment, which is why health care providers must closely supervise patients undergoing lymphoma treatment. In case the patients do not respond to any treatment, they can participate in some clinical trials that test various alternative medicines and therapies.
In conclusion, various cancers considerably threaten people’s life today. The peculiar features and properties of malignant cells point to their insidious nature and complexity. Mutations occurring inside cells cause a variety of cancers, and blood malignancies relate to them as well. Lymphoma is a type of blood cancer that drastically damages lymphocytes and infiltrates lymphatic tissues and organs. In this case, lymphocytes undergo considerable mutations. The medical condition demonstrates a significant mortality and morbidity rate, which is why it is the issue of serious concern for many medical researchers and patients all over the world. Everybody is at risk of having lymphoma due to a wide variety of risk factors that people can be exposed to. To reduce the risk of developing lymphoma to the minimum, one should keep a healthy lifestyle and have regular check-ups to be able to diagnose and combat the disease at the earliest stage. There are various highly efficient medications and treatment modalities that provide recovery or long-lasting remission of lymphoma patients. However, the death statistics of blood cancer patients suggests that even the existing therapies are sometimes helpless in curing lymphomas.