hodgkin lymphoma treatment | HOW TO TREAT THE DISEASE 1. HOW TO FIRST LINE TREATMENT

HOW TO TREAT THE DISEASE
1. HOW TO FIRST LINE TREATMENT



Chemotherapy
Chemotherapy is available in almost all cases. The Protocol most uses is referred to as ABVD (Adriamycin, Bleomycin, Vinblastine, Deticene), which is administered by cycles once every 3-4 weeks. The number of cycles of ABVD chemotherapy depends on the extent of the disease. It is 3-4 in the localized forms and can go up to 6 to 8 in extended forms or if the disease is treated without radiation therapy.

Radiotherapy
In the majority of cases, the full action of chemotherapy radiotherapy in treating locations, including groups of lymph nodes, initially affected by the disease. It requires devices of recent design (particle accelerators).

Radiotherapy has several steps:

The balance, i.e. the phase of preparation and determination of volumes to be irradiated. A review is generally dedicated to the centering.
A series of 15 to 20 treatment sessions over 3-4 weeks (5 days per week).
Side effects of radiation therapy are moderated through current devices. They depend above all of the sites affected by the radiation. They should be discussed at the beginning of the treatment with the radiotherapist-oncologist who plans the treatment.
2. THE TREATMENT OF RELAPSES
The severity of a relapse depends on:

Its occurrence compared to the initial treatment period. Late relapses (when they occur away from the first treatment) are less severe than resistance to the initial treatment.
Same prognostic characteristics than achieving initial
Schematically, the most frequent attitudes are:

Radiotherapy

Chemotherapy based on different drugs from those used for the first time.

An autologous transplant of stem cells (also called bone marrow autograft).

The treatment of relapses is complex and must be carried out in a specialized center.

3 CHEMOTHERAPY

Chemotherapy (often called "chimio" ") is a treatment based on medicines. There are a large number of drugs to destroy cancer cells or to prevent their growth. However, it should be noted that chemotherapy does not specifically target cancer cells and may damage healthy cells.

1. combinations of drugs used in chemotherapy

Several drugs are often associated in the chemotherapy of the NHL. This type of chemotherapy is called combination chemotherapy Protocol. The associated medications have different modes of action in order to alter or destroy cancer cells by various mechanisms. The resulting efficiency is better.

The other reason that use a combination chemotherapy is prevention of drug resistance.

A protocol of chemotherapy is a treatment program that combines anti-cancer drugs prescribed to a certain dose and a precise timetable. It is very important to respect this program as much as possible.

2 cycles of chemotherapy

A single dose of chemotherapy can destroy only a certain percentage of cancer cells. Therefore, it is necessary to administer multiple doses to destroy them all. Chemotherapy is usually given in cycles; each treatment period is followed by a rest and recovery phase during which no medication is administered. The period of treatment and rest intervals constitute what is called a cycle of chemotherapy. The drugs are usually administered according to a timetable that precisely defines the interval between periods of treatment.

3. administration of chemotherapy

According to successful chemotherapy, can you be prescribed medication to swallow (in the form of pills or tablets) or who are injected through intravenous, intramuscular or subcutaneous. If you are called to receive your treatment intravenously for several cycles, your doctor can recommend the establishment of a central venous access (often called catheter). It is a thin pipe, during a brief surgical procedure, is inserted in a vein that is important to facilitate the repeated injections. There are different types of central venous access which may be temporary or permanent.

4. EFFECTS OF CHEMOTHERAPY

Chemotherapy is usually more effective in the destruction of cells that divide rapidly, as cancer cells. But the chemotherapy drugs are not selective and they can also destroy or damage healthy cells, and particularly those that is renewed rapidly as the cells of the hair system or mouth, tube digestive or bone marrow. The side effects of chemotherapy vary depending on drugs and people, and they can be more or less important. The most common adverse reactions associated with chemotherapy, include:

1. a decrease in the production of blood cells

The bone marrow produces permanently red blood cells, white blood cells and platelets.

Myelosuppression is the term used when chemotherapy temporarily prevents the bone marrow to produce the correct rate of blood cells.

Anemia is the term used when myelosuppression reduced the rate of red blood cells and hemoglobin (contained in red blood cells). Anemia usually results in a feeling of fatigue. Most chemotherapy protocols can cause mild or moderate anemia, and it is sometimes necessary to prescribe a treatment to correct. There are indeed of drug that stimulates the production of red blood cells. When anemia is important, it is possible to use a transfusion of red blood cells.

Neutropenia is the term used when the myelosupression causes a drop in the rate of neutrophils, the main types of white blood cells found in the blood. The role of neutrophils is essential in the fight against infections. Too low levels of neutrophils can lead to lower doses of chemotherapy, or even to delay a cycle, to not expose patient to risk of infection.

Thrombocytopenia is the term used when myelosuppression decreases the rate of platelet in the blood. Platelets help blood clot. A too lowered platelets can cause the occurrence of bleeding (at the level of the gums or nose for example) and hematomas. Failure, bleeding may also be more important and more prolonged. It is sometimes necessary to resort to a transfusion of platelets.

2. hair loss

For most patients, hair loss (also called alopecia) is a very annoying side effect of chemotherapy. The loss is about all the hair of the body, at the level of the scalp, eyebrows, eyelashes, arms, legs and pelvis. It is variable depending on the drugs and the people: it is possible that all the hair falls, or simply that it is scarce.

The fall of hair, when it occurs, occurs most of the time about two to three weeks after the first cycle of chemotherapy. In all cases, it is temporary, the hair grows back after chemotherapy is completed. Initially, hair that push may have a texture or a color different from the original but, over time, the hair usually resumes its normal appearance.

3. nausea or vomiting

Chemotherapy can cause nausea or vomiting. These side effects often occur on the day of the administration of the chemotherapy, but they can be produced later. Today there are drugs, antiemetics, that allow to effectively prevent nausea and vomiting. They are usually prescribed prophylactically before the administration of chemotherapy.

4 diarrhea

Diarrhea is one of the possible side effects of chemotherapy. Most importantly, in the case of diarrhea, is to avoid dehydration (fluid loss), drinking regularly. Drugs used to prevent or limit the stool. Any diarrhea if loss of blood or fever accompaniment must be reported quickly to the health care team.

5. canker sores

The lining of the mouth can become red, painful, and get irritated during chemotherapy. This is called mucositis. Infections of the mouth and throat caused by a virus or a fungus can also occur. The health care team must be informed of any persistent pain in the throat. A clinical examination and a sample carrying allows in this case to determine the presence or not of an infection. There are several drugs to treat infections of this type.

To reduce the risk of infections in the mouth, the doctor may ask the patient to consult a dentist for a complete exam and cleaning before starting chemotherapy.

6. change of taste

A change in taste can be seen with certain foods or drinks. There are the complete taste loss, during which the person is unable to recognize the four tastes (sweet, salty, bitter and acid), and the partial taste loss during which the flavor is no longer seen as neatly as usual. Some people also report that the food has a metallic taste. These side effects are temporary and disappear usually after chemotherapy is completed.

7 fatigue

Fatigue is a common side effect of chemotherapy. She gradually fades at the end of the treatment, but it may take weeks or even months before she disappeared completely. Fatigue is sometimes a sign of anemia.

5 RADIATION THERAPY

Radiation therapy appeals to powerful x-rays to destroy cancer cells and shrink tumors. Radiation therapy is a local therapy, which means that it only affects cancer cells in the treated area. Radiation is sometimes used alone for some lymphomas localized, ganglion, or extraganglionnaires, or can be associated with chemotherapy.

A field of radiation is the term used to describe the portion of the body that is exposed to radiation. Radiation is usually concentrated on the lymph nodes and areas surrounding them or the region of origin when it comes of extranodal lymphoma. These fields are determined on a case by case basis and depend on the type of tumor and the stage of the disease.

6. EFFECTS OF RADIOTHERAPY

Radiation are painless and do not have radioactive patients, but they may have side effects. These depend mainly on the area of the body treated:

1. loss of taste and appetite

Chemotherapy results in some people a change of taste and odour. Some foods that you liked so far may not be appetizing at all. Similarly, odors become sickening. In this case, the best is to turn to foods that appeal to you the most and to focus on methods of cooking and dishes that exude the less smell. It is also possible to have less appetite for chemotherapy. To help you maintain a good nutritional balance, you also have to make four or five small meals during the day. Do not hesitate to ask for advice from your health care team.

2 dry mouth

Radiotherapy is likely to cause a temporary reduction in saliva production, resulting in a feeling of dry mouth. Called cela a xerostomia. It is advisable to see a dentist before the radiation that it prescribes treatments fluoride-based in order to prevent the risk of caries.

3. sore throat

Radiation to the neck, throat or chest level can cause sore throat, the feeling of having dry mouth, nausea or cough. It can become difficult to swallow, especially at the end of treatment. Let his doctor when we meet difficulties in swallowing, because there are treatments to relieve this type of problem, knowing that it usually disappears in the weeks following radiotherapy.

4. skin reactions

Radiation can cause slight redness of the skin that often itch and skin (such as after a Sun burn). It is recommended to moisturize the contour of the mouth areas which become irritated easily (your doctor may prescribe creams made from zinc for these areas). These alterations of the skin are reduced and generally disappear within a few weeks.

5 nausea

First radiation therapy can cause nausea, particularly when radiation is at the level of the abdomen. Not eating (especially the spicy, greasy foods and sugar) a few hours before radiotherapy sessions sometimes contribute to limit the nausea. Some patients prefer plan sessions of radiotherapy late in the day to be home when the nausea begin. Your doctor may prescribe an antiemetiqueavant treatment sessions of radiotherapy.

6. hair loss

Radiation can cause hair and hair fall. In contrast to what is happening with chemotherapy, this hair loss occurs in the irradiated area. Hair loss is usually temporary, but it can become permanent, particularly with high doses of radiation.

7 fatigue

Fatigue is due in part to your illness and partly to the frequency of the sessions of radiotherapy and the doses administered