Understand non-Hodgkin’s lymphoma, detected in Jorge Aragão – 07/15/2023 – Health

Data from Inca (National Cancer Institute) indicate that Brazil should close 2023 with 12,040 new cases of non-Hodgkin’s lymphoma — 6,420 in men and 5,620 in women. The estimate is the same for 2024 and 2025.

Singer Jorge Aragão was diagnosed with the disease. The artist’s press office confirmed the information this Saturday (15), but did not say which subtype. According to Inca, this type of cancer comprises more than 50 different neoplasms originating from white blood cells (lymphocytes).

Non-Hodgkin’s lymphoma is the eighth most common type of tumor, without considering non-melanoma skin, according to Inca.

What is non-Hodgkin’s lymphoma?

Lymphomas are tumors that originate in the lymph nodes, which are conglomerates of defense cells (lymphocytes). They come in multiple types. The first division that is made is between Hodgkin’s and non-Hodgkin’s lymphoma.

Non-Hodgkin’s lymphomas are a family of tumors —more than 50 subtypes, according to Inca. Diffuse large B-cell and follicular are the most common. “Within this group of tumors, there are several entities with their own clinical behavior, epidemiology and treatments”, explains Vladimir Cordeiro de Lima, clinical oncologist at the AC Camargo Cancer Center.

Is the disease serious?

It depends. Some are very aggressive and others indolent, which grow and spread slowly. This is the case of follicular. Depending on the type of lymphoma and the age of the patient, it does not need to be treated immediately, just followed up.

“Some are very curable and others are incurable. Usually the indolent ones are not curable, and we only treat them when the disease starts to show symptoms. Other types, such as diffuse large B-cell lymphoma, lymphoblastic lymphoma, Burkitt lymphomas are more aggressive and must be treated. Normally, indolent lymphomas are less serious”, explains Lima.

Non-Hodgkin lymphoma is most common in which age group?

It can affect all ages. Most non-Hodgkin lymphomas affect adults over age 40 and the elderly, but some are more prevalent in children, adolescents, and young adults. Indolent lymphomas tend to be more common in people over age 50.

According to Paulo Hoff, an oncologist at Rede D’Or, this type of lymphoma has had an increasing incidence in recent decades.

What are the symptoms of non-Hodgkin’s lymphoma?

The most common symptom among all lymphomas is an enlarged lymph node (gut). They are painless. In addition, attention should be paid to persistent fever, around 38ºC, and excessive sweating at night, weight loss and hematological changes. There may be other symptoms, depending on which organ the lymphoma affects.

“Any lymph node, especially if it is painless, that progressively enlarges and persists beyond a month should be investigated. Fever, weight loss and sweating occur in about 30% of patients. Most will not have it”, says Lima .

Enlarged lymph nodes can occur in which regions of the body?

Lumps can form where you have lymph nodes. A priori, the most common regions are the neck, groin, inguinal and cervical regions, under the arms. They can also appear in places such as the mediastinum —the region between the two lungs— and behind the knees.

Sometimes non-Hodgkin lymphomas affect organs other than the lymph nodes. This is the case of the tonsils, the spleen, the liver, with structures equivalent to the lymph nodes.

What’s the treatment?

It depends on the type of tumor. It is usually treatable with chemotherapy and immunobiologicals, with great success. According to Hoff, the cure rate for non-Hodgkin lymphomas is very high. Rarely, radiation therapy or surgery is needed. “Of course there are exceptions, but it is a tumor very responsive to systemic treatments”, says the oncologist from Rede D’Or.

“Younger people find it easier to receive more aggressive treatments, because they have more biological reserves, but as they age, the body finds it easier to deal with the treatment. Age is an included criterion, but it does not become a dramatic thing. part of the patients with lymphoma manage to cure themselves, depending on their age. And that is very good”, completes Hoff.

What are the risk factors for non-Hodgkin’s lymphoma?

According to Hoff, most lymphomas are not associated with a very clear risk factor, but there are some familial syndromes and viruses that may be linked to the development of the disease, as is the case with some hepatitis and the HIV virus.

According to Inca, there is also a compromised immune system among the risk factors due to
hereditary genetic diseases, organ transplantation, autoimmune diseases, use of immunosuppressive drugs, presence of the Epstein-Barr virus (EBV), human T-lymphotropic virus type 1 (HTLV-1) or the bacteria Helicobacter pylori. Having first-degree relatives with lymphoma increases the risk of developing the disease.