Introduction: Finn Taylor
Cancer is one of the most feared, and also most common diseases encountered in the world. More specifically, Diffuse Large B-Cell Lymphoma, or cancer of the B-cell lymphocytes of the lymphatic system, is particularly scary for it is quite aggressive and damaging. But because of the modern technology and professionals of this day and age we have learned to combat this cancer as well as provide many careers for upcoming medical professionals. Diffuse Large B-Cell Lymphoma is the cancer of the lymphatic system in which malignant B-cell lymphocytes reproduce rapidly in random parts of the lymph node without a clear pattern. We will address the general signs, symptoms, and etiology of this cancer, the body systems that this cancer initially affects and the body systems that it can spread to, the medical treatments and advancements used to treat this disease, and the careers and education involved in dealing with this aggressive cancer. (Medscape.com, 2016)
What is Diffuse Large B-Cell Lymphoma: Rex
A general overview of disease and symptoms is “the first sign of DLBCL is often a lump in the groin, armpit, or neck. It’s likely to grow quickly and may or may not be painful. In about 40% of people, DLBCL develops in other areas like the stomach or bowel.” (Web MD) “Diffuse large B-cell lymphoma (DLBCL) can affect any age group but occurs mostly in older people (the average age is mid-60s). It usually starts as a quickly growing mass in a lymph node deep inside the body, such as in the chest or abdomen, or in a lymph node you can feel, such as in the neck or armpit. It can also start in other areas such as the intestines, bone, or even the brain or spinal cord.” (cancer.org) “Symptoms depend on what area of the body is affected by the cancer and how fast the cancer is growing. Symptoms may include: Drenching night sweats, Fever and chills that come and go, and Itching.” (medlineplus)
Etiology of Diffuse Large B-cell Lymphoma: Rex
The causes of Large B Cell Lymphoma can be described by (Web MD) “doctors don’t know what causes DLBCL and other non-Hodgkin’s lymphomas. They do know that you are more likely to get them if: You are middle-aged or older. On average, people are diagnosed with DLBCL at 64 years old. You are a man.You are not Asian or African-American.” “About 1 in 3 of these lymphomas is only in one part of the body (localized) when it is found. Lymphomas are easier to treat when they are localized than when they have spread to other parts of the body.” (cancer.org) “For most people, the cause of NHL is unknown. But lymphomas may develop in people with weakened immune systems, including people who have had an organ transplant or people with HIV infection.” (medlineplus)
Organ Systems that Diffuse Large B-cell Lymphoma Affects:Finn Taylor
Diffuse Large B-cell Lymphoma originates in the lymphatic system. The lymph organs include the bone marrow, thymus, spleen, and lymph nodes. These organs help fight infection in the body. Diffuse Large B-cell Lymphoma mostly originates in the lymph nodes, but the organs of the lymphatic system are connected by a network of lymphatic and blood vessels, through which lymph fluids flow, which allows the cancer to spread. Lymphatic fluid consists of white blood cells called lymphocytes. There are both b and t-cell lymphocytes, but Diffuse Large B-cell lymphoma, as the name suggests, is the cancer of the b-cell lymphocytes. In Diffuse Large b-cell lymphoma, the b-cell lymphocytes stop responding to the signals that limit their growth and reproduction,and because of this, the cells start to grow abnormally large and reproduce uncontrollably and fast. Diffuse large b-cell lymphoma is given its name because the malignant large B-cells grow within a lymph node in random locations throughout the lymph node or diffusely, without a specific pattern or architecture. When these cells divide before they are fully mature, they can’t fight infection as normal white blood cells do. The abnormal lymphocytes start to clump in the lymph nodes or in other places for example the bone marrow or spleen. They can then grow into tumours and begin to cause problems within the lymphatic system or other organ systems. For instance, if lymphoma originates in the thyroid gland it can affect the normal production of thyroid hormones. These cancerous lymphocytes can travel from the lymph node to many organs in the body, such as the blood, bone marrow, lymph nodes, spleen, lungs and liver. (Medscape.com, 2016)
These large, cancerous b-cell lymphocytes can travel to many important organs in the body, causing damage in not just the lymphatic system, but other vital organs as wells. Diffuse Large b-cell lymphocytes can spread to the respiratory system, such as the lungs. The lungs are a vital organ that is responsible for absorbing oxygen into the blood and taking out carbon dioxide. If Large B-cell lymphoma spreads to the lungs it can cause a large amount of damage such as a collection of fluid in the pleural cavity also called pleural effusion, irreversible lung damage such as lung fibrosis, development of pneumothorax or a collapsed lung, and development of pulmonary hypertension, which is indicated by increased pressure in the arteries of the pulmonary blood vessel system. (Medscape.com, 2016)
As well as possibly being able to spread to the lungs, there is the probability that diffuse large B-cell lymphoma can spread to the liver. The liver is the largest gland in the body and is a vital organ for keeping the human body alive. It is responsible for getting rid of toxins in the body and producing a bile that breaks down fats. Diffuse Large B-cell Lymphoma of the liver can be responsible for acute or even complete liver failure. This lymphoma can cause abdominal pain, nausea and vomiting, weight loss, and other general signs and symptoms, such as fever, fatigue, and appetite loss. Weakened immune system or immunosuppression can be a complication, which can become more severe during treatment. Due to this, individuals are more vulnerable to infections and there is an increased risk of developing serious complications from these infections. If the abdomen is affected, it can cause intestinal obstruction that results in urine outflow obstruction and kidney damage. Blood loss may occur due to frequent or heavy bleeding, giving rise to severe anemia. The leukemic cells can overgrow and cause clogging of vessels resulting in stroke, or blurring of vision. (Medscape.com, 2016)
New Advancements in Technology: Mac
Diffuse Large B cell lymphoma is a cancer of the blood and can be treated by using a variety of prescription drugs and or transplants. Scientists have been able to closely study the disease thanks to the invention of DNA microarray technology. This technology allows scientists to look at how the cancer grows and develops as well as create new treatments for the cancer. A commonly used drug used to treat Large B cell Lymphoma is Lenalidomide. Lenalidomide has had great success in the treatment of this disease. Doctors often have to perform Bone Marrow transplants for patients with Large B cell lymphoma, this operation allows doctors to use a higher dose of chemotherapy to stop the cancer from spreading. The treatment of Diffuse Large B cell lymphoma has been significantly impacted due to new technologies which allow scientists to study and treat the disease.
DNA microarray technology allows scientists and doctors to identify distinct molecular signatures of Lymphoma. Detecting these molecular signatures is important in catching the disease before it grows to a larger size and becomes more threatening. This technology allows scientists to analyse any cell sample or tissue, allowing them to make accurate and fast diagnoses for a variety of diseases that previously proved difficult to diagnose. Detecting a mutation in a cell or tissue early can lead to actions that inhibit a cancer from growing and it can save lives. Being able to study how the disease acts in its early form is helping scientists understand how the tumor works and will possibly help find a cure to Lymphoma. (Genome.gov, 2015)
Lenalidomide is an immunomodulatory drug that has been extensively studied as a treatment for non-hodgkin lymphoma. The drug has been known to upregulate the tumor suppressor gene. Lenalidomide has been put in a front line setting in clinical trials for Large B cell lymphoma. Successful preclinical and clinical studies have been done using the drug. Lenalidomide is an immunomodulatory drug, it works to treat Large B cell lymphoma by interrupting cytokines, these cytokines contribute to the growth of a tumor and when they are affected, it inhibits the growth of the tumor. Angiogenesis is stopped by Lenalidomide, resulting in the lymphoma tumor having in sufficient nutrition to grow and spread. Lenalidomide is an example of a modern medicine that is leading the way for cancer treatments and is a big step towards finding a cure to cancer. (Drugs.com, 2015)
An autologous transplant is a bone marrow transplant that involves one’s own marrow being transplanted. Bone marrow is taken from one part of the body, frozen and stored, and then reintroduced into the bloodstream. Healthy bone marrow produces stem cells which are necessary to life, however, chemotherapy alters stem cells, and having healthy bone marrow put into the body allows the chemo to be more intense and therefore more effective. Tripp Taylor, a large B cell lymphoma survivor, describes his experience going through in patient chemotherapy and a bone marrow transplant as, “The most degrading and difficult time during of my entire experience with cancer”. The reintroduced bone marrow allows stem cells to restart their production of blood cells, which is inhibited by chemotherapy. Bone Marrow transplants have consistently helped patients with Diffuse large B cell lymphoma treat their cancer. (Medlineplus.gov, 2016)
Recent advancements in technology have lead to vast improvements in the treatment of Diffuse Large B cell lymphoma. DNA microarray technology has allowed scientists to study the cancer and create treatments. The methods that doctors use to save patients lives are constantly being upgraded and becoming more and more useful. Modern day technology is responsible for the life saving medicine and treatments that are used every day to help cure and treat cancer.
Careers: Rex
Nurse Practitioners play an important role in the treatment treatment of Lymphoma and need a Master’s or Doctoral Degree. Medical professionals like these need experience in the field of health care, specialized knowledge and extreme competency, rigorous national certifications to insure correct actions, skills, and mindset. Many tests are given regarding one’s ability to function well in a stressful environment and to not crack under pressure. Also Nurse Practitioners need to continually do research to make advances in their field. The education/training needed to become a Nurse Practitioner includes carrying out diagnostic tests and making specific changes to the tests to provide extra accuracy. They have to be able to distinguish and treat specific “acute or chronic” conditions. Also based on the diagnosis, the nurse needs to find the correct prescription for the patient, manage the patient, their needs, and their concerns. These nurses help the patients through illness, an example of this was highlighted in our interview “Dr. Andreas from UCSF significantly impacted my mental health throughout my inpatient chemo process.” -Tripp Taylor. Tripp, the person we interviewed, shared with us that Nurse Practitioners play a vital role in patients lives while staying in the hospital. Another part of being a “NP” includes being a mentor and an educator. These practitioners can also help lower healthcare costs and boost morale and fulfil the patient’s needs. (AANP.org), (evrynurse.org)
Clinical Research Nurses need to have a bachelor’s degree, which includes 4 years of studying online or at a campus. PHD’s are recommended along with MSN Degrees. Although some employers ask for certain qualifications, Research Nurses look for cures or answers for medical questions and problems. This job involves intensive study of the patient and the studying of test results. Being a research nurse involves being ready to face challenges that come in a variety of forms. The work of an RN can be at a University, Pharmaceutical Company, Hospital, and with government organisations. Some of the common duties are writing grants, advising other doctors, and changing current policies to increase effectiveness and efficiency. (exeter.ac.uk), (wikipedia)
Research Associates must have a PHD, field and lab experience, and extensive training. The position involves a full time commitment to its work and field of study. Also as an “Associate” you are to be supervised and watched by a “Senior Associate.” Assist in research, labs, and dissertations. Normally this position if offered/found at a University or Association. The Associate must to train students and teach them the skills needed to become experienced professionals. (northeastern.edu),(cancer.org)
Conclusion: Mac & Rex
Large B cell lymphoma is an immunomodulatory disease that is treatable through various practices. Chemotherapy, lenalidomide, and bone marrow transplants are all methods that have recently been created and which have significantly impacted the ability to treat Large B cell lymphoma. The cancer itself affects the lymphatic system, and forms solid tumors in the body. Though the cause is not the same for everyone and neither is the treatment,for there are treatments and health care professionals to help patients through the disease.