Lymphoma
The term "lymphoma" refers to about a dozen different types of cancer that are characterized by abnormal, rapidly growing white blood cells in the lymphatic system. Lymphoma can spread through the lymphatic system to almost any part of the body, including the intestines, liver, and brain. Lymphomas generally grow and spread more quickly in patients who have HIV/AIDS than in those who are not infected.
The many different types of lymphoma are generally categorized as either Hodgkin's lymphoma or non-Hodgkin's lymphoma (NHL). Both of these types are considered AIDS-related cancers, although NHL is much more common among patients who have HIV/AIDS. Indeed, it is the second most common AIDS-related cancer. Lymphoma that affects the brain is known as primary CNS (central nervous system) lymphoma.
Lymphatic System
The lymphatic system is a network of thin tubes that, like blood vessels, branch and extend throughout the entire body. A transparent, watery fluid (lymph) flows through the tubes and supplies the body with various disease- and infection-fighting cells. The network is dotted with clusters of lymph nodes, which are small organs where the cells are made and stored.
Other tissues and organs that play a role in making, storing, or filtering the infection-fighting cells include the bone marrow (spongy tissue inside the bones), the spleen (organ in the upper abdomen), the thymus (organ in the chest, beneath the breastbone), and the tonsils.
Non-Hodgkin's Lymphoma
The Epstein-Barr virus (EBV) likely plays a causal role in the development of some types of lymphoma, including NHL. NHL occurs more frequently in gay and bisexual men than in other patients who are infected with HIV.
NHL is the second most common AIDS-associated cancer. Some researchers suspect that it may become the most common AIDS-related cancer. NHL takes several years to spread and develop tumors large enough to detect. More patients who have HIV/AIDS now are developing NHL, because antiretroviral therapy is helping them live longer, healthier lives. People on antiretroviral therapy who have normal CD4+ counts and undetectable viral loads can develop NHL.
NHL can affect many different organs, including the lungs and bone marrow. Symptoms include the following:
- Painless, swollen lymph nodes in the neck, groin, and armpits
- Itchy skin
- Weight loss
- Fever
- Night sweats
NHL usually is treated with chemotherapy, radiation, or both. Treatment is slightly different for patients who are infected with HIV, and antiretroviral therapy may require some modification during chemotherapy. Anyone with HIV/AIDS who has NHL should be treated by a cancer specialist (oncologist) who is an expert in the care and treatment of people with HIV/AIDS. Antiretrovirals can make treatment for NHL more effective.
For a more complete description of NHL, visit oncologychannel.com.Hodgkin's Lymphoma
Symptoms of Hodgkin's lymphoma include the following:
- Painless, swollen lymph nodes in the neck, groin, and armpits
- Itchy skin
- Weight loss
- Fever
- Night sweats
Hodgkin's usually is treated with chemotherapy, radiation, or both. Treatment is slightly different for patients who are infected with HIV, and antiretroviral therapy may require some modification during chemotherapy. Anyone with HIV/AIDS who has Hodgkin's lymphoma should be treated by a cancer specialist (oncologist) who is an expert in the care and treatment of people with HIV/AIDS.
For a more complete description of Hodgkin's lymphoma, visit oncologychannel.com.
Primary (CNS) Lymphoma
Primary CNS (central nervous system) lymphoma occurs in the brain or spinal cord in patients who are HIV-positive and have CD4+ counts below 100 or, more commonly, 50 cells/mL.
One of the symptoms of CNS lymphoma is a persistent headache that does not go away with the usual headache pain relievers. Other symptoms include partial paralysis affecting one side of the body, seizures, and the loss of ability to understand or speak language. The diagnosis usually is based on a microscopic examination of the lymph nodes or other affected tissues (biopsy).
CNS lymphoma is a very aggressive cancer and there is no cure. Radiation can temporarily slow growth of the disease. Patients who are taking antiretroviral drugs rarely develop CNS lymphoma.
HIV/AIDS & Other Cancers
Women who are infected with HIV/AIDS are at increased risk for developing cervical cancer and should receive a Pap smear every 6 months. A Pap smear is a simple test used to detect early precancerous changes in cervical cells and is the single most important step a woman can take to prevent cervical cancer.
Cervical cancer is strongly associated with two types of human papillomavirus (HPV). These types of HPV are sexually transmitted and cause genital warts, which can progress quickly to cancer in people with weakened immune systems. In women, warts can develop on the vulva, anus, vagina, and cervix.
The virus is transmitted through intimate sexual contact. Condoms can provide protection if they are put on before starting sex and worn until the penis is withdrawn.
Treatment for cervical cancer depends on how far the disease has progressed. Early cancer can be removed surgically or treated with radiation. Advanced disease is usually treated with surgery, radiation, and/or chemotherapy. When very advanced cervical cancer is untreatable, radiation can be used to relieve symptoms.
For a more complete description of cervical cancer, visit oncologychannel.com.
Anal Squamous Cell Carcinoma
Men who engage in anal sex are at high risk for anal squamous cell carcinoma, which is associated with human papillomavirus (HPV). The anus, which located at the end of the rectum, is the organ through which stool passes out of the body. Cancer can develop on the outside of the anus or on the inside of the rectum.
Symptoms include the following:
- Bleeding from the rectum
- Lump near the anus
- Pain, pressure, itching, and discharge from the anus
An anal Pap smear is a simple, inexpensive procedure used to detect precancerous changes to cells in the anus. If precancerous changes can be detected before they develop into cancer, they can be treated and the cancer prevented. Regular anal Pap smears may help reduce the incidence of anal cancer.
Although anal cancer occurs more frequently among gay and bisexual men, men and women who are infected with HIV and who regularly engage in anal sex should have routine anal Pap smears.
Anyone with HIV/AIDS who has genital warts or may have been exposed to HPV should contact their physician or other health care provider. Patients with HIV/AIDS who has anal cancer should be treated by a cancer specialist (oncologist) who is an expert in the care and treatment of people with HIV/AIDS.
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