De-group lymphoma from cancer to prevent stigma & promote early diagnosis: Doctors at IHW Council Summit

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Estimated incidences of lymphoma in Indian children is between 15 to 20 per cent

Noting that grouping lymphomas with cancers stigmatizes the disease that is highly treatable and preventable through timely diagnosis, doctors, public health experts and patients who have recovered from lymphoma have called for categorising the disease separately. Speaking at the Lymphoma Awareness Summit, organised by the Integrated Health & Wellbeing (IHW) Council and powered by AstraZeneca, they emphasised on the early treatment of this problem and efforts in the direction of reducing stigma attached to it.

“Lymphomas are lymphoma, and not any blood cancer. The younger people are getting infected with Hodgkin lymphoma at as low as 3-4 years of age – there is no age barrier and the burden is ever increasing. But the treatment of lymphoma is much advanced today – we call it personalized therapy where different natures and stages of the disease are treated with different chemotherapy protocols. Also, people should not be afraid of biopsies,” said Dr Rahul Bhargava- Director and Head Hematology, Hemato Oncology and Bone Marrow Transplant at Fortis Memorial Research Institute of Blood Disorder, Gurugram.

Echoing his thought, C Basu, a recovered lymphoma patient said, “The stigma attached to the word cancer is much higher and if we call lymphoma just lymphoma without grouping it with cancer, it becomes easier for the patient and their family to face the disease.”

Detailing the symptoms of lymphoma, Dr Bhausaheb Bagal, Professor, Consultant, medical oncologist and BMT physician at TATA Prestigious Memorial Hospital, Mumbai said, “Fever without any reason or night sweats and weight loss – these are symptoms of lymphoma. Other symptoms can be enlarged glands in your neck or groin. You can have low WBC count or low hemoglobin or low platelets due to abnormal bone marrow functioning. You will feel easily tired while walking or breathlessness. If you have low platelets, you may have easy bruising or you may bleed easily, and another sign may be repeated infections or immunity going down. Usually if these symptoms persist beyond a few weeks, and there is no other reason, it is best to consult a doctor. Secondly, prevention is important as this disease tends to occur when your immunity is low, for example, if you are under immunosuppressive treatment or undergone kidney transplant or suffering from HIV or AIDS.”

“Lymphoma is a cancer of lymphocytes in the blood, but they are also present in other organs like liver and lymph nodes, so lymphoma usually present with lymph node enlargement and blood changes, but liver or spleen enlargement can also indicate lymphoma. They can also occur in some other organs,” said Dr Sandip Shah, Medical Oncologist and Hematologist and transplant physician, co-founder of hemato oncology team at clinic Vedanta.

Noting the need for proper and early diagnosis, Dr BK Smurti, Medical Oncologist, and hematologist, Lilavati Hospital and Research Center said, “Problems in lymph nodes can mimic tuberculosis and if physicians do not do proper biopsy, misdiagnosis is possible. Lymphoma has various subtypes, up to 30 types, you need a really trained pathologist who is abreast with what is happening and how classifications are expanding or changing to diagnose the subtype of lymphoma. This is very important because the treatments are tailored to which type of lymphoma the patient has. So, getting a diagnosis is the key to treatment of this disease. Many times, the lymph nodes are not painful, so patients delay going to the doctors which delays diagnosis.”

“As per the Globocan 2020 report, India registered 45,049 new lymphoma cases and 23,903 died because of it and what is important to note is that lymphoma is also the most prevalent cancer among children globally. Some studies put that estimated incidences of lymphoma in Indian children is between 15 to 20 per cent. About 54 per cent of blood cancers that occur every year are lymphoma,” said Kamal Narayan, CEO, Integrated Health and Wellbeing (IHW) Council.

“We need a broader societal effort to address stigma related to illnesses and governments at all levels need to do a lot more when it is related to public health. There is a need to raise awareness through small clinics and health centres in small towns and villages to ensure information about diseases like lymphoma and cancers reach the last mile – we are acutely aware of the gaps and trying to bridge this through the health and wellness centres once they become operational. We want access to better and advanced treatment, better facilities, and access to finance for everybody, where initiatives like Ayushman Bharat come to play,” said Urvashi Prasad, Director, Development Monitoring & Evaluation Office, NITI Aayog.

Lymphoma is a cancer of the lymphatic system, which is part of the body’s germ-fighting network. The lymphatic system includes the lymph nodes (lymph glands), spleen, thymus gland and bone marrow. Lymphoma can affect all those areas as well as other organs throughout the body.

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