high grade lymphoma | The Support Non-Hodgkin lymphomas Ganglion of the adult

The Support
Non-Hodgkin lymphomas
Ganglion of the adult



Why this guide?
Your attending physician has given you this guide to inform you about the
Non-Hodgkin lymphomas, their treatment and follow-up, and to facilitate the
Dialogue.
This Guide supplements The one addressed to you by your insurance organization
Illness,  "Taking Care of your long-term affection," which explains the
Administrative and financial management of the disease. Related to the team
Your attending physician has an India established a care protocol that will help you
To be reimbursed at 100%, on the basis of the social security tariff, for the
Care related to the disease.
Other sources of information, in particular associative, are indicated on page 8
of this document. They can be useful to accompany you during the
Treatment and after the illness.
Who are the authors of this document?
This Guide was prepared by the High authority of Health (has) and the National Institute of
Cancer (INCa) in cooperation with health professionals and associations
of patients concerned.
The HAS, an independent, scientifically-oriented public authority, and the cnib,
and scientific authority to coordinate the national policy to combat
Cancer, share, in the field of cancer, a mission to inform the
Public.

What is Hodgkin's lymphoma?
Hodgkin's lymphoma (NHL) is a cancer that develops from
Lymph system Cells *, lymphocytes *.
For reasons that are not yet fully understood, these cells
Become abnormal and then multiply in an anarchic way.
Hodgkin's lymphoma appears most often in a group of
Lymph nodes * (lymph lymphoma) or, more rarely, in a
Other organ (stomach, intestine, skin, brain, etc.). It can be propagated by the
Lymphatic system or the blood system, to any tissue or organ.
There are more than ten different types of non-Hodgkin lymphomas. Their cells
Do not all look the same when examined under a microscope. They are
Develop and propagate differently. When Their evolution is slow, we talk about
indolent lymphoma; If It's faster, we're talking about aggressive lymphoma.
With more than 10 700 new cases estimated in France in 2010, the NHL is located
Sixth most common cancer. They affect a little more often the
Men (54%) and are observed at all ages, including children and adolescents,
But with an increased frequency after 60-65 years.
* Glossary on pages 6 and 7.

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Diagnosing and choosing your treatments
How is the diagnosis made?
The balance Sheet includes a clinical examination * and blood tests.
The diagnosis of lymphoma is determined by the anatomopathologic * examination of a
Ganglion taken during a procedure most often under local anesthesia.
A Scanner * of the neck, chest, abdomen and pelvis * is used to determine
The number and size of the glands affected. An examination of the bone marrow * is
Often necessary to look for the possible presence of cells
Cancer. Additional examinations may be prescribed in some
Cases (Examination of the cerebrospinal liquid *, imaging tests * etc.).
These exams allow you to offer a treatment adapted to your situation,
Depending on the type of lymphoma, its degree of aggression (grade), the extent of
Disease (its stage), your general condition and any contraindications to the
Treatments.
How is the choice of your treatments made?
Doctors who specialize in this disease meet at a meeting
Called the Multidisciplinary Consultation meeting * (RCP). Given your
The situation and relying on good practice benchmarks *, they developed a
Support proposal.
This is then explained to you, during a consultation of the device
By the Doctor who takes care of you for your lymphoma. She
must take into account your opinion and be the subject of your agreement.
A Personalized Care Program (PPS) is then delivered to you and is addressed
to your attending physician.

You may also be offered the opportunity to participate in a clinical trial *.
n which health care professionals take care of you?
You are supported by a team that specializes in an institution
be allowed to treat cancers (list of establishments in your area on
www.e-cancer.fr). This team brings together all the necessary skills.
She works in a regular relationship with your attending physician (a general practitioner
More often). Depending on your situation, many professionals can be
Involved: hematologist *, medical oncologist * and radiotherapist, pathologist *,
Nurse, psychologist, social worker, etc.

Treatments for non-Hodgkin's lymphoma
n What is the purpose of the proposed treatments?
Depending on the case, the proposed treatments may have the following aims:
W to cure lymphoma by seeking to eliminate cancer cells;
(w) to contain the evolution of the disease if it cannot be eliminated;
W to treat symptoms and adverse effects to ensure the best
Quality of life possible.

n What treatments are available?
The management of non-Hodgkin lymphomas is mainly based on the
Chemotherapy. This treatment uses a combination of medications
Anti-Cancer drugs that act throughout the body on cancer cells,
Including those that are not spotted by the exams. Medications
are usually administered orally or intravenously, which means that the
May require the installation of an implantable chamber *. Chemotherapy can be
associated with monoclonal antibody treatment *. We're talking in this case
of Immunochimiothérapie.
Radiation therapy can also be associated with chemotherapy. It uses
Rays to locally destroy cancer cells.
Then, in some cases, a hematopoietic stem cell transplant *
may be necessary. It is carried out by transfusion of stem cells that
May come from the patient himself (Autograft) or from a compatible donor
(Allograft).
In some cases of indolent lymphoma a therapeutic abstention can be
Proposed: The patient is regularly monitored and no treatment is carried out
As long as there are no symptoms.
Adverse reactions * differ depending on the treatment. They are
Explained by the Doctor who is following you and who makes sure they are taken care of.
n the preservation of fertility
Infertility, transient or definitive, may occur in men at the end of
Some chemotherapy. Before getting started, it is therefore essential to
Discuss with the medical team the possibilities of sperm conservation.
The possibilities for the conservation of oocytes or embryos can be
Considered for women treated by radiation from the pelvis.
* Glossary on pages 6 and 7.
Understanding the issues of treatment
N your treatment is designed to take care of the disease while preserving the best
Your quality of life and that of your family.
n Some treatments may cause adverse effects: it is important to
Report them to the healthcare team.
n pain in particular should not be minimized. Solutions exist: Feel free to
To talk to your doctor about it.
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N Support Care
Additional care and support can be implemented to
In the face of the possible consequences of the disease and its treatments: fatigue,
Pain, need for psychological support, social problems, etc.
This care, called support care, is provided by different professionals
(psychologist, social worker, etc.). They exercise, as appropriate, within a
Health facility, in hospitalization at home, in consultation with the city, in
The framework of a health network, a patient association, etc.
Follow-up of non-Hodgkin's lymphoma after treatment
n Why follow up?

A follow-up is offered to
W detect and treat possible late side effects of treatments;
W detect signs of possible recurrence of the disease as soon as possible;
W accompany you if necessary in relational, social or
Professional.n What is follow-up?
Follow-up must be regular and extended over several years.
As a general rule, it is based on:
W A medical consultation and a blood check several times a year during
Five years, then once a year;
W The realization at 6 months, then at 1 year, of a scanner * of the thorax, the abdomen and the
Pelvis *. After one year, the frequency is adapted according to the stage and the
Risk factors.
If necessary, other exams may be prescribed (depending on the treatment you
Have received, such as cardiac, thyroid or pulmonary balance). The calendar
And the duration of this follow-up are adapted for your case by the specialized team
Done the treatment, in conjunction with your treating physician.
Your doctor also tells you the signs that should lead you to
Consult outside scheduled appointments (fever, slimming,
Increased volume of lymph nodes, unusual pains by
Example). The different doctors participating in your follow-up are held
Mutually informed.
* Glossary on pages 6 and 7.
For quality monitoring,
Monitoring is essential
n It is important to ensure that the pace of consultation and examination is respected
Agreement with your attending physician, the healthcare team and other
Stakeholders.
n during or after treatments, patient associations can also help you to
Provide a listening experience or allow you to share experiences (see page 8).
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N Monoclonal antibody
Drug that identifies and blocks certain
Cancer cell receptors, the
preventing it from developing. It's a type of
Targeted treatment.
n hematopoietic stem Cells
Cells made by the bone marrow,
The origin of blood cells and the system
Lymph: the red blood cells used to
Transporting oxygen, the different blood cells
Whites (including lymphocytes) that fight the
Infections, and platelets that contribute to the
blood clotting.
N Implantable Room
Small casing placed under the skin (usually
At the thorax) and connected to a flexible hose and
End, called catheter, slipped into a vein. A
Implantable chamber allows to inject a
Drug in the blood through the skin. She
Facilitates chemotherapy infusions and
Allows you to not damage the veins. We're talking
Also from Port-to-Cath ® or PAC.
N Announcement Device
Set of provisions implemented in the
Health care facilities authorized to treat
Cancers. The objective is to benefit the
Sick people and their loved ones
Better conditions for information, listening and
Support from the announcement of the diagnosis and
Treatments, and throughout the course of care.
N Side Effect
An annoying and often foreseeable consequence of a
Treatment, occurring in addition to its effect
Desired. Side effects depend on the
Treatment received, their association with
Other treatments, administered doses,
Type of cancer and how the person
Ill reacts. We also talk about effects
Secondary.
N Clinical Trial
Scientific study conducted with patients, including
The goal is to look for better
How to take care of the cancer. A
Clinical trial may focus on prevention,
Screening, diagnosis, treatment or
Quality of life. Only patients who accept it
Participate in a clinical trial. They must
Receive oral and written information and sign
An informed consent form. to any
Time they can come back on their decision and
Leave the study.
N Anatomopathologic Review
Examination of tissues or
Cells taken from a patient to identify and
Analyzing disease-related anomalies.
The examination is done first to the naked eye, then to the
Microscope. This review makes it possible to establish the
Diagnosis of cancer and orients the choice of
Treatments.

N Clinical Review
Examination by a doctor Who, after
have asked questions in relation to the
Disease, palpate and examining the patient in order to
contribute to the diagnosis.
N Imaging Exam
A review that allows you to obtain images from a
Part of the body or organ. There are
Different types of imaging exams:
Radiological examinations (X-ray, ultrasound,
Scanner, MRI, etc.) and examinations of
Nuclear Medicine (scan, PET).
N lymph node
Small bulge on the path of the ships
Nodes. Often arranged in chains or
In clusters, the lymph nodes are either superficial
(In the neck, armpit, groin), be deep
(In the abdomen, the thorax). They provide a role
Essential in the protection of the body against
Spread of infections in particular. They
Normally measure less than one centimeter
in diameter. If their size is abnormal, we talk about
of Lymphadenopathy.
n hematologist
Medical specialist in blood diseases and
Of the bodies that manufacture it, including the
Hodgkin's disease, non-lymphoma
Hodgkin or Leukemias. We also talk about
of Hematologist.
N Liquid Cerebrospinal
Fluid in which the brain and the
Spinal cord (extension of the system
Central nervous Centre) which has the function
Nourish and protect them from shocks. Some
Glossary
7
Lymphomas can spread to the liquid
Cerebrospinal This is why it is sometimes
Taken by lumbar puncture for analysis.
N lymphocyte
Variety of white blood cells, responsible for
The body's defense reactions. One distinguishes
B lymphocytes that produce
Antibodies and T lymphocytes whose roles
are multiple.
N Bone marrow
Tissue contained in the bones, which makes
Hematopoietic stem cells *.
N Oncologist
Oncologist. We're talking about medical oncologists
(Chimiothérapeute), radiation therapist
(radiotherapist), surgical oncologist.
N Pathologist
Medical specialist who conducts the examination
Anatomopathologic *. It is also referred to as
Anatomo-Cytopathologiste, pathologist
or "pathology".
N Pelvis
Lower part of the belly containing in particular
The bladder, rectum and the organs of reproduction.
N Trusted Person
person who can accompany the patient
Medical interviews, help him in his
Decisions and be consulted if it is in the
Inability to receive information on its
State of health and express his will. The
Trusted person is chosen by the patient
and designated in writing when he entered the hospital. She
belongs to his family or not. The patient can
Come back on his choice at any time.
N Personalized Care Program (PPS)
Document describing the treatment (or treatments)
To realize, the forecast dates, the places, the
How to take care of the effects
Secondary, the contact details of the person
Contact in case of need. The PPS is given to
The outcome of a consultation of the announcement device
During which the proposed treatment
Is explained to the patient in order to collect his
Agreement.

N Care Protocol
form that opens the rights to a
Charge at 100%. This document is prepared by the
Attending physician and studied by the medical consultant
Of the health insurance that gives its consent. It
is then delivered and explained by the doctor
Treating the patient who signs it.
N Good Practice Repository
Document designed to help professionals
Health to propose exams or
Treatments adapted to a patient in a
Given situation. The repositories are the result of
The analysis of international clinical trials and
In the opinion of experts. We are also talking about
Recommendations of good practice.
n Multi-disciplinary consultation meeting
RCP
Meeting between health professionals during the
from which each patient's record is
In order to develop a proposal for a
Treatment. A consultation meeting
Multidisciplinary unit gathers at least three
Doctors of different specialties.
N Scanner
Review that allows you to get images from the
Body in sections using X-rays. The
Images are reconstituted by computer, which
Allows for accurate analysis of different
Regions of the body. We also talk about TDM
(CT scan).
N Immune System
All cells, tissues and
Bodies that ensure the defence of the body
Against external agents, in particular
Infectious.
N Lymphatic System
System including organs, tissues, and
Vessels that produce, store and
Carry lymphocytes charged with fighting
Against infections and other diseases. The
Lymphatic system participates in the system
Immune *.