What is cutaneous lymphoma?
Lymphoma is oneRakwhich begins in white blood cells called lymphocytes (LIM-fo sites). Lymphomas can occur almost anywhere in the body. When lymphoma starts in the skin, it is called acutaneous lymphoma(Dearcutaneous lymphoma).
Lymphocytes are part of the body's immune system and usually help the body fight infections. There are 2 main types of lymphocytes:
- B lymphocytes (B cells)
- T lymphocytes (T cells)
Most cutaneous lymphomas begin in T cells.
Different types of lymphoma in the skin
There are many of themtypes of skin lymphoma. Many of them are very rare. Your doctor can tell you more about the type you have.
These are the medical names for the most common types of cutaneous lymphoma in the United States.
- Fungal granulomas
- Sesary's team
Questions to the doctor
- Why do you think I have cutaneous lymphoma?
- Is there a chance I don't have cutaneous lymphoma?
- Can you write what type of skin lymphoma you think I have?
- What will happen next?
How does the doctor know that I have cutaneous lymphoma?
Skin lymphomas can be seen and felt. They often start with a red or purple rash that is very itchy and may look like one of the following:
- Small pimples
- Flat surfaces that can be raised or lowered
- Lumps or nodules under the skin
Lymphoma can affect only a small part of the skin or it can affect large parts of the body. Sometimes people with cutaneous lymphoma have other symptoms, such as fever, weight loss, and sweating.
Your doctor will ask you questions about yoursymptomsand your health and perform a physical examination. The doctor will look closely at the skin and may feel nearby lymph nodes (bean-sized clusters of immune cells) under the skin to see if they are involved. Cutaneous lymphomas can sometimes spread to the lymph nodes, causing them to swell or harden.
Tests that can be performed
It can be difficult for doctors to distinguish cutaneous lymphoma from other causes of skin rashes, so it sometimes takes a while to be sure. If your doctor thinks you may have cutaneous lymphoma, tests will be done. These are some of themirritableyou may need:
Biopsy:In this test, the doctor removes a piece of skin to check for cancer cells. This is often done under local anesthesia. This means you are awake, but the area being biopsied is numb.
A biopsy is the only way to know for sure if you have skin lymphoma. There are many types of biopsies. Each type has advantages and disadvantages. Which one to use depends on your case. Ask your doctor which type to use.
Sometimes biopsies may be done on other parts of the body, such as nearby lymph nodes or bone marrow (the soft, inner part of some bones). This is to see if the cancer has spread there.
Blood tests:Certain blood tests can tell your doctor more about the types of cells and chemicals in your blood.
X-ray of the chest:An X-ray may be taken to check for enlarged lymph nodes in the chest.
computed tomography:This is a special type of X-ray examination that provides detailed images. It can be used to look for enlarged lymph nodes or other organs.
MR scan:MRI uses radio waves and strong magnets instead of X-rays to create detailed images. This test is not often done for cutaneous lymphomas unless a CT scan cannot be done for some reason.
Ultrasound:In this test, a small wand is moved over the skin. It emits sound waves and picks up the echo that bounces off the tissue. The echoes are converted into an image on the computer screen. Ultrasound can be used to look for swollen lymph nodes in places such as the abdomen.
PET scan:In this test, you are injected with a special type of sugar that can be seen in your body with a special camera. If cancer is present, this sugar appears as "hot spots" where the cancer is. This test can help show if the lymphoma has spread. Sometimes this is done at the same time as a CT scan (so-calledPET/CT scan).
Questions to the doctor
- What tests should I use?
- Who will do these tests?
- Where will it be performed?
- How and when will I get the results?
- Who will explain the results to me?
- What should I do next?
How serious is my cancer?
If you have cutaneous lymphoma, your doctor will want to know how far it has spread. That's calledsceneCancer. Your doctor will want to know what stage your lymphoma is in so he can decide what type of treatment is best for you.
The stage is based on how the lymphoma has spread to the skin, as well as whether it has spread to other parts of the body.
Some types of skin lymphomas are assigned a grade, such as 1, 2, 3, or 4. The lower the number, the less spread the cancer is. A higher number, such as stage 4, indicates more serious cancer that has spread further. Be sure to ask your doctor about the stage of your cancer and what it means for you.
Questions to the doctor
- Do you know the stage of lymphoma?
- If not, how and when do you find out about the venue?
- Can you explain what this scene means in my case?
- How does stage affect my treatment options?
- What will happen next?
What type of treatment should I use?
There are many ways to treat cutaneous lymphomas. The main types of treatment are divided into 2 groups:
- Treatments focused only on the skin
- Treatments that affect the whole body
Doctors may use one or both types of treatment for cutaneous lymphoma. The treatment plan that is best for you depends on:
- The type of skin lymphoma you have
- Lymphoma stage
- The possibility that some type of treatment will cure the lymphoma or help in some other way
- your age
- Other health problems you have
- Your feelings about the treatment and related side effects
Treatments focused only on the skin
For many cutaneous lymphomas (especially if they are small and have not spread), the first treatment is directed at the cutaneous lymphomas to avoid side effects in the rest of the body. There are many ways to do this.
Surgery:It is rarely the only way to treat cutaneous lymphoma, but it can be used to treat certain types of cutaneous lymphomas that can be completely removed. Even then, other types of treatment can be used.
Radiation:This treatment uses high-energy beams (such as X-rays or atomic fragments) to kill cancer cells. It can be used as the main treatment for some skin lymphomas. The treatment is very similar to an X-ray. The radiation is stronger, but still painless.
The most common side effects are skin changes (usually look like burns) in the treated area. If a large area of the body is treated, it can result in the loss of all body hair and even the loss of fingernails and toenails.
Phototherapy, also known asUV light therapy:UV light can be used to treat some skin lymphomas. The treatment is performed several times a week using a special lamp similar to those used in solariums. Sometimes the drug is taken in pill form before each treatment to make it work better. This type of treatment is calledPUVA.
As with outdoor exposure to sunlight, UV treatment can cause burns. If the pills are taken as part of PUVA, they can make your skin very sensitive to sunlight, so you will need to protect yourself from sunlight in the days after treatment.
Current medications:These are drugs that are applied directly to (or deep into) the skin. They treat lymphoma while limiting side effects in other parts of the body.
- Local steroids:These drugs affect immune cells (such as lymphoma cells) and can be very useful in treating some skin lymphomas. They can be applied to the skin in the form of ointments, gels, foams and creams or injected under the skin.
- Current chemotherapy:Chemotherapy (chemotherapy) is a powerful drug used to treat cancer. Some chemotherapy drugs can be applied directly to the skin (usually as a cream, ointment, or gel) to treat cutaneous lymphomas that have not spread. Side effects may include redness and swelling at the injection site.
- Topical retinoids:Retinoids are drugs related to vitamin A. They can affect certain genes in lymphoma cells that promote their growth or maturation. Some retinoids come in gel form that can be applied directly to the skin. Side effects may include redness, itching, swelling, and sensitivity to sunlight at the site of application.
- Current immunotherapy:Imiquimod is a cream that, when applied to skin lymphomas, triggers an immune response that can help destroy them. This drug is mainly used to treat some other types of skin cancer, but some doctors may also use it to treat early forms of skin lymphoma. It can cause redness, swelling and itching at the application site.
Treatments that affect the whole body
These treatments are most helpful for skin lymphomas that are widespread or fast growing.
photopheresis,also known asECP:This treatment can kill lymphoma cells as well as help the body's immune system attack them.
For each procedure, blood is taken from the patient's vein. It enters a special machine that separates lymphocytes (including lymphoma cells). The cells are mixed with a drug that makes them sensitive to light and then exposed to UV light. They are then mixed with the rest of the blood and returned to the patient's vein. Treatment usually lasts a few hours.
This treatment can make your skin very sensitive to sunlight, so protect yourself from the sun for a few days after the treatment.
Chemotherapy (chemotherapy):Chemotherapy drugs that are taken in tablet form or injected into the blood can reach all parts of the body. Chemotherapy may be used if skin lymphoma is advanced and no longer improving with other treatments or if it has spread to other parts of the body.
Many different chemotherapy drugs can be used. Often one drug is tried first, but sometimes more than one drug is used. Chemotherapy is given in cycles or rounds lasting several weeks. There is a break after each round of treatment.
Chemotherapy can make you feel very tired, sick to your stomach and cause hair loss. These problems usually disappear after treatment is completed. Some chemotherapy drugs can have other side effects. There are treatments for most chemotherapy side effects. If you have side effects, talk to your oncology team so they can help you.
Targeted drugs:Targeted drugs work by targeting parts of cancer cells that distinguish them from normal cells. These drugs do not work in the same way as chemotherapy drugs. They can sometimes help when chemotherapy drugs don't, and they often have various side effects. Some are given intravenously, while others are taken in pill form.
Side effects depend on the medicine you are taking. Talk to your cancer team to learn more about possible side effects.
Immunotherapy:Some drugs work by helping the body's immune system attack cancer cells. These drugs are administered intravenously.
Side effects depend on the medicine you are taking. Talk to your cancer team to learn more about possible side effects.
retinoids:These are drugs related to vitamin A. They can be taken in tablet form for common skin lymphomas.
Side effects may include headache, nausea, fever, thyroid problems, and eye problems. Some retinoids can cause more serious side effects, such as fluid retention.
Transplantation of stem cells:This treatment (also known as a bone marrow transplant) may be an option if other treatments no longer work. It allows doctors to give higher doses of chemotherapy than they would otherwise be able to (because of the serious side effects it would cause).
First, the person receives high doses of chemotherapy. This can destroy the bone marrow where new cells are made. To fix this, the person receives an injection of stem cells (usually from another person). The stem cells go to the bone marrow, where they start producing new blood cells.
A stem cell transplant is a complex treatment that can cause serious side effects and may require a long hospital stay. This should only be done in a center with a team of doctors who are experts in this treatment.
Clinical trials
Clinical trials are scientific research that tests new drugs or other treatments on people. They compare standard treatments with others that might be better.
If you want to learn more about clinical trials that may be right for you, first ask your doctor if your clinic or hospital conducts clinical trials. SeeClinical trialsFind out more.
Clinical trials are a way to obtain the latest anti-cancer drugs. They are one of the best ways doctors can find better ways to treat cancer. But they may not be for everyone. If your doctor can find one that studies the type of cancer you have, it's up to you whether you want to participate. And if you sign up for a clinical trial, you can always stop at any time.
What about other treatments I hear about?
When you have cutaneous lymphoma, you may hear about other ways to treat the cancer or treat the symptoms. These do not always have to be standard medical procedures. These treatments can bevitamins, herbs, special diets and more. You may be considering these treatments.
Some of them may help, but many have not been tested. For some, it turned out not to help. Some were even harmful. Talk to your doctor about anything you're thinking about, whether it's vitamins, diet, or anything else.
Questions to the doctor
- Should I see other types of doctors?
- Cotreatmentdo you think you are the best for me?
- What is the purpose of this treatment? Do you think it can cure lymphoma?
- Should I have other forms of treatment?
- What is the purpose of these treatments?
- What side effects can I get from these treatments?
- What can I do about side effects that may occur?
- Is there a clinical trial that might be right for me?
- What about the special vitamins or diets my friends tell me about? How do I know if they are safe?
- Should I start treatment right away?
- What do I need to do to be prepared for treatment?
- Is there anything I can do to make the treatment better?
- What is the next step?
What happens after the procedure?
Some people may continue treatment, while others may stop at some point. You will be happy when the treatment is over. But it's hard not to worry that the cancer will come back. Even if the cancer never comes back, people still worry about it. You will be seeing an oncologist for many years after treatment. Be sure to visit them allreturn visit. You may need tests, blood tests and scans to see if the cancer has returned. Initially, your visits may be several months apart. So the longer you are cancer free, the fewer visits you will have.
Having cancer and coping with treatment can be difficult, but it can also be a time to look at your life in a new way. You may be wondering how you can improve your health. Call us at 1-800-227-2345 or talk to your cancer team to find out what you can do to get better.
You cannot change the fact that you have cancer. What you can change is how you live the rest of your life - by making healthy choices and being the best you can be.