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Viral trace. Children’s oncologist Naumova spoke about dangerous cancer in children

Hodgkin’s lymphoma is a rare malignant disease of the lymphatic system, which can develop at any age, including in children. Why does the disease arise, who is at risk, and what methods of treatment exist, AIF.ru told The doctor is a children’s oncologist of the advisory and diagnostic center of the Russian Children’s Clinical Hospital of the Ministry of Health of Russia, candidate of medical sciences Alexander Naumov:

– According to official statistics, the prevalence of Hodgkin’s lymphoma in our country is about two cases per 100 thousand population per year. This refers to both adults and children. It is believed that there are two peaks of incidence. The first is 13–18 years old, the second – after 55 years. Of course, a child can also get sick, but in children under 10-13 years old, the frequency of Hodgkin’s lymphoma is about 4-6% among all other cancer, and in adolescents this indicator can reach 16%.

What is the reason

What exactly leads to the development of cancer, including the appearance of Hodgkin’s lymphoma, is not exactly known. However, it was established that the Epstein-Barr (EBV) virus plays a certain role in the development of this disease, which is also associated with the occurrence of chronic fatigue syndrome (CSU). Of course, not every bearer of this virus (and this is about 90% of the world’s population) or the one who suffered infectious mononucleosis caused by aggression of this virus will get the lymphoma of Hodgkin. And even not every patient with this disease in the history of infections associated with EBV took place. Therefore, those who suffered infectious mononucleosis should not think that now they will definitely have cancer. Nevertheless, according to statistics, the first four years after this disease, the risk of developing this cancer of the lymphatic system increases. But then it decreases to the population. However, at least in these four years you should be a guard.

What to pay attention to

To take a general blood test or some other tests to identify Hodgkin’s lymphoma or make sure that it is not, it is pointless. No specific indicators in the blood, by the change of which could be reliably diagnosed, does not exist. Therefore, all hope is the vigilance of the parents and the patient himself.

Anxious symptoms, the appearance of which should be an obligatory occasion to show the child to a children’s oncologist, are: a progressive increase in lymph nodes, especially supra- and subclavian, as well as cervicals. But we are talking primarily about the asymmetric increase in lymph nodes, which also do not decrease even after recovery from SARS. However, you should definitely not worry if a cold child simply increased slightly (and, symmetrically) the cervical lymph nodes, and in a couple of weeks they have decreased to normal sizes. With lymphoma, this does not happen. But if the parents are concerned that the child, after mononucleosis, has long been preserved for increased lymph nodes for a long time, then they can seek advice on a children’s oncologist. With lymphoma, at least one group of lymph nodes will always be affected. But this will not necessarily be obvious. If increased lymph nodes are located in the chest or abdominal cavity, parents will not find them, and doctors may not immediately find them. And sometimes the task of the oncologist is to understand where this lymph node is. Therefore, it is also very important to pay attention to other alarming symptoms:

  • An increase in body temperature is more than 38 degrees for no apparent reason. A small subfebrile temperature that can remain after ARVI for some time.
  • Unreasonable body weight by 10% or more, as well as shed night sweat. This is not just a small perspiration, but a condition in which the child is forced to wake up at night, and change his pajamas and bedding due to excessively abundant sweating.

How the diagnosis is made

To make a diagnosis, an oncologist will prescribe an ultrasound of enlarged lymph nodes and abdominal organs, as well as chest x-rays. If the affected lymph nodes are noticed in these studies, the patient will probably be prescribed computed tomography for a more detailed study. In the future, the oncologist will determine indications for the biopsy of the lymph node. The resulting material will go to a histological study, on the basis of which the diagnosis will be confirmed or refuted.

With the diagnosis of Hodgkin’s lymphoma before the treatment, it is also important to perform PET/CT with 18FDG – during such a study, the patient is introduced by a radiopharmaceutical vehicle that will actively accumulate in the cells of lymphoma. The results of the study allow you to determine the stage of oncological disease, on which the duration of treatment depends.

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About treatment and forecast

The diagnosis of “cancer”, especially in a child, is a huge stress for himself and, of course, for parents. But it is important to identify the disease as soon as possible and begin treatment. In this case, the chances of recovery will be very high.

Hodgkin’s lymphoma is distinguished by a very good response to therapy. And if the disease is detected on time, in the initial stages, then the probability of relapse is extremely low. And the treatment in such cases is sufficiently well tolerated, and in most cases it will not even require the constant location of the child in the hospital, that is, it can take an outpatient basis. With Hodgkin lymphoma, chemotherapy and radiation therapy are necessarily used. This treatment standard is developed on the basis of international protocols and approved in the clinical recommendations of the Ministry of Health of Russia.

Source: aif.ru


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