Have you ever heard of a strange disease called MALT Lymphoma? Probably not. Because it is a bit rare, which means it is not a disease that affects everyone. But it is good for us to know about it. Because this is also a type of cancer. But don't be afraid, it spreads slowly in the body. Today, we will talk about it in detail, as if we were talking to a friend.
What is MALT Lymphoma? Simply put...
Okay, MALT Lymphoma is a small subtype of the larger cancer group called `non-Hodgkin lymphoma`. In other words, it is one of the most common types of slow-growing lymphomas called `marginal zone lymphoma`.
This disease usually affects people over the age of 65. It is also more common in men than women. The best thing is that doctors have treatments that can cure this disease. That is, they can put the disease into ``remission`` , or a dormant state. However, we must remember that sometimes it can recur.
What are the types of MALT Lymphoma?
There are two main types of MALT lymphoma:
1. Gastric MALT Lymphoma: This starts in your stomach, that is, in the stomach. The inner layer of the stomach, which we call the `mucosa` , is where it starts. Most of the time, this type stays where it started, but sometimes it can spread to areas outside the stomach. This is the most common type of MALT lymphoma.
2. Non-gastric MALT Lymphoma: This type can affect the mucous membranes in your lungs, salivary glands, thyroid gland, and skin . It can also affect the tissues around your eyes, such as the tear ducts .
How common is this disease?
MALT lymphoma is actually a relatively rare disease. It accounts for about 7% of all non-Hodgkin lymphomas. To put that into perspective, according to the American Cancer Society, 80,550 people will be diagnosed with non-Hodgkin lymphoma in 2023 alone. That's compared to 300,590 new cases of breast cancer. So you can see how rare this is.
How quickly does MALT Lymphoma spread?
This is an important point. This disease grows very slowly in the body. In the early stages, there may be no major symptoms. Sometimes, MALT lymphoma is discovered by chance while being tested for another disease.
What are the symptoms of this?
Symptoms vary depending on where the lymphoma is located. However, all MALT lymphomas start in the mucosa , which is the moist lining that lines the inside of some of our body's organs.
Symptoms of Gastric MALT Lymphoma
This is caused by the stomach, and symptoms may include:
- Heartburn and indigestion: Just like the heartburn and indigestion we all know.
- Stomach ache.
- Nausea and vomiting.
- The food is tasteless.
- Being thin for no reason.
- Gastrointestinal bleeding.
Symptoms of Non-gastric MALT Lymphoma
This type can affect the eyes, lungs, salivary glands, skin, and thyroid gland.
If the eyes are affected:
- Drooping eyelid.
- Redness or inflammation of the eyes.
- Swelling around the eyes.
- Double vision.
If the lungs are affected:
- Difficulty breathing.
- Chest pain.
- Coughing up or coughing up blood.
If the salivary glands are affected:
Swelling can be seen:
- The ears are in front.
- Under the chin.
- Inside the mouth.
If skin is affected:
- Red, pink, or purple spots on the skin.
- Skin lumps.
If the thyroid gland is affected:
- Symptoms of hypothyroidism: These include extreme fatigue, dry skin, unexplained weight gain, or increased sensitivity to cold.
- A lump in the front of the neck.
What causes MALT Lymphoma?
There are several main causes of this disease, including bacterial or viral infections and autoimmune disorders .
- Bacteria and viruses:
- Long-term infection with the bacteria `H. pylori` is the main cause of gastric MALT lymphoma. `H. pylori` is a bacterium that causes gastritis and ulcers in the stomach.
- Other bacteria, such as `Achromobacter xylosoxidans`, `Campylobacter jejuni`, `Borrelia burgdorferi` and `C. psittiaci`, have also been found to be associated with both types of MALT lymphoma.
- Hepatitis C virus can also be associated with both gastric and non-gastric MALT lymphoma.
- Autoimmune disorders:
- Diseases such as `Hashimoto's disease` (a condition that affects the thyroid gland) and `Sjögren's syndrome` (which causes things like dry eyes and mouth) can cause some non-gastric MALT lymphomas.
What are the risk factors for developing MALT Lymphoma?
If someone in your family has had lymphoma, you may also be at risk of developing MALT lymphoma. However, this is not common for everyone.
How is MALT Lymphoma diagnosed?
Doctors perform several tests to diagnose this disease and see how far it has spread.
Blood tests
Doctors may do blood tests like these:
- `CBC (complete blood count):` looks at the types of cells in the blood.
- `LDH (lactate dehydrogenase): This can be elevated in some cancers.
- `CMP (comprehensive metabolic panel)` (comprehensive metabolic test): Checks the function of organs such as the kidneys and liver.
- Hepatitis C test.
Biopsy
Doctors may perform biopsies like this:
- Bone marrow biopsy: To see if the cancer has spread to the bone marrow.
- Needle biopsy: A small piece of tissue is taken from a suspicious lump and examined.
Sometimes, if gastric MALT lymphoma is suspected, a biopsy can be taken during an upper endoscopy , which involves inserting a small camera through the mouth to examine the stomach.
Imaging tests
These tests help find out where the lymphoma is and how far it has spread (stage):
- `Computed tomography (CT) scans`.
- `Positron emission tomography (PET) scans`.
Laboratory tests
Medical pathologists use tests like these to examine tissue or cancer cells:
- `H. pylori test`: A biopsy sample is taken to check for the presence of this bacteria.
- Flow cytometry: A special test that helps identify the nature of cells.
Determining the stage of cancer (for gastric MALT lymphoma) (Cancer staging)
Doctors use cancer staging methods to plan treatment and predict the expected outcome after treatment. For gastric MALT lymphoma, one of the following methods may be used:
- Stage I: The cancer is only in the inner layer of the stomach.
- Stage II: The cancer has spread to nearby lymph nodes, to distant lymph nodes, or to nearby organs and tissues.
- Stage IV: The cancer has spread to several lymph nodes, the bone marrow, and above and below the diaphragm.
- There is no such thing as Stage III for gastric MALT lymphoma.
How is MALT Lymphoma treated?
Treatment depends on many factors, including the type of MALT lymphoma, its cause, and the stage of the disease. For example, some studies suggest that early-stage gastric MALT lymphoma can be completely cured with antibiotics, especially if it is caused by H. pylori infection.
Treatment options may include:
- `Watchful waiting/active surveillance`: Doctors may recommend this approach for people with early-stage MALT lymphoma who are not showing any symptoms. This means observing the disease without treatment.
- Antibiotics: This treatment kills the bacteria H. pylori, which causes gastric MALT lymphoma. Some studies suggest that killing H. pylori can even cure the disease.
- Radiation therapy: Doctors may use radiation therapy to treat both types of MALT lymphoma.
- Monoclonal antibody therapy: This treatment may help people with gastric MALT lymphoma that does not respond to radiation therapy or those with non-gastric MALT lymphoma.
Can MALT Lymphoma be completely cured?
Yes, as mentioned earlier, early-stage gastric MALT lymphoma, especially that caused by H. pylori, can be cured with antibiotics. In other cases, treatment can put the disease into `remission` , that is, a dormant state. However, it can come back (`recurring`).
What is the prognosis of the disease?
You may be relieved to hear this. People with MALT lymphoma can live for years, even if the disease recurs after treatment. This is because it is a slow-growing type.
What is the survival rate?
According to one study, about 88% of people with MALT lymphoma are still alive five years after diagnosis. But keep in mind that these survival rates are just estimates based on the experiences of others and data collected over time. Your experience may vary. In these cases, your doctor is the best person to give you information.
Can MALT Lymphoma be prevented?
In fact, medical researchers still don't know all the factors that contribute to people developing this disease. One study found that avoiding H. pylori infection can reduce the risk of developing gastric MALT lymphoma .
How do I take care of myself?
Many people need lifelong medical care. This means regular checkups to see if the disease has come back. Typically, you will need tests and scans every three to six months for up to five years. After that, you will need to have checkups once a year.
When should I see the doctor?
People with MALT lymphoma usually see their doctors regularly. However, see your doctor right away if you have:
- If you have MALT Lymphoma and notice new changes (which may be symptoms) in your body.
- If you are undergoing treatment and your symptoms get worse.
- If you are in `remission`, that is, when the disease has improved, you are seeing changes in the way it feels, as if the disease is `recurring`.
What questions should I ask my doctor?
If you have MALT Lymphoma, you may want to ask your doctor these questions:
- What type of MALT lymphoma do I have?
- What is the stage of my disease?
- Do I need treatment?
- If I need treatment, what treatment would you recommend?
- Are there any clinical trials I should consider?
Remember: MALT Lymphoma is a rare type of cancer that affects the lining of our organs and other parts of the body, a type of non-Hodgkin lymphoma. It grows slowly, so it often doesn't cause any major symptoms. Doctors can treat it, and sometimes cure it. But the disease can come back, so more treatment may be needed. If you have this disease, talk to your doctor about what to expect.
Finally, take-home message
Okay, let me simply tell you a few things you need to remember from what we've talked about:
- MALT Lymphoma is a slow-growing type of cancer. Don't be afraid, but be vigilant.
- There are two types: gastric (in the stomach) and non-gastric (in other places).
- The bacteria `H. pylori` is a major cause of gastritis.
- Symptoms depend on where the lymphoma is located, and there may be no signs at first.
- There are treatments, and sometimes it can be completely cured, especially in the early stages of gastric cancer.
- The disease can recur after going into remission, so you should continue to be under medical supervision.
- If you have any doubts or questions, don't be afraid to talk to your doctor. That's the best thing to do.
I hope this information is useful to you. Stay healthy!
` MALT lymphoma, non-Hodgkin lymphoma, cancer, gastric MALT lymphoma, H. pylori, lymphoma symptoms, lymphoma treatment
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