13-year-old Josh Cubbin from Wigan Children with Cancer UK's short films to raise awareness for childhood diseases
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00:00 Lymphoma is a type of blood cancer which develops in the body's lymphatic system or lymph nodes.
00:19 There are two main types of lymphoma. Hodgkin lymphoma, also known as Hodgkin's disease,
00:27 and NHL, short for non-Hodgkin's lymphoma. These are biologically very different tumours
00:35 despite both being lymphomas. NHL, including Burkitt lymphoma, accounts for about half
00:43 of all lymphomas in children, Hodgkin's disease the other half. The incidence of NHL
00:50 increases and peaks in young school-aged children, whereas Hodgkin's disease is most commonly
00:57 seen in teenagers.
01:03 Hodgkin's lymphoma symptoms include a persistent, maybe lasting a few weeks, painless swelling
01:11 of a single lymph gland, usually in the neck, armpit or groin. Cough or breathlessness can
01:20 occur if the glands in the chest are affected. Fever, sweats, particularly at night, itching
01:29 and weight loss. Non-Hodgkin's lymphoma symptoms in children include again painless swelling
01:37 of a single lymph gland, commonly in the neck. Cough or breathlessness can occur if the glands
01:44 in the chest are affected. Stomach pains or stomach swelling if the abdominal lymph glands
01:51 are affected. Fever and night sweats, tiredness, weight loss or feeling full after only a small
02:01 meal.
02:06 The exact diagnosis will be confirmed by removing part or all of an affected lymph gland so
02:14 that the cells can be examined in the laboratory. This is known as a biopsy and is usually carried
02:21 out under general anaesthetic. Further tests such as x-rays, CT and MRI scans and blood
02:27 tests are carried out to determine the exact size and position of the lymphoma and whether
02:34 it has spread. This is known as staging. Hodgkin's lymphoma can be defined in one of several stages,
02:43 numbered 1 to 4. The numbers simply mean the number of parts of the body or lymph nodes
02:51 that have been affected. In addition, there is a letter A or B assigned to the number.
02:59 A means you don't have any of the systemic symptoms such as itching, weight loss etc.
03:07 B means that you do have some of those symptoms.
03:16 The main treatment for lymphoma in children is chemotherapy. Sometimes patients with Hodgkin's
03:22 lymphoma will also require radiotherapy. The type and amount of treatment given depends
03:30 on the stage of the disease at diagnosis and the response to chemotherapy seen on scans.
03:37 Where chemotherapy is used, it usually will be given every few weeks for a number of months.
03:44 Where radiotherapy is used, it is usually given for a few minutes each day over a period
03:50 of a few weeks. Treatment for lymphoma generally lasts for around 6 months.
04:01 Treatment for lymphoma often causes side effects. These will depend on the particular treatment
04:07 being used and the part of the body being treated and may include hair loss, tiredness,
04:16 nausea and vomiting, a reduced resistance to infection, bruising and bleeding and gut
04:24 and nutritional symptoms. A small number of children may develop late side effects, sometimes
04:32 many years later, that are caused by their treatment for lymphoma. The main risks arise
04:40 from the use of radiotherapy which can impair growth and cause infertility. There is also
04:47 a risk of underactive thyroid associated with irradiation to the neck. Both radiotherapy
04:54 and chemotherapy have also been associated with heart and lung complications. There is
05:01 an increased risk of second cancers in those who survive childhood cancer thought to be
05:06 associated with the various treatments used.
05:14 The survival rate for lymphoma is high. Almost all children with this cancer can be cured.
05:22 It is important to note that survival rates vary depending on the stage of the lymphoma.
05:29 Occasionally the cancer can recur. When this happens it is called a relapse. Relapse
05:36 occurs most likely as a result of a few of the original cancer cells surviving the treatment.
05:44 Sometimes this is because cancer cells spread to other parts of the body and were too small
05:50 to be detected during the follow-up immediately after treatment. Treatment of the relapse
05:56 will vary and will be discussed with you as it may differ from the original course of
06:01 treatment.
06:01 [Music]