Saturday, April 27, 2013

Lymphoma

Lymphoma is a type of blood cancer that occurs when B or T lymphocytes, the white blood cells that form a part of the immune system and help protect the body from infection and disease, begin behaving abnormally. Abnormal lymphocytes may divide faster than normal cells or they may live longer than they are supposed to. Lymphoma may develop in many parts of the body, including the lymph nodes, spleen, bone marrow, blood or other organs and eventually they form a mass of cells called a tumor. Tumors grow and invade the space of surrounding tissues and organs, depriving them of oxygen and nutrients.

There are two main types of lymphoma:
  • Non-Hodgkin Lymphoma (NHL): This type of lymphoma is most common in middle aged or elderly people. NHL can occur in lymph nodes and/or other organs that contain lymph tissue. The cancer may be located in one place in your body, but often, it is located in multiple areas throughout the body.This is because cancerous ("malignant") lymphocytes often circulate throughout your body, just like normal lymphocytes. NHL can be either "B-cell lymphoma" or "T-cell lymphoma," depending on which type of lymphocyte becomes cancerous.There are over 40 different types of NHL. Some types of NHL grow very quickly. Other types grow more slowly.
  • Hodgkin Lymphoma (HL): This type of lymphoma is most common in young adults.The cancerous ("malignant") lymph nodes contain a particular type of malignant lymphocyte, which is known as a Reed-Sternberg cell.
Signs and Symptoms
  • Lymphadenopathy or swelling of lymph nodes - It is the primary presentation in lymphoma.
  • B Symptoms - Can be associated with both Hodgkin's lymphoma and non-Hodgkin's lymphoma. It consists of fever, night sweats, weight loss. 
  • Other Symptoms : loss of appetite or anorexia, fatigue, respiratory distress or dyspnoea, itching.
Treatments

Biologic Therapy
This treatment increases your body's natural ability to fight cancer. It does this by giving a boost to your immune system.There are several kinds of biologic therapy:
  • Monoclonal Antibodies: These are drugs like Rituxan®, which directly target lymphoma cells and do not harm normal cells.These drugs are sometimes called "smart drugs" or "guided missiles" because they know exactly where to go in your body.
  • Radioimmunotherapy: These are therapies like Rituxan®, which have a radioisotope attached to them.These "guided missiles" are able to destroy cancer cells because they attach to the lymphoma and deliver small doses of medicine to the cells.
  • Interleukin 2: This is a medicine that activates the immune system so that it can kill cancer cells.
  • Vaccines: These are treatments that help the body protect itself against the lymphoma.
Chemotherapy ("Chemo") This treatment uses drugs to kill cancer cells and reduce the size of cancer tumors. Chemotherapy drugs may also affect healthy cells and cause side effects like hair loss or mouth sores.There are many types of chemotherapy drugs. Many drugs are often used together for chemotherapy.

Radiation Therapy
This treatment uses radiation (high energy x-rays) to kill cancer cells.The treatment often only takes place in the part of your body where the lymphoma is located.

Transplants
Sometimes high doses of chemotherapy destroy the lymphoma cells and your bone marrow, which is the "factory" for blood cells. To help your bone marrow make new healthy blood cells, some stem cells (immature cells that will grow up into red blood cells, white blood cells, and platelets) may be taken with a special machine before chemotherapy is given.
These cells are then transplanted (put back) into the body. These transplanted cells will then find their way to the bone marrow and restore it, so that it can build healthy new blood cells.
There are two types of transplants:
  • Autologous transplants- this uses your own bone marrow or stem cells.
  • Allogeneic transplants- this uses bone marrow or stem cells from a donor (someone else, often a brother or sister).

Watchful Waiting
This means that you do not have to get any active treatment now. But, you may need to get treatments later, if tests show that your cancer is growing. Watchful waiting is usually recommended only for people with slow-growing lymphomas.

Rituximab
Rituximab is a chimeric monoclonal antibody against the protein CD20, which is primarily found on the surface of B cells. Rituximab destroys B cells, and is therefore used to treat diseases which are characterized by excessive numbers of B cells, overactive B cells, or dysfunctional B cells. This includes many lymphomas, leukemias, transplant rejection and autoimmune disorders.

Nutrition and Supplement
  • Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, soy, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
  • Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as kale, spinach, and peppers).
  • Avoid refined foods, such as white breads, pastas, and sugar.
  • Eat cruciferous vegetables (such as broccoli, cabbage, and cauliflower).
  • Use healthy oils in foods, such as olive oil or vegetable oil.
  • Reduce or eliminate trans fatty acids, found in such commercially baked goods as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
  • Avoid coffee and other stimulants, alcohol, and tobacco.
  • Drink 6 - 8 glasses of filtered water daily.
  • Exercise lightly, if possible. 
dad went for a check up at polyclinic on monday morning due to his excessive loss of weight. doctor advised that he has 3 lows - red and white blood cells and platelets, and that his spleen is swollen. he was then referred to tan tock seng hospital and warded that very afternoon. after various scans, blood tests and preliminary bone marrow test, he is diagnosed with lymphoma yesterday. as there are many types of lymphoma and each has different course of treatment, we are waiting for a more detailed bone marrow result before doctor can choose the best treatment for dad.

thank you all who took time off to visit dad at the hospital for the past 5-6 days and earlier this afternoon. all the gifts, advice and help offered are very much appreciated.

hamper from management & staff of tanglin club



cordyceps, strawberries and grapes from boss mary

fruits basket from tanglin club boss



lingzhi and cordyceps from cousin jennifer
did not manage to snap pictures of all the food and fruits that were given but still, thank you all!

countdown to wedding day : 196

Tuesday, April 23, 2013

19 April - Dad's Lunar Birthday

dad's god-daughter bought the cake for him

it took the waitress a while to get this group shot done =P

finally a picture with dear without making faces >.<

mum & dad
dad's birthday dinner with extended family at miao yi vegetarian restaurant. everyone agrees that the food is the best amongst all that we have tried.

countdown to wedding day : 200

Tuesday, April 16, 2013

01 April - 提亲日

dear's parents came to my place with aunt pam to discuss on the details of the wedding - things my parents ask for and things they need to prepare. this session is called 提亲 - request to marry the bride. the main discussion was on 过大礼 (betrothal - formal state of engagement to be married) and everyone agreed for it to be held on the sunday before actual wedding day.

过大礼 - groom's preparation
  1. 22 boxes teo chew biscuits
  2. ang bao in replacement of pig trotters
  3. si dian jin
  4. 2 bottles liquor
  5. dragon phoenix candles 
  6. oranges
过大礼 - bride's preparation
  1. 2 bottles orange juice in return for liquor
  2. dowry consisting of prosperity lamps, descendant set (baby bath tub, mug, potty, tray, basin), tea set, dining set, mug set, sewing kit (needles, thread, measuring tape, scissors), essential items (jewellery box, handkerchief, bath/face towel, bedroom slipper, fan, mirror, comb, wooden clog, ruler, face powder), bedding set
Wedding Banquet
there will be 2 separate banquets for bride and groom families. my parents requested for 3 tables at orchid country club, exclusive of 3 pax of vegetarian (my parents and cousin-in-law) and future parents-in-law requested for 3 tables at 天国.

Actual Day
both sets of parents are not fussy about auspicious timings or to follow strict traditions and hence, we have the privilege of sleeping in a little longer. *beams* dear will be coming to my place to fetch the bride between 0700 - 0730 and targeting to reach his place by 0930. 

it was a pleasant meet-up for both families. as dear's parents were leaving, there was a small commotion along the corridor. they forgot to ask one of the most important detail - pin jin (bride price). i turned and asked my parents who are standing at the door bluntly. totally not surprised by my dad's answer - 随意.

11 April - Dad's Birthday

bought durian cake and mini puffs at four seasons nex for a change as they were having promotion for their puffs. mum seemed to like the cake and mini puffs more than dad. *grins*



countdown to wedding day : 207