Doctors and patients join hands to fight this indolent cancer: Ruijin opens the first follicular lymphoma specialty clinic, wait and watch
This was the day Aunt Wang stepped into the door of Ruijin Hospital again after many days.
The familiar medical staff in the hematology department nodded to her, like old friends they had known for a long time. She was diagnosed with non-Hodgkin's follicular lymphoma many years ago. After systematic and long-term treatment, she has now returned to a normal and happy life. Not only herself, but also her relatives and friends often call her "Miracle".
"I know there is an excellent team and rich experience here, so I have always been full of confidence in curing the disease." Aunt Wang said with a smile. Although various indicators have long since become normal, she still needs to go to the specialized disease clinic of Ruijin Hospital. See a doctor, or have regular follow-up visits with a follow-up doctor to ensure that there is no recurrence of the disease and that everything is stable.
However, this time, she walked into a specialized clinic - after the National Day holiday, Shanghai's first follicular lymphoma specialized clinic was officially opened at Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. In just one week, 15 patients have received targeted follow-up management here. "From the volunteer team composed of patients to the specialized outpatient clinics, we have experienced the support and warmth in the fight against the disease."
With the development of society as a whole, especially aging, viral infections and many environmental factors, the incidence of lymphoma is increasing, and it has now become one of the top ten most common tumors in the world.
Follicular lymphoma is an indolent lymphoma. "Lymphoma is divided into two types: aggressive and indolent. Indolent, as the name suggests, grows very slowly, and follicular lymphoma accounts for 70% of them." Wang Li, chief physician of the Hematology Department of Ruijin Hospital, said that some patients may have lymph nodes in their lymph nodes when they first develop the disease. There are many, and the stage has reached stage 3 or 4, but overall, the tumors at each site are small, even less than 1 cm. In this case, follow-up observation and clinical observation are the main ones, and other tumors Treatment will only be initiated when certain indications are reached.
"Take indolent lymphoma as an example, represented by follicular lymphoma. In the past, the incidence rate in China or Asia was relatively low, but in recent years there has been a significant increase trend." Zhao Weili, deputy director of Ruijin Hospital, said that according to the latest statistics, my country Nearly 100,000 new lymphoma patients are diagnosed every year. Compared with the treatment of some highly malignant and aggressive lymphomas, follicular lymphoma has some special characteristics. "Patients with indolent lymphoma do not need treatment at one stage, which is its advantage; but the disadvantage is that patients need to follow very professional Doctors engaged in diagnosis and treatment of lymphoma will conduct regular follow-up visits.”
She talked about the original intention of opening this clinic, “As the number of confirmed patients and patients on observation and waiting continues to increase, as well as the number of patients in the maintenance treatment stage using targeted drugs continues to accumulate, examinations are required every 3 months in the first year. Examinations are required every six months for two years, and regular examinations are required from the third year onwards. It is very important for doctors to understand the development of the disease. "Because of this, under the condition of shortage of manpower and space, the Hematology Department of Ruijin Hospital has prioritized the opening of filtration. Specialized clinics for patients with lymphoma lymphoma tell patients how to observe and wait, help patients to be hospitalized or enter day wards for treatment in a timely manner, and follow up to observe whether the condition is stable. While providing full-cycle, standardized, normative, and high-quality diagnosis, treatment, and follow-up, they also Provide doctors and patients with more convenient and sufficient communication opportunities.
"As current diagnosis and treatment become more and more standardized, many patients have access to international guidelines, domestic guidelines and popular science and public welfare activities on their own, so patients have some understanding of the standardized treatment of lymphoma." Wang Li said that currently, in the treatment of filtration For patients with alveolar lymphoma, Ruijin Hospital adopts internationally accepted treatment principles. For example, early-stage patients are controlled by local radiotherapy; late-stage patients are judged by tumor burden to determine whether they need chemotherapy or follow-up.
“With the joint efforts of colleagues from the National Center for Translational Medicine, National Key Laboratories, Ruijin Hospital and other medical institutions, we hope that lymphoma will eventually become a disease that can be treated with targeted drugs based on the pathogenesis and under the guidance of a precise molecular classification system. " Zhao Weili introduced that taking follicular lymphoma as an example, initial treatment is no longer just based on clinical indicators and imaging reports. Molecular biological testing will be performed on newly diagnosed patients to clearly understand the stage of the disease, thereby reducing the patient's risk. Anxiety.
"On the other hand, our treatment is also developing in the direction of 'no chemotherapy'." In the past, chemotherapy regimens similar to those for acute lymphoma caused many patients to face life discomforts such as hair loss and loss of appetite. For patients in front-line jobs, "In recent years, with the introduction of innovative drugs such as original bendamustine and octuzumab, the complications of chemotherapy have become smaller and smaller. Many patients no longer suffer from hair loss and do not need PICC placement." No matter what, you can still go to work if your condition allows," Zhao Weili said. Patients like Aunt Wang who have completed their treatment can follow up by appointment, and the time flexibility is even greater.
"In the past, we encountered various types of patients at the joint lymphoma medical and nursing clinic. After setting up a dedicated follicular lymphoma clinic, the waiting time for patients can be greatly shortened." He Yang, nursing supervisor of Ruijin Hospital, said that in addition to Understand their confusion, needs, mood, etc., such as medication guidance after returning home, home exercise and rehabilitation guidance, etc. Nurses can provide reminders and attention during the outpatient period, ultimately helping patients enhance their confidence to overcome the disease and learn self-management.
Zhao Weili revealed that in addition to the follicular lymphoma-specific outpatient clinic, the hematology department also opened specialized outpatient clinics such as hematopoietic stem cell transplantation, autologous transplantation, and allogeneic transplantation to facilitate the maintenance and follow-up of patients after transplantation. "Starting from follicular lymphoma, we hope to explore new ways. This is also the concept of treating blood diseases: first, it must be more humane, second, it must be more precise, and third, it must be more convenient."
