LINFOMAS: EL 60% DE LOS DIAGNOSTICADOS DEJARON PASAR 6 MESES ANTES DE CONSULTAR AL MÉDICO
Al ser una enfermedad que no tiene un factor desencadenante y para muchos tipos no poseer carga hereditaria, aconsejan atender y consultar ante síntomas como ganglios aumentados de tamaño que no duelen y que no están por una infección, sudoración nocturna, picazón persistente en todo el cuerpo, fiebre o febrículas, pérdida peso sin razón, escalofríos o tos o disnea al acostarse.
Seis de cada diez personas diagnosticadas con linfoma en la Argentina tardaron seis meses en concurrir al médico después del primer síntoma y un porcentaje aún mayor, 75%, desconocía completamente los signos de este cáncer del sistema linfático con un alto porcentaje de curación asociado a la detección precoz, cuyo Día Mundial se conmemora este jueves.
Los datos surgen de la sección argentina de una encuesta global realizada en 2018 por la Coalición Linfoma, que en el país se realizó en alianza con la Asociación Civil Linfomas de Argentina (ACLA).
«A diferencia de otras enfermedades oncológicas, como por ejemplo el cáncer de pulmón que se relaciona al hábito de fumar, en la mayoría de los linfomas no hay un factor desencadenante que uno pueda prevenir», explicó a Télam el jefe del Servicio de Hematología del Hospital Británico y expresidente de la Sociedad Argentina de Hematología (SAH), Germán Stemmelim.
Y por otro lado, «para la inmensa mayoría de los linfomas no hay una carga hereditaria, al punto que no tiene sentido estudiar a los familiares de un paciente para prevenir un linfoma» como sí ocurre con el cáncer de mama o de colon, dos tipos de tumores para los que sí cuentan este tipo de antecedentes.
Por eso, al diagnóstico se llega fundamentalmente prestando atención a los síntomas que no son exclusivos de esta enfermedad con 84 subtipos de linfomas que se pueden subdividir en dos grandes grupos: linfoma Hodgkin y linfoma no Hodgkin.
Y la detección precoz es fundamental porque, cuando va de la mano de un tratamiento adecuado, «la curación se alcanza en porcentaje superior al 80%» en el caso del linfoma de Hodgkin, mientras que entre los linfoma no Hodgkin este pronóstico varía con los más de 30 subtipos, pero «las más frecuentes como el linfoma difuso de células grandes B se curan en un porcentaje aproximadamente del 65%», explicó Stemmelim.
El linfoma es un tipo de cáncer del sistema linfático, es decir, de la red de órganos, ganglios, conductos y vasos linfáticos que se encargan de combatir los gérmenes, formando parte de la respuesta inmunitaria del organismo
«Buscamos concientizar a personas que tienen determinados síntomas que son visibles a simple vista pero que muchas veces son desatendidos por confundirlos con otras enfermedades banales como una gripe, aunque esto no quiere decir que todos los linfomas tengan estos síntomas», dijo a Télam la presidenta de ACLA, Haydée González.
De hecho, desde hace varios años la organización viene llevando adelante su campaña «Piedra Libre al Linfoma», con actividades todo el año pero sobre todo en torno al Día Mundial de Concientización que se conmemora cada 15 de septiembre.
«Si te ves ganglios aumentados de tamaño que no duelen y que no están por una infección; si tenés sudoración nocturna, picazón persistente en todo el cuerpo, fiebre o febrículas; si perdés peso sin razón; si sentís escalofríos; si tenés tos o disnea generalmente al acostarte podés (…) consultar con tu médico o médica de siempre (…) Ayúdanos a hacer esta información más conocida y así podamos encontrar al linfoma más rápido», dice el texto principal de la campaña que acompañan famosos que atravesaron la enfermedad.
«Yo nunca tuve ningún contacto cercano con el linfoma, lo estudié como un tema más a diferencia de hipertensión y diabetes, que les presté más atención porque hay antecedentes en la familia», contó a Télam el médico pergaminense Maximilano Morales que en 2011 fue diagnosticado con un linfoma de Hodgkin.
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Autor del libro testimonial «De médico a paciente en un segundo» (2020) y de un video con más de 2,5 millones de visualizaciones que lo muestra en el mismo momento en que estaba siendo trasplantado de médula, Morales admite que aún siendo médico se dejó estar para la primera consulta y fue su novia de entonces, también médica, quien lo empujó a hacerla.
Autor del libro testimonial De mdico a paciente en un segundo 2020 y de un video con ms de 25 millones de visualizaciones que lo muestra en el mismo momento en que estaba siendo trasplantado de mdula
Autor del libro testimonial «De médico a paciente en un segundo» (2020) y de un video con más de 2,5 millones de visualizaciones que lo muestra en el mismo momento en que estaba siendo trasplantado de médula.
«Recuerdo que hice el comentario ‘¡este ganglio de mierda que no se me va más!». Ella enseguida empezó a indagarme y cuando le dije que lo tenía hace tres semanas y no dolía, ella me dijo ‘vos tenés un linfoma’», contó.
Pocos días después, sería uno de sus profesores en la Universidad de Rosario el encargado de realizarle la tomografía que no fue auspiciosa y lo llevó directo a la biopsia que le confirmó el diagnóstico.
A sus 36 años y ejerciendo otra vez como médico, hoy Maximiliano está prácticamente curado luego de seis diferentes tipos de protocolos de quimioterapia, un autotrasplante que no funcionó, y un trasplante de médula ósea que fue exitoso, con su hermana menor como donante.
El linfoma es un tipo de cáncer del sistema linfático, es decir, de la red de órganos, ganglios, conductos y vasos linfáticos que se encargan de combatir los gérmenes, formando parte de la respuesta inmunitaria del organismo.
Integran el sistema linfático el bazo y el timo (órganos); los ganglios linfáticos (como las amígdalas); la médula ósea y las adenoides (tejidos): la mutación de las células que los componen puede conducir a un linfoma.
A nivel mundial, este tipo de cánceres afecta a un millón de personas y en Argentina tiene una prevalencia estimada de 14.613 casos diagnosticados en los últimos 5 años, según datos 2020 del Observatorio Global del Cáncer (Globocan) de la Agencia Internacional de Investigación sobre Cáncer de la OMS.
Se estima que en Argentina se diagnosticaron 4.579 linfomas aquel año y casi 2000 personas murieron por esta enfermedad.
Por otro lado, la incidencia va en aumento a nivel global a razón de un 3% y se dice que cada 90 segundos se produce un nuevo diagnóstico.
De hecho, el linfoma no Hodgkin es el tercer tipo de cáncer con mayor crecimiento después del melanoma y el cáncer de pulmón; mientras que el linfoma Hodgkin constituye hoy la enfermedad oncológica con mayor incidencia en jóvenes y la tercera causa de muerte por cáncer en niños.
Stemmelim explicó que se desconocen los motivos de este crecimiento, aunque «hay algunas causas que son bien conocidas, como contraer determinadas infecciones entre las que se encuentran el VIH y los tratamientos inmunosupresores que se dan en el campo del trasplante», dos condiciones que «están asociadas a un incremento del riesgo de tener un linfoma» porque el debilitamiento del sistema inmunitario «pueden producir secundariamente el desarrollo de un linfoma».
Y pese a tener una incidencia equiparable a la del cáncer cervicouterino (4.583 nuevos diagnósticos al año), es una de las enfermedades oncológicas menos conocidas en todo el mundo.
Más que a la prevención, la búsqueda de Maximiliano Morales en sus posteos virales, conferencias y libros es ayudar a los pacientes ya diagnosticados a atravesar la enfermedad pero también a sus colegas profesionales de la medicina, a humanizar la relación médico-paciente.
«Yo mismo tuve una mala experiencia de acercamiento médico paciente cuando me informaron telefónicamente el resultado de la biopsia con cero tacto y he escuchado muchas historias estos años producto de una formación que relega la parte social, empática, al punto que a veces vos no sabes si estás hablando con un médico o un robot», dijo.
En cuanto a los tratamientos, existen diferentes tipos: quimioterapia, inmunoquimioterapia, anticuerpos monoclonales, radioterapia, la utilización de drogas blanco dirigidas a mecanismos fisiopatológicos de la enfermedad y trasplante de médula ósea.
Stemmelim explicó que «los avances más significativos registrados en los últimos años» en el desarrollo de nuevos tratamientos están vinculados a la «estimulación de la respuesta inmunológica del propio paciente contra el linfoma», como es el caso de la terapia de células T con receptores quiméricos de antígenos (CAR-T) y los anticuerpos monoclonales bioespecíficos (BiTEs).
Fuente: Telam
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