A type of skin cancer that negatively affects the body’s T cells is called mycosis fungoides. It is also a type of lymphoma that happens when certain white blood cells become cancerous. Most of the time, the primary symptom of this type of cancer is a skin rash. Unfortunately, there is no way to cure this disorder. However, with early diagnosis and proper treatment, people may not experience symptoms for long periods.
In other words, mycosis fungoides is a type of blood cancer that begins to develop in the T cells (a type of lymphocyte). Normally, lymphocytes help the body fight against viruses, bacteria, and other germs. It also belongs to a group of rare blood cancers that cause skin changes (including itchiness, rashes, plaques, or tumors). It is called cutaneous T-cell lymphoma (CTCL).
What Are The Symptoms of Mycosis Fungoides?
This type of blood cancer often appears in several stages of skin changes. While the main symptom is a rash, it may also cause the following. Examples include:
- Premycotic phase – It usually causes a scaly skin rash that appears on sun-exposed parts of the body. For example, the lower abdomen, thighs, buttocks, and breasts (chest).
- Patch phase – The skin around the rash becomes thin and may also be itchy and dry, similar to eczema symptoms.
- Plaque phase – During this phase, people with mycosis fungoides may experience small and raised bumps on the skin.
- Tumor phase – This is the last phase of this type of cancer, and it causes tumors that penetrate more deeply than plaques. Usually, they appear on the thighs, groin, armpits, and inside the elbow.
In more severe cases, abnormal T cells may enter the bloodstream. In this case, the abnormal cells are known as Sezary cells. As a result, mycosis fungoides may evolve into Sezary syndrome, which may also cause a rash on the body (erythroderma).
Causes
Nowadays, healthcare providers do not fully understand what exactly causes mycosis fungoides. However, they think certain genetic mutations and environmental factors could play a role. For instance, when there are mutations in a specific gene (such as DNA or chromosomes), it begins to give cells different instructions, which causes them to grow and multiply abnormally. When the abnormal cells become too numerous, they form a mass called a tumor. Most people who develop mycosis fungoides have a missing genetic material or errors in the DNA. Moreover, these genetic mutations are not inherited. It means they do not pass from the biological parents to their biological children during conception. In addition, experts continue to study possible causes of mycosis fungoides, including exposure to certain environmental toxins and infections.
In addition, there are some factors that could make you more prone to mycosis fungoides. These include:
- Age – While it may happen at any age, it often affects adults over 50.
- Sex and race – Males and Black individuals are more likely to develop this type of blood cancer compared to females or other races.
- Environmental and occupational exposure – These include prolonged exposure to pesticides, detergents, aromatic halogenated hydrocarbons, and chemicals (such as those used in farming, painting, or textile work).
- Chronic infections – For example, bacterial skin infections (including those caused by Staphylococcus aureus), viral infections (Epstein-Barr virus), and others.
- Weakened immune system
- A medical history of long-term (chronic) eczema or other inflammatory skin disorders.
There are other factors that could worsen mycosis fungoides. For example, LCT (large cell transformation), high eosinophil count, and abnormal blood flow cytometry.
What Are The Potential Complications of Mycosis Fungoides?
People who ignore the symptoms and do not get treatment may also experience the following complications. Check some of them below:
- Chronic itching
- Sleep disturbances (insomnia)
- Mental health problems (including depression and anxiety)
- Ulcerated tumors
- Sezary syndrome
- Spread of the cancer – This type of blood cancer can spread to the following internal organs in more advanced stages. These include the spleen, liver, lungs, and gastrointestinal tract.
- Alopecia
- Weight loss
This article does not contain a full list of mycosis fungoides complications. However, you can talk with your doctor about ways to manage or even prevent them. Additionally, it is not possible to prevent mycosis fungoides because physicians still do not know the exact cause. However, if you notice changes in existing moles or nodules, visit a dermatologist. This can help identify mycosis fungoides in the early stages.
Diagnosis
In most cases, it is difficult to diagnose mycosis fungoides because it causes symptoms similar to those of other skin disorders. That’s why it is often mistaken for eczema or psoriasis. Doctors often begin the diagnosis with a physical examination to check for irregularities linked to the disease. They may also ask some questions about your medical history and symptoms to get more clues about your disorder. To confirm or exclude mycosis fungoides, doctors often perform the following tests. For example:
- Skin or lymph node biopsy – During this procedure, physicians will remove a small sample of the affected skin or lymph node for testing. They will check for cancerous cells.
- Blood tests – Physicians usually perform these tests to check for changes in the blood cells and chemical markers.
- Imaging tests – The following tests are used to get detailed images of different parts of the body. They often perform CT (computed tomography) scans, PET (positron emission tomography) scans, and others.
Furthermore, doctors may perform additional tests to determine the stage (extent) of the cancer. Commonly, physicians also consider the following factors. Examples include:
- The number and size of skin lesions
- Whether the cancer has spread to the lymph nodes, bloodstream, or other organs
Treatment
The treatment is often different for people with mycosis fungoides. It often depends on the severity of the cancer, overall health, your response to treatment, age, gender, and preferences. Check some common options used to treat mycosis fungoides below:
- Skin-directed therapy – This option involves topical gels, steroids, retinoids, or ultraviolet (UV) light that is delivered or applied directly to the skin to destroy cancerous cells. Sometimes, physicians may also prescribe topical chemotherapy drugs (such as Mechlorethamine).
- Systemic therapy – This treatment includes medicines (including Bexarotene or Methotrexate). In more advanced cases, physicians may also prescribe interferon alfa and histone deacetylase (HDAC) inhibitors, or intravenous (IV) chemotherapy.
- Immunotherapy – When the previous options do not work, physicians may recommend this treatment to boost your immune system to find and destroy cancerous cells.
- Monoclonal antibodies (such as targeted therapy) – This therapy also involves medicines that find and destroy a protein in the cancerous cells, causing them to die. For example, Mogamulizumab-kpkc and Brentuximab vedotin.
- Radiation therapy – This option uses powerful energy beams to destroy cancerous cells. While this energy often comes from protons or X-rays, it may also come from other sources.
However, chemotherapy drugs are rarely used to treat mycosis fungoides.
Frequently Asked Questions
Can mycosis fungoides be cured?
Unfortunately, there is no sure way to cure this type of blood cancer. That’s why the treatment goal is to relieve the symptoms, prevent life-threatening complications, and improve your quality of life.
What is the life expectancy of someone with mycosis fungoides?
If this type of blood cancer is found in the early stages, the 10-year survival rate is about 95%. However, in more advanced stages, people often live 3-5 years after diagnosis.
What triggers mycosis fungoides?
While physicians do not know the exact cause of mycosis fungoides, they have identified some common changes in specific chromosomes (including missing genetic material or genetic material with errors) in people with this type of cancer. If you have any other questions, ask your healthcare provider.
