People with lymphoma have swollen lymph nodes (glands). Lymphoma is cancer that starts in disease-fighting white blood cells called lymphocytes. These cells have DNA changes that make them grow and spread instead of dying.
Doctors divide lymphomas into stages based on how fast they grow and how much they spread. They also use the stage to help plan treatment.
Symptoms
Many lymphoma symptoms are similar to those of other, less serious diseases. A swollen lymph node, for example, can be caused by infection or the flu. But if a person’s swollen lymph nodes don’t go away and other symptoms occur, it’s important to see a doctor.
The doctor will do a general examination, checking for swelling in the lymph nodes in the neck, armpits and groin. If a doctor suspects lymphoma, further testing is needed. This may include a gallium scan, in which a small amount of the radioactive substance gallium is injected and then used to outline organs on a scan; it can identify inflammation and tumors. A biopsy can also be used to check for lymphoma. During this test, the doctor will remove a part or all of a lymph node and send it to a laboratory to be examined under a microscope for cancer cells. The doctor might also use a needle to take a sample of bone marrow, the spongy center inside bones where blood is made, and look for lymphoma cells.
If lymphoma isn’t treated, it can progress to more serious forms. Some types of lymphoma are slow-growing, or indolent. These kinds of lymphomas, which are more common in older people, don’t spread as quickly and don’t cause symptoms as rapidly as aggressive or high-grade lymphomas.
Some types of lymphoma can affect the spleen and liver, causing enlarged organs. In addition, some forms of lymphoma can affect the nerves and cause pain, tingling and weakness in the arms and legs. Lymphoma can also spread to other parts of the body through the lymphatic system.
There are several risk factors for developing lymphoma, including infection with certain viruses such as HIV and Epstein-Barr virus (EBV) in people whose immune systems are weakened; occupational exposure to chemicals such as insecticides, herbicides or radiation; and a family history of Hodgkin or non-Hodgkin lymphoma. It’s also more likely to develop in people who are overweight.
If a patient has a slow-growing lymphoma, they might not need treatment straight away. They may be placed on watch and wait, in which case the doctor will check the patient regularly to make sure the lymphoma isn’t growing. Other patients will be given treatment right away.
Diagnosis
When a person has symptoms of lymphoma, their doctor will order tests to check for the disease and see how far it has spread. These tests include physical exams, blood tests and imaging studies. The type of lymphoma the patient has determines their treatment plan.
A doctor can usually tell if a person has Hodgkin or non-Hodgkin lymphoma from the results of a physical exam and their family medical history. The doctor will check for swollen lymph nodes in the neck, armpits and groin, as well as a swollen spleen or liver.
In some cases, the doctor will recommend a biopsy of a swollen lymph node or lump. The tissue sample will be examined under a microscope to look for cancer cells. The doctor may also ask for a blood sample to check the number of certain types of cells in the body, and a urine test to measure the amount of protein in the blood.
Some people with slow-growing lymphoma don’t need treatment straight away, and may never need it. This is called watch and wait, and is possible if the cancer is in a slow-growing part of the body and hasn’t spread to other organs.
If the lymphoma is in a faster-growing part of the body, the doctor will probably advise starting treatment as soon as possible. The doctor will explain the options for treatment and discuss whether the person is fit enough to have the treatments.
The doctor will also do a CT or PET scan to help find out if the lymphoma has spread to other parts of the body. The results from the imaging tests will give the doctor more information about which type of treatment is best for the person.
If the lymphoma has spread, the doctor may also recommend a lumbar puncture (spinal tap) to remove fluid from the spinal cord with a needle. This test allows the doctor to look for the presence of cancer cells in the fluid that surrounds the brain and spinal cord. The doctor may also remove a sample of the bone marrow for further testing.
Treatment
There are different treatments for lymphoma, depending on the type and stage of the cancer. Your treatment plan may include medication, radiation or surgery. You may also get biological therapy, which uses your body’s own immune system to fight the cancer. Your team might also suggest a bone marrow transplant. Some types of lymphoma are indolent, or slow-growing. If yours is, your doctors might recommend watchful waiting instead of treatment right away. This means you will have regular checkups and will be treated if your symptoms get worse or the lymphoma spreads.
Your doctor will use your results from the blood tests and imaging exams to create a treatment plan. Your treatment might include chemotherapy, which is a group of drugs that kills cancer cells. The medicines are usually given through a vein (intravenously), but sometimes they are taken by mouth. You may be given this medication in combination with radiation or another drug. You can receive these treatments in a hospital or at home, with your own healthcare team.
You might have a hematologist, who is a doctor that specializes in blood diseases. You might also have a medical oncologist, who focuses on treating cancer with medications. Your team might also have a radiology oncologist, who focuses on using radiation to treat cancer. You might also have a pathologist, who studies the structure of the tissues and organs to identify disease.
Some forms of lymphoma are more likely to happen because of certain factors. These might include autoimmune conditions, such as rheumatoid arthritis and celiac disease. Other risk factors might include age, sex and having certain infections.
Having lymphoma can be very stressful. You might find that doing things you enjoy, or talking with friends and family, helps to ease your stress. You can also try relaxation techniques, exercise or taking time to yourself. You might also want to ask for help from a support network, such as other people who have lymphoma or their families. You can learn more about support groups at the National Cancer Institute’s website. You can also look for a local cancer support group in your area.
Prognosis
The outlook (prognosis) for lymphoma cancer varies depending on the type and stage of the disease. The type of Hodgkin or non-Hodgkin lymphoma, a person’s age and general health, and how the lymphoma responds to treatment all affect the prognosis.
Doctors use a system called the International Prognostic Index (IPI) to help them decide on a treatment plan. This system assigns a number to each factor and gives a score that predicts the chance of recovery from lymphoma.
People with indolent lymphoma, or cancer that grows slowly and stays confined to one area, may not need immediate treatment. The doctor may recommend watchful waiting instead, or the person might have chemotherapy to kill any remaining cancer cells. This can ease symptoms and improve the chances that any future cancers will be curable.
Most people with lymphoma have a combination of different types and stages of disease, and survival rates vary from person to person. The numbers you see in the news are based on large groups of people and don’t tell you what might happen to you. Your own prognosis depends on your specific type and stage of lymphoma, as well as your general health, your response to treatment, and the risk factors for blood cancer that you have.
Leukemia and lymphoma are different cancers, but they share some symptoms like fever, night sweats, and itchy skin. Both are caused by abnormal DNA changes in white blood cells that develop into cancer cells and spread to other tissues. The causes of these DNA changes aren’t always known, but they might be related to immune system disorders and certain medications.
Lymphoma is most common in older adults, but it can occur at any age. Some types are more likely to happen in men than in women, but others are more common in either gender. People with immune system problems or who take immunosuppressive drugs are at increased risk for developing lymphoma. This includes people with HIV or AIDS, and those who have had radiation therapy or chemotherapy for another illness. The risk of lymphoma increases with each additional year that a person is alive.
