What Is Lymphoma

Overview

Lymphoma is a type of blood cancer that compromises the immune system. The immune system's essential lymphocytes are the only cells that it directly impacts. Another name for lymphoma is lymphatic cancer or cancer of the lymphatic system.

The two most common types of lymphoma are Hodgkin and non-Hodgkin. Each type affects your lymphocytes.¹

 Non-Hodgkin's lymphoma 

• Is the cause of over 90% of lymphomas.
• Although it can also happen in the liver, spleen, stomach, or bones, it typically occurs in a lymph node. There are more than 60 subtypes of non-Hodgkin lymphoma, each with a different growth and spread rate and symptom severity.
• T-cell lymphomas and B-cell lymphomas, which together make up around 80% of all lymphomas, can be classified as non-Hodgkin lymphomas.

Hodgkin lymphoma

• Hodgkin disease is an alternative name.
• The two subtypes of Hodgkin lymphoma are nodular lymphocyte-predominant and classical Hodgkin lymphoma, which account for 95% of cases.

Lymphoma is the sixth most common kind of cancer overall (excluding non-melanoma skin cancer).

At the age of 85, one in 39 persons will be told they have non-Hodgkin lymphoma. By the time they are 85 years old, one in 414 people will be told they have Hodgkin lymphoma.²

Causes of lymphoma

The exact cause of lymphoma is unknown. Yet, it starts when a genetic mutation occurs in a lymphocyte, a type of white blood cell that fights infection. The mutation instructs the cell to divide quickly, producing lots of sick lymphocytes that keep reproducing.

Moreover, the cells can continue to exist while other normal cells would have died due to the mutation. This causes the lymph nodes, spleen, and liver to enlarge, as well as an excessive number of sick and inefficient lymphocytes to accumulate in the lymph nodes.³

Signs and symptoms of lymphoma

Several lymphoma symptoms resemble those of other diseases. Even if you experience these symptoms, you may not have lymphoma. But if your symptoms persist for more than a week, you should consult your doctor. Some signs of lymphoma include:

• One or more lymph nodes in your neck, armpits or groin may enlarge painlessly.
• Persistent tiredness
• Unidentified fever
• Drenching night sweats
• Difficulty in respiration
• Abdominal swelling
• Loss of appetite
• Frequent infections
• Bleeding or bruising 
• Unaccounted-for weight loss
• Itchy skin^4,5

Management and treatment for lymphoma

The type of lymphoma, the stage of the disease (i.e., how widely it has spread throughout the body), and the likelihood of growth rate all influence the course of treatment.

Staging

A CT scan of the abdomen and a bone marrow sample are used to determine the cancer's extent. If one is available, a PET scan can give further details regarding distant spread, especially to the bones. A PET scan may be a more accurate staging test than a CT scan because it detects lymph glands that are metabolically abnormally active but may not yet be swollen. CT scans show larger lymph nodes.

Treatment options

Chemotherapy, radiation therapy, and monoclonal antibodies are available as treatment options. Surgery, which is effective in removing early-stage bowel, breast, and other malignancies, is ineffective in treating lymphoma. In some instances, if the lymphoma has returned or there is a significant risk that it will do so in the future, a stem cell transplant with intense chemotherapy immediately before it may be necessary.

Radiation treatment combined with chemotherapy is used to treat early Hodgkin's disease. For large or unresponsive locations, radiation therapy can be necessary.

Non-Hodgkin lymphoma patients may benefit from localised radiotherapy alone or from radiation therapy along with combination chemotherapy.

In order to successfully treat non-Hodgkin lymphoma that is rapidly progressing or "aggressive," chemotherapy must typically be started right away. In most cases, "involved field radiation," which exclusively targets the affected site, is needed for early-stage disease and advanced stages with bulky locations.

Palliative care

Your medical team may discuss palliative care with you if you have lymphoma in some instances. Without trying to treat cancer, palliative care attempts to enhance your quality of life by easing its symptoms.

Pain relief and symptom management are two additional benefits of palliative care in addition to reducing lymphoma's progression. Chemotherapy, radiation therapy, and other pharmacological therapies are all possible forms of treatment.⁵

FAQs

How is lymphoma diagnosed

Physical examination: Your doctor will check for swelling in your spleen, liver, lymph nodes in your neck, underarms, and groin.

Removing a lymph node for testing: Your doctor may advise doing a lymph node biopsy in order to remove all or part of a lymph node for laboratory testing. Complex assays can identify the presence of lymphoma cells and the types of cells involved.

Blood tests: Blood tests that measure the number of cells in a sample of your blood can help your doctor better determine the diagnosis of your ailment.

Taking a bone marrow sample for analysis: During a bone marrow aspiration and biopsy process, a needle is injected into your hip bone to take a sample of your bone marrow. To search for lymphoma cells, it is analysed.

Imaging tests: Your doctor can advise imaging studies to look for lymphoma signs in other areas of your body. A few possible tests are positron emission tomography (PET), CT, and MRI.

How can I prevent lymphoma?

Lymphoma risk factors are still being discovered by researchers. There is evidence to suggest that a person's risk of having lymphoma is increased by particular viruses and family medical history. If you believe that your personal or family medical history may raise your chance of developing lymphoma, speak with your healthcare professional.⁴

Who are at risk of lymphoma

Each form of lymphoma affects a particular population:

Non-Hodgkin lymphoma is more prevalent in men than in women in late adulthood (ages 60 to 80).

Hodgkin lymphoma is more prevalent in early adulthood (age 20 to 39) and late adulthood (age 65 and older). When it comes to adult Hodgkin's lymphoma, men are slightly more likely than women to get it.⁴

How common is lymphoma

The most prevalent of the three lymphoma varieties in adults is non-Hodgkin lymphoma. Non-Hodgkin lymphoma affects 20 out of every 100,000 people annually, while adult Hodgkin lymphoma affects 3 out of every 100,000 people.⁴

When should I see a doctor?

If you are concerned about any persistent signs or symptoms, schedule a visit with your doctor.³

The staging and prognosis of lymphoma

Staging

The tests used to identify lymphoma assist your doctor in determining how widely the cancer has spread. Staging is what this is, and it assists your medical team in recommending the best course of action for you.

Stage 1 lymphoma

Only one lymph node area or one organ outside of the lymph nodes has cancer.

Stage 2 lymphoma 

On the same side of the diaphragm, two or more lymph node regions have cancer. Lymph nodes nearby and in one particular area/organ outside the lymph nodes contain cancer. On the same side of the diaphragm, additional lymph node regions may be affected.

Stage 3 lymphoma 

On both sides of the diaphragm, lymph node regions are affected by cancer. It might have spread to the spleen, a region or organ close to the lymph nodes, or even to both.

Stage 4 lymphoma

The cancer  has progressed to more than one area, either inside or outside the lymphatic system. (for example, liver, lung, bone marrow, or bone).

Prognosis

The prognosis refers to the anticipated course of an illness. Although no doctor can accurately anticipate the exact course of an illness, you may want to talk to your doctor about your prognosis. Instead, your doctor can give you a basic idea of how patients with the same type and stage of cancer are expected to survive.

Your doctor will think about the following while formulating a prognosis:

• The  type of lymphoma you have
• The  rate and size of tumour growth
• Additional  variables like age, health, and medical history
• Your doctor will be able to give you the best treatment recommendations with the use of these details⁶

Summary

One of the frequent tumours of our immune system is lymphoma. It accounts for around 5% of all malignancies. Both young and elderly persons may be impacted. Persistent fevers, excruciating night sweats, inadvertent weight loss, and generalised or regional lymphadenopathy are some of the signs of this illness. Since early detection and treatment of lymphomas improve survival rates with the fewest problems, the primary care provider should seek a haematology consultation or opinion as soon as possible if any of these symptoms are noticed.