Lymphoma is cancer that begins in infection-fighting cells of the immune system, called lymphocytes. These cells are in the lymph nodes, spleen, thymus, bone marrow, and other parts of the body. When you have lymphoma, lymphocytes change and grow out of control.
There are two main types of lymphoma:
•Non-Hodgkin: Most people with lymphoma have this type.
Non-Hodgkin and Hodgkin lymphoma involve different types of lymphocyte cells. Every type of lymphoma grows at a different rate and responds differently to treatment.
Lymphoma is very treatable, and the outlook can vary depending on the type of lymphoma and its stage. Your doctor can help you find the right treatment for your type and stage of the illness
Lymphoma is different from leukemia. Each of these cancers starts in a different type of cell.
•Lymphoma starts in infection-fighting lymphocytes.
•Leukemia starts in blood-forming cells inside bone marrow.
Lymphoma is also not the same as lymphedema, which is a collection of fluid that forms in body tissues when there is damage or blockage to the lymph system.
Scientists don’t know what causes lymphoma in most cases.
You might be more at risk if you:
•Are in your 60s or older for non-Hodgkin lymphoma
•Are between 15 and 40 or older than 55 for Hodgkin lymphoma
•Are male, although certain subtypes may be more common in females
•Have a weak immune system from HIV/AIDS, an organ transplant, or because you were born with an immune disease
•Have an immune system disease such as rheumatoid arthritis, Sjögren’s syndrome, lupus, or celiac disease
•Have been infected with a virus such as Epstein-Barr, hepatitis C, or human T-cell leukemia/lymphoma (HTLV-1)
•Have a close relative who had lymphoma
•Were exposed to benzene or chemicals that kill bugs and weeds
•Were treated for Hodgkin or non-Hodgkin lymphoma in the past
•Were treated for cancer with radiation
Warning signs of lymphoma include:
•Swollen glands (lymph nodes), often in the neck, armpit, or groin that are painless
•Shortness of breath
Many of these symptoms can also be warning signs of other illnesses. See your doctor to find out for sure if you have lymphoma.
Getting a Diagnosis
Before you have any tests, your doctor will want to know:
•How have you been feeling?
•When did you first notice changes?
•Do you have pain? Where?
•How is your appetite?
•Have you lost any weight?
•Do you feel tired or weak?
•What are your current medical problems and treatments?
•What is your past medical history including conditions and treatments?
•What is your family medical history?
Your doctor will do a physical exam, including a check for swollen lymph nodes. This symptom doesn’t mean you have cancer. Most of the time, an infection — unrelated to cancer — causes swollen lymph nodes.
You might get a lymph node biopsy to check for cancer cells. For this test, your doctor will remove all or part of a lymph node, or use a needle to take a small amount of tissue from the affected node.
You might also have one of these tests to help diagnose, stage, or manage lymphoma:
• Bone marrow aspiration or biopsy. Your doctor uses a needle to remove fluid or tissue from your bone marrow — the spongy part inside bone where blood cells are made — to look for lymphoma cells.
• Chest X-ray. It uses radiation in low doses to make images of the inside of your chest.
• MRI. It uses powerful magnets and radio waves to make pictures of organs and structures inside your body.
• PET scan. It uses a radioactive substance to look for cancer cells in your body.
• Molecular test. It looks for changes to genes, proteins, and other substances in cancer cells to help your doctor figure out which type of lymphoma you have.
• Blood tests. These check the number of certain cells, levels of other substances, or evidence of infection in your blood
Questions for Your Doctor
•What type of lymphoma do I have?
•What stage is my lymphoma?
•Have you treated people with this kind of lymphoma before?
•What are my treatment options?
•How will the treatments make me feel?
•What will help me feel better during my treatment?
•Are there any complementary treatments I could consider, along with the usual medical care? Are there any I should avoid?
The treatment you get depends on what type of lymphoma you have and its stage.
The main treatments for non-Hodgkin lymphoma are:
• Chemotherapy, which uses drugs to kill cancer cells
•Radiation therapy, which uses high-energy rays to destroy cancer cells
•Immunotherapy, which uses your body’s immune system to attack cancer cells
•Targeted therapy that targets aspects of lymphoma cells to curb their growth
The main treatments for Hodgkin lymphoma are:
If these treatments don’t work, you might have a stem cell transplant. First you’ll get very high doses of chemotherapy. This treatment kills cancer cells, but it also destroys stem cells in your bone marrow that make new blood cells. After chemotherapy, you will get a transplant of stem cells to replace the ones that were destroyed.
Two types of stem cell transplants can be done:
•An autologous transplant uses your own stem cells.
•An allogeneic transplant uses stem cells taken from a donor.
Taking Care of Yourself
Lymphoma treatment can cause side effects. Talk to your medical team about ways to relieve any symptoms you have.
Also ask your doctor about changes to your diet and exercise that can help you feel better during your treatment. Ask a dietitian for help if you’re not sure what types of food to eat. Exercises like walking or swimming can relieve fatigue and help you feel better during treatments like chemotherapy and radiation. You might also try alternative therapies like relaxation, biofeedback, or guided imagery to help relieve pain.
What to Expect
Treatments have improved a lot, and many people do very well after treatment. Your doctor will talk to you about a survivorship care plan. Your outlook depends on:
•The kind of lymphoma you have
•How far the cancer has spread
•The type of treatment you get
•What other health problems you have.