Lymphoma is cancer that starts in cells of the immune system. It can be hard to hear your doctor say you have lymphoma. But there are things you can do to get the support you need.
Some lymphomas grow slowly and don’t cause any symptoms. Other types can be more serious. People who have a weak immune system might be at higher risk.
Symptoms
Lymphoma starts in the body’s lymph system, which protects against infections and some diseases and helps fluid move through the body. It includes bean-sized collections of lymph nodes throughout the body and an organ called the spleen. Lymph nodes and the spleen make and store lymphocytes, other immune system cells, and blood.
Lymphoma symptoms vary from person to person and depend on where the cancer is in the body. Some people have no symptoms at all. Others may have swollen glands in the neck, armpit or groin. The swollen glands feel firm and full of fluid, similar to enlarged tonsils in children. These swollen glands can grow and cause lumps under the skin. If the swollen glands are in the chest, they can press on the windpipe and cause coughing or a feeling of pressure in the throat. Lymphoma in the gastrointestinal tract can cause stomach pain and loss of appetite. If the cancer is in the spleen or liver, it can lead to abdominal pain and swelling.
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If a doctor thinks you have lymphoma, they’ll do tests to check for it. These include a physical exam, a sample of the fluid in your spleen or liver (an MRI scan), and a test to see if the bone marrow has normal lymphocytes mixed with abnormal RS cells.
Your doctor will also do a biopsy of an enlarged lymph node to find out if you have lymphoma and what type you have. A biopsy involves removing some of the swollen lymph node and having a specialist called a hematopathologist examine it under a microscope to look for lymphoma cells.
Some types of lymphoma are low-grade and grow slowly, so they can be hard to diagnose. If your lymphoma is high-grade, it grows faster and you’re more likely to have symptoms.
The risk of developing lymphoma varies by age, race and family history. People who have had certain viral infections like the Epstein-Barr virus or HIV are at increased risk. Certain chemicals or radiation exposure may increase your risk of getting lymphoma as well.
Diagnosis
Symptoms of lymphoma vary depending on the type and stage of the cancer. To diagnose it, your doctor will ask about your symptoms and health history. Then they will do a physical examination, including checking your groin, armpits and neck for any swelling. You will also have a blood test to measure how well your white blood cells are working. These blood tests can be used to check for certain types of lymphoma or to see how well treatment is working.
If your doctor thinks you might have a lymphoma, they may do a biopsy of a swollen gland or other affected area. A biopsy is when a tiny bit of tissue is removed for testing in the laboratory. A specialist called a hematologist will look at these cells to see if they are cancerous and what type of lymphoma you have. Your doctor might also do a bone marrow biopsy. This is when a special needle is inserted into your hip bone to take a sample of the blood-forming cells inside your bones. This can be done with a CT or ultrasound scan to guide the needle.
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Another way to diagnosis lymphoma is to do a PET scan. This uses a small amount of a radioactive drug to show up areas of your body that are growing more quickly than normal. This can help your doctor tell if a swollen lymph node is cancerous or if it’s scar tissue from an old injury. A PET scan can be done with a CT or MRI scan to get more detailed pictures of the lymph nodes and other parts of your body.
Your doctor might also do a lumbar puncture (spinal tap). This involves inserting a long needle into the lower back where spinal fluid is stored. This can be done under local anaesthetic in hospital. This fluid can be tested to find out if you have lymphoma or other conditions such as infectious mononucleosis (also known as EBV-associated B cell lymphoma).
You might also have a genetic test if your doctor suspects you might have lymphoma. This involves looking at a sample of DNA from your cells to check for changes that might be caused by the cancer. Your doctor might use fluorescence in situ hybridization or polymerase chain reaction to do this.
Treatment
Depending on the type of lymphoma, your doctor may recommend radiation therapy or chemotherapy. They might also try biological therapy, which uses natural or man-made substances to boost your body’s own immune system to fight the cancer. Some of these include interferon, antibodies (such as rituximab and obinutuzumab), or drugs that target specific parts of cancer cells. Your team will talk to you about your treatment options including their likely outcomes and side effects.
Lymphoma develops when healthy lymphocytes in the body change and grow out of control. These cancerous cells form tumors and can spread throughout the lymphatic system, which includes lymph nodes in the abdomen, groin, pelvis, chest, armpits, neck, and thymus. It can also affect the bone marrow, liver, and other organs in the body.
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The changes in DNA in the cell give different instructions, which allow diseased cells to keep growing and multiplying long after healthy cells would die. This causes the lymph nodes, spleen, and liver to swell. Other factors, such as a weakened immune system, can increase the risk of lymphoma. People who take medicines to suppress the immune system, such as after an organ transplant or due to hepatitis B or HIV infection, may be at higher risk of developing lymphoma.
A hematologist will perform tests to diagnose lymphoma. These can include blood tests that check your overall health and measure chemicals that show how well your liver and kidneys are working. They might also order a biopsy to get a sample of the cancerous cells. This can be done by removing a small piece or an entire enlarged lymph node and sending it to a laboratory for testing. A specialist called a hematopathologist will examine the cells to see if they are lymphoma cells and what kind of lymphoma it is.
Your Winship team will also recommend imaging tests to evaluate the extent of the lymphoma. CT and MRI scans can provide information about the size of the tumor, whether it has spread, and how fast it is growing. A PET scan combines a small amount of radioactive material with CT or MRI to detect cancerous cells in the lymph node and other parts of the body.
Prevention
There is no way to prevent some types of Lymphoma. However, you can help lower your risk by avoiding certain infections and conditions that may lead to them. You can also ask your doctor about getting regular checkups, which may catch the disease in its earliest stages.
Most lymphomas start in the lymphatic system, a network of lymph nodes in your armpits, neck and groin that remove excess fluid from the body and produce immune cells to fight infection. In lymphoma, white blood cells called lymphocytes grow out of control and collect in the glands, forming cancerous tumours that impair your immune system.
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Some types of lymphoma are easier to treat than others, and your chances of survival will depend on the type you have, how far it has spread and your general health. You might be able to get treatment in the form of drugs that kill or slow the growth of the lymphoma, or radiation therapy that destroys or damages lymphatic tissue. Surgical removal of the affected lymph nodes, bone marrow or organs is also possible for some forms of lymphoma.
People who have a family history of the disease, especially non-Hodgkin lymphoma, are at higher risk for developing it themselves. Some infections like Epstein-Barr virus, hepatitis C or Helicobacter pylori increase the risk, as do some chemicals and radiation. Immunodeficiency — a weak immune system, which could be caused by HIV or the use of immunosuppressive drugs after an organ transplant — also increases your risk. Autoimmune diseases such as rheumatoid arthritis or celiac disease can also trigger the condition.
A healthy diet can help reduce the risk of certain lymphomas. A diet low in fat and rich in fruits, vegetables, whole grains and fish can help maintain a balanced weight and support your immune system. It is important to avoid foods high in saturated and trans fats and to limit salt intake. You should also drink plenty of water and reduce your consumption of alcohol, caffeinated drinks and diet soda. You may want to talk with your doctor about taking vitamin D and omega-3 fatty acid supplements.
