Lymphoma Cancer: Symptoms, Causes, Risks, Stages, Medications & Treatments
Commonly asked questions about lymphoma cancer:
- What is lymphoma cancer?
- What are the types of lymphoma?
- What are the causes and risk factors of lymphoma?
- What are symptoms of lymphoma?
- What treatments are available for Hodgkin’s Lymphoma?
- What treatments are available for non-Hodgkin’s Lymphoma?
What is Lymphoma Cancer?
Cancer cells can affect nearly any organ of the body, may it be as tiny as an appendix or as large as the lungs.
The human immune system consists of several lymph nodes scattered throughout the body — an extensive network of lymphatic channels that connect and drain these nodes and act as a path for the lymph to flow; discrete patches of lymph tissues present in various organs such as the gut, and an army of several immune cells and antibodies that attack foreign bodies, cancer cells as well as diseased cells.
Lymphoma refers to the cancer of lymphocytes, a special kind of white blood cells that carry out a specific immune reaction.
The lymphocytes are infection-fighting cellular species that are present in abundance in the thymus, spleen, bone and the lymph nodes.
Lymphocytes may be present anywhere in the body and so, cancer may begin in any part.
Lymphoma Cancer Statistics
Approximately 5.3 percent of all cancer cases and nearly 56 percent of all blood cancer cases around the globe are due to lymphoma.
Lymphoma is broken down into two types: Hodgkin’s and Non-Hodgkin’s.
Non-Hodgkin’s Lymphoma is recognized as the No. 1 type of blood cancer and ranks seventh among all the cancer types on a worldwide basis, according to the National Institute of Health. Hodgkin’s ranks 25th overall.
According to the American Cancer Society, Non-Hodgkin’s Lymphoma (NHL) accounts for approximately 4 percent of all cancer cases in the United States. In addition:
- Of the 72,580 diagnosed cases of NHL, approximately 40,170 males were diagnosed in 2016. This estimate includes both children and adults.
- Approximately 8,630 females and 11,520 males are likely to die from complications of NHL, resulting in 20,150 total mortalities.
In 2013, approximately 1,954 cases of Hodgkin’s were diagnosed in the United Kingdom, according to Cancer Research UK. In 2014, Hodgkin’s accounted for approximately 355 deaths in the United Kingdom.
In 2013, approximately 13,413 cases of NHL were diagnosed and approximately 4,801 deaths were linked to NHL in the United Kingdom.
What Are The Types of Lymphoma?
Lymphoma is divided into Hodgkin’s (HL) and Non-Hodgkin’s Lymphoma (NHL). However, there are several subcategories that are grouped along with these conditions, including multiple myeloma and immunoproliferative diseases.
NHL accounts for 90 percent of all lymphoma cases.
Hodgkin’s Lymphoma (HL)
HL has Reed-Sternberg cells, whereas NHL does not.
In 1832, Dr. Thomas Hodgkin identified these exclusive cells in an HL-affected tissue. Both types have been observed to behave differently in terms of symptoms, prognosis and their response to treatment.
HL may start seeding anywhere. Most commonly, it is thought to arise from the lymph nodes present in the neck. However, those of the groin, underarms, chest and the abdomen may also be affected initially.
One in every 10 individuals diagnosed with HL may show signs and symptoms related to liver, bones or lungs. About one in three Hodgkin’s Lymphoma cases may have symptoms related to the spleen.
Non-Hodgkin’s Lymphoma (NHL)
Non-Hodgkin’s Lymphoma has more than 60 different types, each of which tends to behave differently, including:
Follicular lymphoma stands to be the most common of all the low-grade NHL types and accounts for 25 percent of all lymphoma cases in the United Kingdom. Follicular lymphoma is the cancer of B-cells and mainly targets the elder group.
Mantle cell lymphoma
Mantel cell lymphoma is a low-grade NHL that accounts for 5-10 percent of all NHL cases in the United Kingdom. Similar to follicular lymphoma, mantel cell is a disease of the B-cells and targets those between 50 to 60 years of age. Mantle cell is recognized as low-grade NHL, however, it may grow fast and may be treated as a high-grade lymphoma.
Marginal zone lymphoma
Marginal zone lymphoma targets the B-cells, and is more likely to target individuals above 60 years. It is a slow-growing cancer, and accounts for 12 percent of the B-cell lymphoma cases.
Small lymphocytic lymphoma
Also known as chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma is responsible for approximately six percent of all lymphoma cases in the United Kingdom. If the disease is limited to lymph nodes only, it is termed as small lymphocytic lymphoma.
In this type of lymphoma, cancerous B cells get stuffed within the bone marrow spaces or do the same to the spleen and the lymph nodes. Lymphoplasmacytic lymphomas prefer to target males, and seemingly have an affinity towards people above 65 years. This rare cancer type accounts for less than 2 percent of all B-cell lymphomas.
Cutaneous T-cell lymphomas
A skin lymphoma, cutaneous T-cell lymphomas are commonly referred to as mycosis fungoides. It is very rare.
Diffuse large B-cell lymphoma
Diffuse B-cell lymphoma is known to be a high-grade non-Hodgkin’s disease and is more common than other types. This disease has a preference towards males and may affect any age group.
Commonly referred to as a ‘Burkitt tumor’ or ‘malignant lymphoma’, Burkitt lymphomas are named after surgeon Denis Parsons Burkitt, who discovered it in 1958. It is a type of high-grade NHL that originates from B-lymphocyte. It is classified into three variants: endemic variant, sporadic kind, and the immunodeficiency-associated variant.
Enteropathy-associated T-cell lymphoma
A very rare type of lymphoma, enteropathy-associated T-cell lymphoma affects the T-cells present in the stomach. It occurs more commonly in the jejunum or the ileum.
In this type, cancer affects specific components of white blood cells, known as the plasma cells. Plasma cells produce antibodies for combating infections. When these antibody-producing species become cancerous, they make harmful antibodies, most of which affect kidneys. Cancerous plasma cells also fill up the bone marrow and overcrowd it, so much so that the population of healthy cells becomes compromised.
What Are The Causes and Risk Factors of Lymphoma?
The following causes and risk factors may increase an individual’s likelihood of being diagnosed:
Most NHLs tend to occur when a person is above 60 years. About 60 percent of NHL cases have been observed in people who are over the age of 65 years.
HL, meanwhile, is associated with younger ages. In the United Kingdom, men between the ages of 20-24 and 75-79, and women between the ages of 20-24 and 70-74 are more commonly targeted by HL.
According to Cancer Research UK, HL is more likely to target males. NHL is slightly more prevalent in males, too.
Race, ethnicity, and geographical locations
In the United States, Caucasians are more commonly affected with NHL. Moreover, according to the American Cancer Society, cases are more common in the developed parts of the world.
A positive family history for HL greatly increases one’s chance of being diagnosed. The siblings of a young person with HL are at great risks. Moreover, the identical twin of an HL-affected patient is also at a very high risk.
According to American Cancer Society, patients of HIV/AIDS are at greater risks of getting HL, due to a compromised immune system. Viruses may possess the capability to mutate the DNA of healthy immune cells, so as to transform them into cancerous species.
A rare type that takes place in the stomach is known as mucosa-associated lymphoid tissue (MALT) lymphoma.
A compromised immune system
An immune system that is not competitive enough to fight off infections and cancer-causing species may become highly susceptible towards the development of cancer. Individuals with AIDS, autoimmune diseases, those who have had an organ transplant, or those who are on steroids for six months or more are at greater risk.
What Are The Symptoms of Lymphoma?
The most common symptom of lymphoma is persistent painless swelling. Swelling is the result of a lymph node that is infiltrated with cancerous immune cells. The swelling may affect the neck, armpit, and groin area.
Swelling that is painless and persistent for six consecutive weeks needs to be medically evaluated. Approximately 70 percent of HL cases display symptoms of swollen masses on their necks.
Lymph node swelling is also common in cases of infection, but it settles within a few days.
Lymphoma may also present with certain non-specific symptoms. Such symptoms must be given medical attention. Some common non-specific symptoms include:
- Heavy night sweats that occur regularly or often
- Unexplained fevers and come and wane away often
- Losing more than one tenth of your weight with no obvious cause
- Itching that aggravates upon the ingestion of alcohol
- Vomiting or pain the in stomach after intake of alcohol
- Unexplained cough
- Unexplained breathlessness
Approximately 25 percent of HL patients experience general symptoms. Weight loss, unexplained fever and night sweats are recognized as ‘B symptoms’ and are common in NHL cases.
What Treatments Are Available For Hodgkin’s Lymphoma?
Treatment depends on the stage of the cancer. HL and NHL generally have a high success and survival rate following treatment.
There are two main treatments for Hodgkin’s Lymphoma:
Radiotherapy for HL is a localized treatment. It is often targeted to a single affected lymph node, a group of lymph nodes or one side of the body.
Chemotherapy for HL is treated according to each stage. In the early stages of the disease, the patient may undergo 2-4 cycles of ABVD chemotherapy (Adriamycin, Bleomycin, Vinblastine, and Dacarbazine). Patients with advanced stage HL may undergo eight cycles of treatment with other chemotherapy drugs, including ‘ESHAP’ (Etoposide, prednisolone, cytarabine and cisplatin).
Other types of treatment for HL include steroids and stem cell transplantation.
What Treatments are Available for Non-Hodgkin’s Lymphoma?
Some patients may need only one treatment option after being diagnosed with Non-Hodgkin’s Lymphoma, while other patients may require a combination of two or three options, depending upon:
- The stage of NHL
- Type and grade of NHL
- General health condition
Treatment options for NHL include:
This option uses cytotoxic drugs that circulate in the bloodstream to reach the lymphoma cells.
For low-grade NHL, most patients typically have “CVP” regimen (Cyclophosphamide, Vincristine, and Prednisolone) along with Rituximab.
Other chemotherapy options, for those whose lymphoma returns after first treatment or those who are at Stage 3 or Stage 4, include:
- CHOP (Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone)
- FMD (Fludarabine, Mitoxantrone, and Dexamethasone)
- FAD (Fludarabine, Doxorubicin, and Dexamethasone)
For high-grade NHL, the most common chemotherapeutic option is R-CHOP regimen.
Radiotherapy is oftentimes used as a local treatment, if the lymphoma cells are present in one or two areas of lymph nodes (Stage 1 or Stage 2).
This option acts on the cell processes and stops the diseased cells from growing and/or dividing. Monoclonal antibodies, like Rituximab, is the most commonly used biological therapy for lymphoma.
Other treatment options, which may be used to escalate the chances of cure for HL, include surgery and stem cell transplantation.