Lymphoma

Most people feel negative emotions when they hear the word cancer, and lymphoma is no exception. However, the good news is that recovery chances are higher if this cancer is detected and treated in early stages. Let's have a detailed understanding of lymphoma, its types, causes, symptoms, diagnosis, treatment, and prevention strategies.

What is Lymphoma?

Lymphoma is a term used for various types of blood cancers originating in the lymphatic system. The lymphatic system is a network of lymphatic vessels, tissues, and organs that play a vital role in the body's immune response. It consists of lymph nodes, spleen, thymus, and bone marrow, among other components.

Lymphoma occurs when lymphocytes, a white blood cell type responsible for fighting infections, undergo malignant changes and multiply uncontrollably. These abnormal cells can accumulate in the lymph nodes, bone marrow, or other organs, causing tumours and disrupting the normal functioning of the immune system.

Types of Lymphoma

Lymphoma can be broadly classified into two main categories: Hodgkin's and non-Hodgkin's lymphoma:

• Hodgkin's Lymphoma: This type of lymphoma is characterised by a specific type of cancerous cell called the Reed-Sternberg cell presence. Several subtypes of Hodgkin's lymphoma include classical Hodgkin's lymphoma and nodular lymphocyte-predominant Hodgkin's lymphoma.
• Non-Hodgkin's Lymphoma (NHL): This category encompasses a diverse group of lymphomas that do not involve the presence of Reed-Sternberg cells. NHL can be further classified based on the type of lymphocyte involved and the aggressiveness of the disease. Some common subtypes of NHL include follicular lymphoma, diffuse large B-cell lymphoma and mantle-cell lymphoma.

Causes of Lymphoma

One cannot pinpoint the exact causes of lymphoma cancer. However, doctors have identified several factors:

• Genetic factors: Certain genetic mutations or chromosomal abnormalities can increase the possibility of developing lymphoma.
• Immune system dysfunction: A weakened or compromised immune system, either due to inherited conditions or acquired factors like HIV/AIDS or immunosuppressive medications, can increase the risk of lymphoma.
• Environmental factors: Exposure to certain chemicals, radiation, or infectious pathogens, such as the Epstein-Barr virus (EBV) and human T-cell leukaemia virus type 1 (HTLV-1), has been linked to an increased chance of lymphoma.
• Age: The risk of developing lymphoma increases with age as the immune system becomes less efficient.

Symptoms of Lymphoma

The symptoms of lymphoma can vary greatly and depend on the type and stages of the disease. Some common lymphoma symptoms are:

• Swelling in the lymph nodes of the armpits, neck or groin
• Unexplained fever or night sweats
• Unexplained weight loss
• Fatigue or lack of energy
• Itchy skin or lymphoma rashes
• Persistent cough or shortness of breath
• Abdominal pain or swelling

When to See a Doctor?

If you experience any persistent or unexplained symptoms, it's crucial to consult a doctor promptly. Early detection of the condition is vital for effective treatment and better outcomes.

Lymphoma Stages

Lymphoma is typically staged based on the extent of the disease and the areas of the body affected. The staging system helps doctors determine the correct treatment approach and assess the prognosis. The commonly used staging system for lymphoma includes the following stages:

• Stage I: The lymphoma is localised to a single region or group of lymph nodes.
• Stage II:  On the same side of the diaphragm, the lymphoma in two or more lymph node regions.
• Stage III: The lymphoma has spread to lymph node regions on both the left and right sides of the diaphragm.
• Stage IV: The lymphoma has started involving one or more organs outside the lymphatic system. These organs can be the bone marrow, liver, or lungs.

Risk Factors

While the exact causes of lymphoma are not fully identified, several factors may increase an individual's risk of developing the disease, such as:

• Age: The risk of developing lymphoma increases with age, particularly after age 60.
• Gender: Certain types of lymphoma are more common in males, while others are more prevalent in females.
• Weakened immune system: People with weak defence or immune systems due to the presence of conditions like HIV/AIDS, autoimmune disorders, or immunosuppressive medicines have a higher risk of developing lymphoma.
• Family history: Having a first-degree relative with lymphoma may increase an individual's risk.
• Exposure to certain chemicals or radiation: Prolonged exposure to chemicals like pesticides, solvents, or radiation may increase the risk of developing lymphoma.
• Infections: Certain viral infections, such as the human T-cell leukaemia virus type 1 (HTLV-1) and Epstein-Barr virus (EBV), have been linked with an increased possibility of lymphoma.

Lymphoma Diagnosis

Diagnosing lymphoma typically involves a combination of various tests and procedures:

• Physical analysis: A doctor will conduct a thorough physical examination, looking for swollen lymph nodes or other signs of lymphoma.
• Blood tests: Blood tests aid in detecting abnormalities in blood cell counts or the presence of specific markers associated with lymphoma.
• Imaging tests: Imaging techniques like CT, PET, or MRI scans can identify the location and extent of lymphoma involvement.
• Biopsy: A biopsy is taking a sample of lymph node tissue or bone marrow for microscopic examination. It is the most definitive test for diagnosing lymphoma and determining its specific type.
• Immunophenotyping: This test analyses the specific proteins (markers) on the surface of lymphoma cells, which helps distinguish between different types of lymphoma.
• Genetic testing: Genetic tests help identify specific genetic abnormalities or mutations linked with certain types of lymphoma.

Lymphoma Treatments

The treatment for lymphoma depends on various factors, including the type and stage of the disease, the patient's age, overall health, and personal preferences. The following are some common treatment options:

• Chemotherapy: Chemotherapy includes the use of powerful medications to kill cancer cells. It can be administered intravenously or in pill form and may be used alone or in combination with other lymphoma treatments.
• Radiation therapy: Radiotherapy uses high-energy radiation to target and destroy cancer cells. It can be used as a primary treatment approach or in combination with chemotherapy, depending on the type and stage of lymphoma.
• Targeted therapy: Targeted therapies precisely target and interfere with the molecular processes responsible for the growth and survival of cancer cells. Examples include monoclonal antibodies and small-molecule inhibitors.
• Stem cell transplantation: In some cases, doctors may recommend a stem cell transplant to replace the damaged bone marrow with healthy stem cells.
• Immunotherapy: Immunotherapy treatments boost the body's immune system to fight cancer cells more effectively. Examples include immune checkpoint inhibitors and CAR T-cell therapy.
• Supportive care: Supportive care measures help manage the side effects of lymphoma and its treatment, such as pain management, nutritional support, and management of infections or other complications.

How to Prevent Lymphoma?

While there is no guaranteed way to prevent lymphoma, certain lifestyle choices and preventive measures can help reduce the risk:

• Healthy lifestyle: A balanced diet (rich in fresh fruits and vegetables), regular exercise, and a healthy weight can support immune system function and reduce the risk of lymphoma.
• Avoid risk factors: Limiting exposure to chemicals, radiation, and infectious agents linked to lymphoma can help mitigate the risk.
• Practice safe habits: Practicing safe sex and avoiding high-risk behaviours that can compromise the immune system can help reduce the risk of lymphoma associated with certain infections.
• Regular screening: For people with a family history or other risk factors, regular screening and monitoring may aid in early detection and prompt treatment, if necessary.

Conclusion

Lymphoma is a serious and life-threatening condition. It requires immediate medical attention, diagnosis, and prompt treatment. Early detection and management are critical for improving treatment outcomes and increasing the possibility of a successful recovery. By understanding the types, causes, symptoms, and risk factors associated with lymphoma, individuals can take proactive steps to seek medical attention and receive the necessary care.

FAQ's

1. Where does lymphoma spread to?

The spread of lymphoma depends on the type and stage of the disease. Lymphoma can spread to various body parts, including lymph nodes in different body regions, such as the bone marrow, spleen, liver, lungs, brain, and skin.

2. Is lymphoma usually curable?

The curability of lymphoma depends on various factors, including the type of lymphoma, its stages, and the patient's overall wellness. Some types of lymphoma, such as Hodgkin's lymphoma and certain types of non-Hodgkin's lymphoma, are curable when detected and treated early. However, other types of lymphoma may be more difficult to cure and require ongoing treatment to manage the disease.

3. Can you fully recover from lymphoma?

When diagnosed and properly treated in its early stages, lymphoma can be fully recovered. With correct treatment, many patients can achieve complete remission, where there are no detectable signs of cancer. However, the chances of recovery depend on various factors, such as the type and stage of lymphoma, the patient's age, and overall health.

4. How long can you have lymphoma without noticing?

The time it takes to notice symptoms of lymphoma can vary significantly. In some cases, symptoms may appear within a few weeks or months, while in others, lymphoma can remain undetected for years. The type of lymphoma, its aggressiveness, and the affected areas of the body can influence the onset and visibility of symptoms. 

5. Which stage of lymphoma is curable?

Early-stage lymphomas (Stage I and Stage II) are more likely to be cured with prompt and proper treatment. The cancer is localised in these stages and has not spread extensively throughout the body. However, it's important to note that even advanced-stage lymphomas (Stage III and Stage IV) can sometimes be cured or managed effectively with aggressive treatment approaches, such as chemotherapy, radiation therapy, stem cell transplantation, or targeted therapies.

Dr. Byreddy Poojitha

MBBS, MD, DM
CARE Hospitals, HITEC City, Hyderabad, CARE Hospitals, Banjara Hills, Hyderabad

To Book an Appointment, call:

+91 406 810 6585