What is lymphoma?

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What is the lymphatic system?

The lymphatic system consists of lymph nodes (lymph glands), a network of thin lymphatic channels (similar to thin blood vessels), and organs such as the spleen and thymus.

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Functions of  Lymphatics :

  • Lymph nodes are joined together by a network of lymphatic channels. Lymph mainly consists of a fluid that forms between the cells of the body.
  • The watery lymph fluid (which contains nutrients and waste of the cells)  travels in the channels, through various lymph nodes and eventually drains into the bloodstream.
  • The lymphatic system is also a major part of the immune system. Lymph and lymph nodes contain white blood cells called lymphocytes and antibodies which defend the body against infection. 

What is cancer?

Cancer is a disease of the cells in the body. The body is made up from millions of tiny cells. The cancer cells are abnormal and do not respond to normal control mechanisms. Large numbers of cancer cells build up either because they multiply out of control, or they live much longer than normal cells would do, or both. Lymphoma is one type of cancer.

Types of Lymphoma :

  • Hodgkin’s
  • Non Hodgkin’s

What is the difference between Hodgkin’s and Non Hodgkin’s Lymphoma

  • It’s only possible to tell the difference between Hodgkin lymphoma and non-Hodgkin lymphoma when the cells are looked at under a microscope. 
  • In most cases of Hodgkin lymphoma, a particular cell called the Reed-Sternberg cell is found when cells from the lymph node are examined during diagnosis.

What causes a lymphoma and how does it develop?

The cause is not known. The cancer seems to start from one abnormal cell. In the case of non-Hodgkin’s lymphoma, the cancer develops from a lymphocyte cell which becomes abnormal. The exact reason why the cell becomes cancerous is unclear. If the abnormal cell survives, it may multiply and produce many abnormal cells.

Who gets lymphoma and how common is it?

Anyone can be affected. Most cases occur in people over the age of 60. It is the seventh most common type of cancer . Men are more commonly affected than women.

Sign and symptoms

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Swollen lymph nodes

  • The most common early symptom is to develop one or more swollen lymph nodes in one area of the body – most commonly the side of the neck, an armpit or the groin.

Other symptoms

  • Unexplained weight loss ( more than one tenth of your total body weight )
  • Fever that comes and goes without any obvious cause
  • Heavy sweating , especially at night
  • Some people have unexplained itching

Doctors call this group of symptoms ‘B’ symptoms

Diagnosis and assessment

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A specialist will normally arrange a biopsy of one of the swollen nodes. A biopsy is when a small sample of tissue is removed from a part of the body. 

Grade of the lymphoma

The microscope allows abnormal cells to be seen. By looking at certain features of the cells, and by doing various other tests on the cells, the exact type of lymphoma can be diagnosed.

  • High-grade (fast-growing). The cancerous cells tend to grow and multiply quite quickly and are more aggressive.
  • Low-grade (slow-growing). The cancerous cells tend to grow and multiply quite slowly and are not so aggressive.

Assessing the extent and spread (staging)

If the biopsy confirms that you have a non-Hodgkin’s lymphoma, then further tests are usually advised. For example, you may have a CT or MRI Scan, Blood Tests, a bone marrow biopsy or other tests. This assessment is called staging. The aim of staging is to find out how much the lymphoma has grown locally, and whether it has spread to other lymph nodes or to other parts of the body.

 Treatments

Treatments which may be considered include the following:

Chemotherapy

Chemotherapy is a treatment which uses anti-cancer medications to kill cancer cells, or to stop them from multiplying.

Monoclonal antibodies

This treatment is sometimes used in addition to chemotherapy. (For example, a product called rituximab is the commonly used monoclonal antibody.) Monoclonal antibodies are small proteins and are different to normal chemotherapy. They work by attaching to the abnormal lymphocytes, which helps to destroy them without harming other cells.

Radiotherapy

Radiotherapy is a treatment which uses high-energy beams of radiation which are focused on cancerous tissue.

Surgery

Surgery is not used very often. Occasionally, an operation may be done to remove an organ (such as the spleen) or part of an organ that is badly damaged by a lymphoma. Sometimes a large mass of tumour may be removed to de-bulk the tumour prior to chemotherapy.

Intent of the treatment :

  • Treatment may aim to cure the lymphoma. Some non-Hodgkin’s lymphomas can be cured. In particular, most high-grade non-Hodgkin’s lymphomas can be cured with treatment. Remission means there is no evidence of lymphoma following treatment. If you are in remission, you may be cured.
  • Treatment may aim to control the lymphoma. If a cure is not realistic, it is often possible to limit the growth or spread of the lymphoma with treatment. 
  • Treatment may aim to ease symptoms. If a cure is not possible, treatments may be used to reduce the size of lymphoma tumours. 

Quick Facts

Worldwide, approximately one million people live with lymphoma  At the same time, less than 50% of the population know about this potentially life-threatening disease.

On World Lymphoma Awareness Day (15 September), we highlight a few important facts:

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  1. Lymphomas are cancers that develop in the lymph system, which is part of the body’s immune system.
  2. Lymphoma is the most common blood cancer diagnosed in adults and the third most common cancer diagnosed in children.
  3. The different sub-types of lymphoma are divided into two main types: Hodgkin’s lymphoma and non-Hodgkin’s lymphoma 
  4. Worldwide, over 62 000 people are diagnosed with Hodgkin’s lymphoma every year. Of those, 60% are male and 40% are female. Approximately 25 000 people die every year from this disease.
  5. While the exact cause of lymphoma remains unknown, non-Hodgkin’s lymphoma occurs much more frequently in HIV-infected people than in the general population.
  6. There are some indications that certain chemicals, such as insecticides and wood-preserving materials, are linked to this form of cancer.
  7. Lymphoma often causes fever and night sweats. Further lymphoma symptoms depend on which areas of the body are affected, for example the neck, groin or underarm area.
  8. Lymphoma may be treated with chemotherapy and lymphoma involving the brain may be treated with radiation therapy.
  9. Effectiveness of treatment depends on the particular cell characteristics of the lymphoma, its location, and how much it has spread, as well as the strength of your immune system.
  10. Early diagnosis and treatment greatly improves the outcome of the disease.
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