What is lymphoma?
A lymphoma is a cancer of cells in the lymphatic system. Lymphomas are divided into two types – Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. There are different types of non-Hodgkin’s lymphoma. It is important to know exactly what type you have. This is because the treatments and outlook (prognosis) can vary for different types of lymphoma.
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.
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 :
- 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
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.
- 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
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 which may be considered include the following:
Chemotherapy is a treatment which uses anti-cancer medications to kill cancer cells, or to stop them from multiplying.
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 is a treatment which uses high-energy beams of radiation which are focused on cancerous tissue.
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.