Lymphoma is a cancer which presents as a solid tumor of lymphoid cells. Read this article to get information about types, causes, warning signs, diagnosis and treatment of lymphoma.
Lymphoma is a general term for cancers that involves the cells of the immune system, called lymphocytes. Just like other cancers, lymphoma takes place when lymphocytes are in a state of uncontrolled cell growth and multiplication. Lymphocytes are the cells that play a role in the lymphatic system of the body. The lymphatic system is part of the body’s immune defense system which helps to fight diseases and infection. Lymphomas account for 3 percent of all cases of cancer. Lymphoma represents many different cancers of lymphocytes with about 35 different subtypes. Hodgkin’s lymphoma is the most common type of lymphoma and all other types of lymphoma are grouped together and called non-Hodgkin’s lymphomas.
The lymphatic system consists of a network of vessels that carry fluid called lymph. Lymphocytes are white blood cells which are present in lymph fluid. In the precancerous stages of development, lymphocytes attack a variety of infectious agents as well as many cells that threaten the body. The lymphatic system is also comprised of lymph nodes which filter the lymph that flows through them. When a large number of microbial organisms collect inside the lymph nodes, they swell and tenderize and indicate local infection.
Types of lymphoma:
Lymphomas are of two types: Hodgkin lymphoma (HL, also called Hodgkin’s disease) and non-Hodgkin lymphoma (NHL). Both HL and NHL can take place in the same places and have similar symptoms. They are differentiated only at a microscopic level.
Hodgkin lymphoma derives from a specific abnormal ancestry of B cells and non-Hodgkin lymphoma may derive from either abnormal B or T cells. There are five subtypes of HL and 30 subtypes of NHL and all are distinguished by unique genetic markers. Several NHL subtypes look similar but they function differently and respond differently to therapies.
Causes of Lymphoma:
Uncontrolled growth of the cells resulted in cancer. In the body, normal cells follow an orderly path of growth, division, and death. Apoptosis is the programmed cell death and cancer resulted when this process breaks down. Scientists do not know exact causes of lymphoma. Several potential risk factors have been associated to a raised risk of developing lymphoma, but it is unclear what role they play in the actual development of lymphoma. These risk factors include:
Age: Usually, the risk of NHL rises with advancing age. In the elder people, HL is related with a poorer prognosis than that observed in younger patients.
Infections:
- Infection with hepatitis B or hepatitis C virus
- Infection with HIV
- Infection with Epstein-Barr virus (EBV), one of the etiologic factors in mononucleosis
- Infection with Helicobacter pylori, a bacterium that lives in the digestive tract
Medical conditions that compromise the immune system:
- HIV
- Autoimmune disease
- Diseases requiring immune suppressive therapy, frequently used following organ transplant
- Inherited immunodeficiency diseases (severe combined immunodeficiency, ataxia telangiectasia, among a host of others)
Exposure to toxic chemicals:
- Black hair dye, which for more than 20 years has been associated to higher rates of NHL
- Farm work or a profession with exposure to certain toxic chemicals for example pesticides, herbicides, or benzene and/or other solvents
Genetics: Family history of lymphoma
The presence of all these risk factors does not mean a person will actually have lymphoma. Actually, most people with one or several of these risk factors do not develop lymphoma.
Symptoms or Warning Signs of Lymphoma:
- Painless lumps in your neck, armpits or groin:
Lymphoma may cause swelling of lymph nodes in the neck, chest, abdomen, and on the skin which are noted as lumps. Most people first notice these lumps while bathing or changing. Also, it may be first felt by your partner. In cases of sinus infection, lymph nodes in the neck often swell or can be symptomatic of the flu. However, if they persist for a long time or take place aside from other sickness they might be cause for concern. If all of the other symptoms along with these enlarged nodes should be present, it may be warning sign for lymphoma. Lymphomas of the skin appear as itchy red or purple lumps. Lymph nodes might swell and become firm without any evident pain in the case of non-Hodgkin lymphoma.
- Weight loss:
Generally, weight loss takes place rapidly over a period of a few months for no known reason. Often patient can lose ten to fifteen pounds over a couple of months.
- Excessive sweating at night:
Excessive sweating during night may be quite troublesome. Without any apparent reason, an individual may wake up at night soaked in sweat.
- Fever:
Continuous fever over a period of time should be a cause for you to consult a doctor. Fever associated to node swellings takes place commonly with infections and many lymphomas are frequently mistaken as infections at the early stage. In patients who affected by Hodgkin lymphoma, a characteristic fever called Pel-Ebstein fever is frequently takes place.
- Itchiness all over your body:
Itchiness (pruritis), rashes and lesions can be a sign of lymphoma, relating to the secretion of some special chemicals from the lymphoma cells.
- Breathlessness along with swelling of the face and neck:
In rare cases, a lymphoma in the neck or chest grows very large which may block the flow of some vessels and cause a swelling of the face and neck along with a feeling of breathlessness.
- Loss of appetite:
Lymphomas spread within body and grow in size. Many individuals feel a considerable loss in their appetite. More than 10% weight loss can be a matter of concern as it is a poor predictive factor for lymphomas.
- A feeling of weakness:
As the growth of cancer cells occurs, it requires more and more nutrients of the body and so nutrient deficiency take place in the body which makes patient to feel weaker.
Any organ of the body can be susceptible to the lymphoma and it may give rise to some unusual symptoms also. A lymphoma in the brain can cause a headache or leg weakness and a lymphoma in the stomach can cause pain in the abdomen.
How is lymphoma diagnosed and staged?
Physicians will request a complete physical exam as well as personal and family medical histories to diagnose lymphoma. To review the results of several tests, an oncologist (cancer specialist) will usually be consulted as he/she will try to find out what’s causing the problem. An oncologist may ask about your personal and family medical history.
To test blood cell, kidney, and liver performance, blood tests will be used. High levels of a chemical called lactase hydrogenase (LDH) have been associated with an aggressive form of NHL and so it is also detected.
If cancer exists, several imaging techniques are employed to find out how far they have spread. Common imaging tests include:
- X-rays
- Lymphangiogram
- Gallium scan
- Computerized tomography (CT) scans
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET) scans
Bone marrow examinations will also be carried out if the lymphoma has infected the bone marrow. Bone marrow samples are frequently taken from the hip and inspected for the presence of abnormal B or T cells.
Biopsy is the absolute way to make a cancer diagnosis. It can be carried out by removing a small sample of the tumor and look at it under the microscope. The sample may be collected by inserting a needle through the skin, surgical methods, or laparoscopic methods. If cancer exists, a pathologist examines the sample under a microscope to determine.
Treatment of lymphoma:
Treatment of lymphoma depends on the type of cancer, the stage of the cancer (how much it has spread), age, health status, whether or not one has received previous cancer treatment, and additional personal characteristics. Usually, lymphoma treatment is designed to result in complete remission of the disease, a state where there may be lymphoma cells in the body but they are undetectable and cause no symptoms.
Chemotherapy, radiation therapy, and biological therapy are the common lymphoma treatments.
Durable remission is the ultimate goal of lymphoma treatment. Recurrence of the cancer is also possible. After durable remission therapy, the patient may see improvement (lymphoma shrinks), a stable disease (lymphoma is the same size), progression (lymphoma worsens), or a refractory disease (the lymphoma resists treatment).
Induction therapy is also performed in some patients to induce remission. To take over for a failing treatment or maintenance therapy, salvage therapy is also designed to prevent recurrence.
- Chemotherapy:
In chemotherapy, chemicals are used to interfere with the cell division process, damaging proteins or DNA. So, cancer cells will commit suicide. The main target of these treatments is rapidly dividing cells (not necessarily just cancer cells). Normal cells generally can recover from any chemical-induced damage while cancer cells cannot.
Generally, it is used to treat cancer that has spread or metastasized as the medicines travel throughout the entire body. Treatment takes place in cycles so the body has time to heal between doses. But, there are still common side effects for example hair loss, nausea, fatigue, and vomiting. Combination therapies frequently include multiple types of chemotherapy or chemotherapy in conjunction with other treatment options.
- Radiation:
It is also known as radiotherapy. It destroys cancer by focusing high-energy rays on the cancer cells. Radiation causes damage to the molecules that make up the cancer cells and leads them to commit suicide. In radiotherapy, high-energy gamma-rays are emitted from metals for example radium or high-energy x-rays that are created in a special machine and can be used as a standalone treatment to shrink a tumor or destroy cancer cells. It is also used in conjunction with other cancer treatments.
Radiation therapy is responsible for some side effects like mild skin changes resembling sunburn or suntan, nausea, vomiting, diarrhea, and fatigue. Some patients also tend to lose their appetites and have difficulty in maintaining weight. However, most side effects subside a few weeks after completing treatment.
Prevention of lymphoma:
No known ways are available for the prevention of lymphoma. But, physicians suggest avoiding known risk factors and avoiding viral infections or conditions that suppress the immune system.
Detecting Early Signs of Lymphoma Symptoms video from Youtube:
Lymphoma Causes and Symptoms video from Youtube:
