Lymphomas are blood cancers that develop in the immune system, more specifically in the lymphatic system- part of the body’s germ-fighting network and includes lymph nodes, spleen, thymus gland and bone marrow. It’s not clear what causes lymphoma, but it begins when a disease-fighting white blood cell called a lymphocyte develops a genetic mutation.
This mutation tells the lymphocyte cell to multiply rapidly, creating more and more mutated cells. The mutation also allows the mutated cells to go on living when normal cells would normally die. This results in a collection of too many diseased and infected lymphocytes in the lymph nodes, causing the lymph nodes to swell.
Common places for these lymph nodes to swell are in the neck, armpits and groin. Other signs and symptoms of lymphoma include persistent fatigue, fever, night sweats, shortness of breath and unexplained weight loss.
Many subtypes of lymphoma exist, but there are two main categories:
Hodgkin’s Lymphoma: mostly affects young adults and can be found almost anywhere in the body. This disease has subtypes, but recent advances in diagnosis and treatment have given patients the chance for a full recovery.
Non-Hodgkin’s Lymphoma (NHL): is the most common type of lymphoma, with 74,000 cases (4% of all cancers in the U.S.) diagnosed each year. There are many subtypes of NHL and treatment will vary depending on the diagnosis.
Because there are so many different types of lymphoma, an accurate diagnosis is key to developing a treatment plan. The most common tests and procedures used in a diagnosis include a physical exam, a lymph node biopsy, blood tests, a bone marrow biopsy and imaging tests such as CT, MRI and PET.
Treatment of lymphoma depends on the type and progression of the disease, but some treatment options include:
- Active surveillance: some forms of lymphoma are very slow growing and it may be best to wait and treat the disease when it causes signs or symptoms that interfere with daily activities. Until then, patients may undergo periodic tests to monitor any progression.
- Chemotherapy: drugs are usually administered through a vein, but can also be taken as a pill, depending on the specific drug being received.
- Target Drug Therapy: uses drugs that attack specific vulnerabilities or malfunctions within the cancer cells.
- Biological Therapy or Immunotherapy: uses treatments that help the body’s own immune system recognize and attack cancer cells.
- Radiation therapy: uses high-powered beams of energy, such as X-rays, to kill cancer cells.
- Stem Cell (or Bone Marrow) Transplant: a procedure to replace diseased bone marrow with healthy bone marrow. Before a stem cell transplant, high doses of chemotherapy or radiation therapy will be given to destroy diseased bone marrow. Then an infusion of blood-forming stem cells is given to help rebuild healthy bone marrow. Stem cells may be from a donor or in some cases the patient’s own stem cells.
Risk factors for lymphoma include being a male over 65 years old, having an impaired immune system and having infections such as Espstein-Barr or Helicobacter pylori.