Lymphoma

Lymphoma is a type of blood cancer that affects the lymphatic system, forming from the lymphocytes, affecting the immune system. Lymphocytes are white blood cells that are a part of the immune system and are broken down into two major subgroups: B lymphocytes and T lymphocytes. They are plainly referred to as B cells or T cells. Lymphoma occurs when there is a malignant transformation of either the B or T cells, and they grow rapidly and uncontrollably.

Types

There are two main types of lymphoma:

  • Hodgkin's lymphoma
  • Non-Hodgkin lymphoma (NHL)

Hodgkin's lymphoma, also known as Hodgkin's disease, is named after Thomas Hodgkin and is characterized by the presence of an abnormal cell called a Reed-Sternberg cell when examining the cancer cells of lymphoma. Reed-Sternberg cells typically originate from B lymphocytes and are quite large in size when compared to other cells. Hodgkin's lymphoma is less prevalent than NHL, and typically occurs in individuals between the ages of 15 and 40, or anyone who is 55 or older.

NHL is one of the most common forms of cancer among men and women, and can be split into multiple subgroups depending upon the appearance and characterization of the malignant lymphocytes. The main difference in classification that makes lymphoma NHL is the absence of Reed-Sternberg cells. The risk of developing NHL has been found to increase with age.

Signs And Symptoms

The symptoms for both versions of lymphoma are quite similar, and lymphoma can occur in almost any part of the body, with Hodgkin's lymphoma starting from the upper portion of the body in particular like the chest, underarms and neck. Common symptoms of lymphoma include:

  • Painless swelling of the lymph nodes
  • Excessive sweating at night during sleep
  • Enlargement of the spleen leading to abdominal pain
  • Abnormal, and often dramatic, weight loss
  • Unexplained fever
  • Heavy itching
  • Chills
  • Fatigue and shortness of breath

The majority of these symptoms aren't specific and can be attributed to other diseases or ailments that are unrelated to lymphoma, or any other cancer, for that matter. The easiest way to determine whether these symptoms should be attributed to lymphoma is if they persist for an extended period of time, and have no other possible explanation.

Causes/Risk Factors

At the moment, there is no clear cut explanation as to what causes lymphoma, whether it is Hodgkin's or NHL. However, there are some notable risk factors that have been discovered over the years.

For NHL, these risk factors include:

  • People who live in farming communities have been found to be at a higher risk of developing NHL, with some studies showing evidence of a correlation between NHL and chemicals used to kill insects and weeds.
  • Medical conditions that affect the immune system like HIV or autoimmune disease.
  • Any form of medication that might suppress the immune system.
  • While NHL can occur at any age, the potential risk factors for developing this form of cancer increase with age.

Risk factors for Hodgkin's lymphoma include:

  • Males are at a slightly higher risk for developing Hodgkin's disease.
  • Weakened immune system due to HIV or AIDS, or an organ transplant that requires the use of a medication to suppress the immune system.
  • While it still remains unclear, there has been evidence showing possible signs of an increased risk factor amongst blood relatives, primarily siblings.

Indisputable risk factors have yet to be determined at this time.

Test/Diagnosis

When a person shows any signs or symptoms that might suggest some form of lymphoma, a physician might request extensive blood tests to be performed and will refer the patient to a cancer and blood disease specialist. These blood tests determine the performance of blood cells and vital organs. A biopsy is also commonly performed where a sample of tissue from a swollen area is examined by a pathologist. Imaging tests are also used to determine if a lump or mass is present to adminster a biopsy.

Treatment

There are several methods of treatment for lymphoma depending on its classification and stage. For Hodgkin's lymphoma, types of treatment include:

  • Radiation therapy: high energy rays are used to decrease the size of any mass lymphoma cells. The radiation is restricted to only the areas of the body that are affected by Hodgkin's lymphoma.
  • Chemotherapy: a combination of drugs are administered to kill off lymphoma cells. Sometimes chemotherapy is used in conjunction with radiation therapy.
  • Bone marrow or stem cell transplant: not commonly used due to the effectiveness of radiation therapy and chemotherapy. However, this form of treatment is typically considered if other therapies have proven to be ineffective.

The treatment for NHL is similar to Hodgkin's lymphoma, with the inclusion of one more form of treatment called the watch-and-wait method:

  • Watch-and-wait: also referred to as "watchful waiting," this method allows the physician to monitor NHL without committing to any particular form of treatment, like chemotherapy. Patients are required to visit their doctors more frequently so they can monitor if the disease begins to progress. This eliminates any side effects that are associated with common NHL treatments for patients diagnosed with early stages of NHL who may not need immediate treatment.

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