What Is Lymphoma?
The term “lymphoma” describes a group of cancers of the lymphatic system. The lymphatic system is responsible for resorption of fluids into the circulation and immune defense against foreign invaders, such as bacteria, which might otherwise cause infection. Since the lymphatic system is a network of nodes and vessels that extends throughout the body, a lymphoma may develop nearly anywhere in the body.
There are two main types of lymphoma—Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). HL and NHL are also known as Hodgkin disease and non-Hodgkin disease, respectively. A physician can distinguish between these types by looking for cells of a specific type, known as Reed-Sternberg cells, among other cells that make up the cancer. Reed-Sternberg cells are present in HL but are absent in NHL.
According to the Lymphoma Research Foundation, HL can be classified as classical HL (CHL), which accounts for ninety to ninety-five percent of cases, and nodular lymphocyte predominant HL (NLPHL). Although there are four subtypes of CHL, every subtype is characterized by abnormal B lymphocytes. B lymphocytes are a type of white blood cell which normally helps to fight infection. In comparison, NLPHL is generally slower to grow and spread than CHL.
NHL may be described by the cell type from which it developed or by how fast it grows and spreads. Although NHL may develop from different types of white blood cells—such as B-cells, T-cells, and NK cells—most types form from B-cells. NHL may be indolent (slow-growing) or aggressive (fast-growing). According to the National Cancer Institute, the most common types of NHL in adults are diffuse large B-cell lymphoma, which is usually aggressive, and follicular lymphoma, which is usually indolent.
What Causes Lymphoma?
Lymphomas develop as a result of changes to the genetic material within white blood cells. These changes result in the pattern of cell growth and division characteristic of lymphoma. Although increased likelihood of developing a lymphoma is associated with the following factors, in most cases, physicians and scientists are still trying to determine what causes lymphoma to develop:
- Being a male
- Being overweight
- A weakened immune system
- Viral infection
- Immediate family history of lymphoma
- Radiation treatment for another cancer
- Exposure to carcinogens
- Having a lymphoma in the past
How Is Lymphoma Detected?
Our specialists collect information regarding medical history, surgical history, social history, and family history; conduct laboratory testing; and review radiological studies to approach patient care in the most comprehensive and personalized manner.
If lymphoma is suspected, doctors often begin with a physical examination of a patient’s lymph nodes to check for swelling. The physician may then choose to resect (remove) all or a part of an enlarged lymph node for laboratory analysis. If lymphoma is found, the doctor may choose to perform a bone marrow biopsy to determine if the lymphoma has spread to the bone marrow. Alternatively, a physician may suspect a patient’s lymph nodes to be swollen due to a simple infection. In this case, he or she may prescribe antibiotics to rule out this possibility if swelling of the lymph node or nodes resolves.
If your doctor suspects that another part of your body may be involved by a lymphoma, he or she may order imaging to reach a diagnosis, document the staging of the disease, and/or plan treatment, if necessary. Imaging might include a CT scan, PET scan, or PET-CT scan. A CT (computed tomography) scan uses X-rays to generate a three-dimensional picture of the body whereas a PET (positron emission tomography) scan uses a small amount of radioactive tracer to locate any cancer cells by how readily they take up the radiotracer. A PET-CT combines the features of CT scan with those of a PET scan.
Stages of Lymphoma
“Staging” occurs when a physician uses test and scan results to determine which parts of the body are involved by cancer, in this case lymphoma. Staging is important because different stages of lymphoma are better addressed with treatments which may differ in amount, combination, or type. In adults, the same staging system is used for HL as is for NHL, with the exception of lymphomas of the skin. According to the Lymphoma Association, there are four main stages for lymphoma:
In stage I lymphoma, only one group of lymph nodes is affected either above or below the diaphragm.
Stage II lymphoma is described by two or more groups of lymph nodes affected either above or below the diaphragm but not both above and below the diaphragm.
Lymph nodes on both sides of the diaphragm are involved in stage III lymphoma.
In stage IV, lymphoma is found in either organs outside the lymphatic system or in the bone marrow.
Signs and Symptoms of Lymphoma
The following may be indicative of lymphoma but may also be indicative of other illnesses:
- Swollen lymph nodes, often in the neck, underarm, and/or groin
- Shortness of breath
- Loss of appetite
- Night sweats
- Stomach pain
- Weight loss
It is important you tell your doctor if you have any of these signs and symptoms, so he or she may determine their cause and plan treatment, if necessary.
How Is Lymphoma treated?
Treatment of lymphoma, depending on the stage and type, may include chemotherapy, immunotherapy, stem cell transplant, radiation therapy, and/or surgery. These treatments may be used individually or in combination based on your doctor’s recommendations. It’s important to discuss all of your treatment options with your doctor to help make the decision that best fits your needs. Some important factors to consider when deciding on a lymphoma treatment plan include
- Your age, health, and lifestyle.
- The stage of your cancer.
- Any other serious health conditions you have.
- Your feelings about the need to treat the cancer right away.
- Your doctor’s opinion about if you need to treat the cancer right away.
- The likelihood that treatment will help fight or cure your cancer.
- Possible side effects from each treatment method.
You may feel the need to make a quick decision, but it is very important to ask questions if there is anything about which you’re not entirely sure. It is very important for you and your doctor to communicate and work together to weigh the benefits of each treatment option against the possible adverse effects in order to ultimately determine which treatment option is best for you.
NYCBS Clinical Trials in Lymphoma
Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the art treatment methods. Sometimes they may be the only way to get access to newer treatments. They are also the best way for doctors to learn how to better treat disease. If you would like to learn more about clinical trials that might be right for you, contact New York Cancer and Blood Specialist today at (855) 528-7322 to learn more.