What Is Lymphoma?
Lymphoma is a type of cancer that begins in infection-fighting cells of the immune system, called lymphocytes. These cells are in the lymph nodes, spleen, thymus, bone marrow, and other parts of the body. When you have lymphoma, lymphocytes change and grow out of control.
Lymphoma is very treatable, and the outlook can vary depending on the type and stage of the illness. Understand the basics of lymphoma, the differences between Hodgkin and non-Hodgkin lymphoma, and why some people may be more susceptible to this type of cancer. Your doctor can help you find the right treatment for your type and stage of the illness.
Lymphoma is different from leukemia. Each of these cancers starts in a different type of cell.
- Lymphoma starts in infection-fighting lymphocytes.
- Leukemia starts in blood-forming cells inside the bone marrow.
Lymphoma is also not the same as lymphedema, a collection of fluid that forms in body tissues when the lymph system is damaged or blocked.
Types of Lymphoma
There are two main types of lymphoma:
- Non-Hodgkin — most people with lymphoma have this type.
- Hodgkin
Non-Hodgkin lymphoma
Non-Hodgkin lymphoma (NHL) makes up about 90% of lymphoma diagnoses. This form of the disease has two categories: B-cell lymphomas and T-cell lymphomas. B-cell lymphomas affect 80% of people with non-Hodgkin lymphoma. There are different subtypes of B-cell and T-cell lymphomas, some of which are more aggressive and need treatment right away, usually chemotherapy. More slow-growing (indolent) types of NHL may not require immediate treatment. Instead, doctors take a watch-and-wait approach.
B-cell lymphomas include:
- Diffuse large B-cell lymphoma
- Follicular lymphoma
- Primary mediastinal B cell lymphoma
- Mantle cell lymphoma
- Post-transplant lymphoproliferative disorder
- Marginal zone lymphoma
- Waldenström’s macroglobulinemia
- Burkitt lymphoma
T-cell lymphomas include:
- Anaplastic large cell lymphoma
- Peripheral T cell lymphoma not otherwise specified
- Angioimmunoblastic lymphoma
- Hepatosplenic T-cell lymphoma
- Extranodal NK/T-cell lymphoma
Cutaneous T-cell lymphoma is a rare skin-related form of the condition that usually requires only ointments applied to the skin for treatment.
Hodgkin lymphoma
If you've formed mutant cells called Reed-Sternberg cells, your doctor will diagnose you with Hodgkin lymphoma. There are two main types: classical and nodular lymphocyte predominant. Cancer treatments such as chemotherapy can cure many people with this type of lymphoma. And if it comes back, chemo combined with stem cell transplants works well to wipe out the disease.
Lymphoma Causes
Doctors aren't entirely sure why lymphoma develops, but it starts with changes in the DNA of lymphocytes. Normally, DNA in cells carries instructions that control how fast cells grow and multiply and when they should die. But in lymphoma, the DNA in lymphocytes changes.
These changes cause the cells to behave abnormally — they grow uncontrollably and live longer than they should. This uncontrolled growth leads to too many abnormal lymphocytes, especially in areas such as the lymph nodes, spleen, and liver, causing these organs to enlarge.
Lymphoma Risk Factors
You may have a higher chance of lymphoma if you:
- Are in your 60s or older for non-Hodgkin lymphoma
- Are between 15 and 40 or older than 55 for Hodgkin lymphoma
- Are male or assigned male at birth, although certain subtypes may be more common in females and people assigned female at birth
- Have a weak immune system from HIV/AIDS, an organ transplant, or because you were born with an immune disease
- Have an immune system disease such as rheumatoid arthritis, Sjögren's syndrome, lupus, or celiac disease
- Have been infected with a virus such as Epstein-Barr, hepatitis C, or human T-cell leukemia/lymphoma (HTLV-1)
- Have a close relative who had lymphoma
- Were exposed to benzene or chemicals that kill bugs and weeds
- Were treated for Hodgkin or non-Hodgkin lymphoma in the past
- Were treated for cancer with radiation
Lymphoma Symptoms
Warning signs of lymphoma include:
Local symptoms of lymphoma
- Swollen glands (lymph nodes), often in the neck, armpit, or groin that are painless
- Cough
Systemic symptoms of lymphoma
- Shortness of breath
- Fever
- Night sweats
- Fatigue
- Weight loss
- Itching
Many of these symptoms can also be warning signs of other illnesses. See your doctor to find out for sure if you have lymphoma.
Are there any early warning signs of lymphoma?
Many times, the first symptom of lymphoma is painless swelling of lymph nodes in your neck, groin, or underarm.
Lymphoma Diagnosis
Before you have any tests, your doctor will do a physical exam, including a check for swollen lymph nodes. This symptom doesn't mean you have cancer. Most of the time, an infection -- unrelated to cancer -- causes swollen lymph nodes. They'll also ask about your family's medical history and symptoms.
You might get a lymph node biopsy to check for cancer cells. For this test, a doctor will remove all or part of a lymph node or use a needle to take a small amount of tissue from the affected node.
You might also have one of these tests to help diagnose, stage, or manage lymphoma:
Bone marrow aspiration or biopsy. Your doctor uses a needle to remove fluid or tissue from your bone marrow -- the spongy part inside the bone where your body makes blood cells -- to look for lymphoma cells.
Chest X-ray. This test uses low doses of radiation to make images of the inside of your chest.
MRI. A technician uses powerful magnets and radio waves to take pictures of organs and structures inside your body.
PET scan. This imaging test uses a radioactive substance to look for cancer cells in your body.
Molecular test. This test is used to find changes to genes, proteins, and other substances in cancer cells to help your doctor figure out which type of lymphoma you have.
Blood tests. These check the number of certain cells, levels of other substances, or evidence of infection in your blood.
Questions for Your Doctor About Lymphoma
If your diagnosis is positive for lymphoma, here are some questions to consider asking your doctor:
- What type of lymphoma do I have?
- What stage is my lymphoma?
- Have you treated people with this kind of lymphoma before?
- What are my treatment options?
- How will the treatments make me feel?
- What will help me feel better during my treatment?
- Are there any complementary treatments I could consider along with the usual medical care? Are there any I should avoid?
Lymphoma Treatment
The treatment you get depends on your type of lymphoma and its stage.
Treating non-Hodgkin lymphoma
The main treatments for non-Hodgkin lymphoma are:
- Chemotherapy, which uses drugs to kill cancer cells
- Radiation therapy, which uses high-energy rays to destroy cancer cells
- Immunotherapy, which uses your body's immune system to attack cancer cells
- Targeted therapy, which targets aspects of lymphoma cells to curb their growth
Treating Hodgkin lymphoma
The main treatments for Hodgkin lymphoma are:
- Chemotherapy
- Radiation therapy
- Immunotherapy
If these treatments don't work, you might have a stem cell transplant. First, you'll get very high doses of chemotherapy. This treatment kills cancer cells but also destroys stem cells in your bone marrow that make new blood cells. After chemotherapy, you will get a transplant of stem cells to replace the ones that were destroyed.
Your doctor can do two types of stem cell transplants:
- An autologous transplant uses your own stem cells.
- An allogeneic transplant uses stem cells taken from a donor.
Can lymphoma go away without treatment?
Some types of lymphoma can go away without treatment, but it depends on the type of lymphoma and the person who has it:
Follicular lymphoma. This type of lymphoma can go away without treatment, especially if it's not causing health problems beyond swollen lymph nodes. It often grows slowly and responds well to treatment, but it's hard to cure and can come back after treatment.
Low-grade lymphoma. This type of lymphoma grows so slowly that patients can live for many years without symptoms, and some may never need treatment.
Intermediate-grade lymphoma. This type of lymphoma gets worse quickly without treatment, but treatment can cause remission in many cases.
Hodgkin lymphoma and high-grade non-Hodgkin lymphoma. These types of lymphoma can often go into complete remission and may not need further treatment.
Lymphoma Management and Outlook
Lymphoma treatment can cause side effects. Talk to your medical team about ways to ease any symptoms you have.
Also, ask your doctor about changes to your diet and exercise that can help you feel better during your treatment. Ask a dietitian for help if you're not sure what types of food to eat. Exercises such as walking or swimming can ease fatigue and help you feel better during treatments such as chemotherapy and radiation. You might also try alternative therapies such as relaxation, biofeedback, or guided imagery to help ease pain.
Treatments have improved a lot, and many people do very well after treatment. Your doctor will talk to you about a survivorship care plan. Your outlook depends on:
- The kind of lymphoma you have
- How far the cancer has spread
- Your age
- The type of treatment you get
- What other health problems you have
Lymphoma Support (Resources)
You can get support from people who have gone through this kind of illness. Contact the Leukemia & Lymphoma Society or Lymphoma Research Foundation to learn more.
It’s also crucial to keep your loved ones close — they can offer both emotional and practical support, such as helping around the house when you're in the hospital. Also, find someone you can openly talk to about your feelings and worries, whether it's a friend, family member, or a professional such as a counselor or social worker.
Takeaways
Lymphoma is a cancer stemming from lymphocytes, the infection-fighting cells within your immune system. It appears in two forms: non-Hodgkin lymphoma (which is more common) and Hodgkin lymphoma. Lymphoma's causes remain mostly unknown, but risk factors include age, gender, a compromised immune system, infection, and exposure to certain chemicals.
Symptoms such as swollen glands, weight loss, fever, and night sweats could suggest lymphoma. Treatment varies by type and stage of lymphoma but may include chemotherapy, radiation, immunotherapy, targeted therapy, and potentially stem cell transplants.
Lymphoma FAQs
What is the survival rate for lymphoma?
Overall, the 5-year survival rate for non-Hodgkins lymphoma is 74%, but this varies based on the type and stage of your cancer.
How long can you live with lymphoma without knowing?
Some types of lymphoma grow so slowly that you can live for years without knowing you have the disease.
