Lymphoma care

Lymphoma is a general term for cancers that develop in the lymphatic system (the tissues and organs that produce, store and carry white blood cells). The lymph system helps defend the body from infection and other diseases.

Lymph nodes are located throughout your body. They act as a filter, collecting dead cells and germs to protect your body. Lymphoma can occur almost anywhere because the lymph system is a network that runs from head to toe.

There are two main types of lymphoma:

• Non-Hodgkin lymphoma is cancer of the white blood cells (lymphocytes). These cells live in the bone marrow. White blood cells make antibodies to fight infection and help control the body's immune system. There are many different types of non-Hodgkin lymphoma, and the treatment plans and prognosis vary based on the specific type.
• Hodgkin lymphoma, also known as Hodgkin disease, occurs when white blood cells (lymphocytes) become abnormal. These abnormal cells divide and multiply and eventually create a tumor. Adult Hodgkin disease, if caught early, is usually curable.

Lymphoma risk factors

Although scientists don’t know yet what causes non-Hodgkin lymphoma, some factors seem to make you more likely to develop it. These include:

• Non-Hodgkin lymphoma is slightly more common in men
• Non-Hodgkin lymphoma is slightly more common in whites
• More common in those over age 60
• Living in a farming community. Some studies suggest that certain herbicides and pesticides may play a part in lymphoma, but this has not been proven
• Bacteria or viruses, including human immunodeficiency virus (HIV), Epstein-Barr virus (EBV), human T-lymphotropic virus (HTLV) and the bacterium Helicobacter pylori
• Some inherited syndromes

Some factors can increase your risk for Hodgkin lymphoma:

• Age, 20s and those over 55 are at higher risk
• Men are at slightly higher risk than women
• Family history of Hodgkin lymphoma
• History of EBV infection
• Weakened immune system

The symptoms of lymphoma are similar to many other health problems or conditions, many of which are not serious. Symptoms for both types of lymphoma include:

• chest pain
• coughing
• fever that lingers
• headaches, concentration problems, personality changes
• night sweats
• reddened patches on the skin
• severe itchiness
• swollen lymph nodes,especially in the neck, underarms or groin
• trouble breathing
• tiredness
• unexplained weight loss
• weakness in the arms and/or legs

These symptoms are not always painful. If you have any of these symptoms for more than two weeks, call your primary health care provider.

If you have swollen lymph nodes that don’t get better or other symptoms that could be either Hodgkin lymphoma or non-Hodgkin lymphoma, here are a few common tests your health care provider may do:

• physical exam
• blood tests
• chest X-rays
• biopsy

These tests, especially the biopsy, will identify the specific type of lymphoma. They will also help you and your health care provider decide what treatment will be best for you.

After diagnosis, you may need to have additional tests to help decide how much the cancer has spread.

For those with a non-Hodgkin lymphoma diagnosis, these tests or procedures may include:

• computed tomography (CT) scan
• positron emission tomography (PET) scan
• magnetic resonance imaging (MRI)
• ultrasound
• bone marrow aspiration and biopsy
• spinal tap
• blood tests to determine if blood cells are normal in number and appearance and if your blood chemistry is normal.
• liver and kidney function tests
• echocardiogram to evaluate the size and function of the heart
• immunophenotyping (cells from a lymph node, blood or bone marrow are examined to determine what type of non-Hodgkin’s lymphoma cells are present)
• pulmonary function test

For those with a Hodgkin lymphoma diagnosis, these tests or procedures may include:

• chest X-ray
• computed tomography (CT) scan
• positron emission tomography (PET) scan
• magnetic resonance imaging (MRI)
• bone marrow aspiration and biopsy
• bone scan
• blood tests
• echocardiogram
• pulmonary function test

If you are diagnosed with lymphoma, your doctor will discuss the best options to treat it. This depends on several factors, including:

• type of lymphoma
• stage and category of disease
• symptoms
• your age and general health

Your health care provider will work with you to create the best lymphoma treatment plan for you. It will be based on the type of lymphoma you have, the stage of the lymphoma and how quickly it is spreading, your age and your medical concerns and preferences.

Treatment may include

• chemotherapy (medical oncology)
• radiation therapy
• immunotherapy
• stem cell (bone marrow) transplant.