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Lymphoma refers to malignant tumors of the lymph system. The lymph system is a series of nodes or glands located in numerous places throughout the body, connected by a network of vessels which carry lymph fluid, or white blood cells. The lymph system is part of the immune system and key in fighting off disease. Lymphoma is considered a serious disease because cancer can spread throughout the body via the lymph vessels. However, recent advances in medicine have made lymphoma more treatable than ever before, and there is much success in defeating it.
There are several different kinds of lymphoma divided into two basic categories: Hodgkin's lymphoma, named after Dr. T. Hodgkin, and non-Hodgkin's lymphoma. Within each category there are subtypes or classifications. While Hodgkin's lymphoma has five subtypes, there are about 35 recognized types of cancer that fall into the non-Hodgkin's category, and differentiating between them can be difficult.
Regardless of category, each classification or subtype behaves differently and in most cases requires its own specific treatment regimen. Therefore, careful diagnosis is necessary. If your oncologist is part of a research board working through a University, you may have the advantage of your case being presented before a review board to gain a consensus on the pathology or type of lymphoma, staging and treatment. If not, it is always wise to seek a second opinion from another experienced oncologist who will review your test results and make his or her own diagnosis.
Some types of lymphoma are tougher to fight than others, but generally speaking, this disease responds to treatment in most cases. The main concern is a tendency for recurrence with certain types of lymphoma. Chemotherapy and radiation can also produce long-term effects years after lymphoma has been cured, but this situation is expected to improve with time as medical advancements continue to be made.
The most common symptom of both non-Hodgkin’s lymphoma and Hodgkin’s lymphoma is a painless swelling in a lymph node, usually in the neck, armpit or groin. The swelling is caused by an excess of affected lymphocytes (white blood cells) collecting in your lymph node.
Some people may find that the swelling aches.
Swollen nodes or glands are a common response to infection, so if you have swollen nodes do not panic. It is highly unlikely they are the result of lymphoma.
Other symptoms will usually only begin once the cancer has spread through most or all of your lymphatic system. This causes the lymphatic system to stop working properly, which weakens your immune response. Symptoms of advanced lymphoma include:
unexplained tiredness or fatigue
night sweats
unexplained weight loss
fever
trouble getting rid of infections
a persistent cough or feeling of breathlessness
persistent itching of the skin all over the body
Other symptoms will depend on where in the body the enlarged lymph glands are. For example, if the lymphoma is in the abdomen (tummy), you may have abdominal pain or indigestion.
A few people with Hodgkin’s lymphoma have abnormal cells in their bone marrow when they are diagnosed. This can reduce the number of healthy cells in the blood and lead to:
breathlessness and tiredness
an increased risk of infection
excessive bleeding, such as nosebleeds, heavy periods and spots of blood under the skin
In rare cases, people with Hodgkin’s lymphoma may have pain in their affected lymph gland when they drink alcohol.
To someone newly diagnosed with lymphoma, treatment options may be difficult to understand. There are nearly 30 types of lymphoma, and often there are multiple treatment options for a single disease. Here is a brief guide to understanding lymphoma treatment.
After the diagnosis of lymphoma and finding out the exact type of Hodgkin's or non-Hodgkin's lymphoma, a number of tests are carried out to find out the extent of disease (the stage of lymphoma) and other factors that determine the prognosis. When all these investigations are complete, the oncologist counsels the patient regarding the best treatment options available.
There are four main types of treatment for lymphomas:
Chemotherapy – Drugs that are administered as infusions in your veins or as pills. Common chemotherapy schedules include ABVD, R-CHOP and CHOP.
Radiotherapy – High energy rays that are directed at the tumor. Radiotherapy can be delivered over small areas (involved field radiation) or large areas (extended field radiation).
Antibody therapy (also called biological therapy) – Using drugs like Rituximab that target special molecules on the surface of cancer cells.
Bone marrow or stem cell transplant – Using high doses of chemotherapy or radiation to kill all cancer cells while saving the bone marrow with transplantation of marrow or stem cells.
Hodgkin’s lymphoma is usually treated with chemotherapy and radiotherapy. Treatment options are based on the stage of lymphoma and some prognostic factors. Nearly all patients receive chemotherapy, and radiation may be used in early stage disease usually after chemotherapy or occasionally as the only treatment.
Treatment Options for Hodgkin’s Lymphoma
There are nearly 25 different types of non-Hodgkin’s lymphoma. Some of them behave very differently from others. The treatment of all NHL is not the same but depends on the type and behavior of the particular type. Chemotherapy is usually the main treatment. Radiation or monoclonal antibody therapy may be added to chemotherapy in some situations for added benefit.
Treatment Options for Aggressive Non-Hodgkin’s Lymphoma – includes treatment for a group of common NHL including diffuse large B-cell lymphoma.
Follicular (Low Grade) Lymphoma Treatment – treatment of slow growing lymphomas.
Mantle Cell Lymphoma Treatment – a lymphoma that looks slow-growing but behaves aggressively.
Gastric MALT Lymphoma Treatment – treatment of a type of lymphoma that affects the stomach.
Primary CNS Lymphoma Treatment – a lymphoma that affects mainly the brain.
Cutaneous T-cell Lymphoma Treatment – treatment of skin lymphoma.
Burkitt’s Lymphoma Treatment – a fast-growing lymphoma that affects children.