Lymphoma is a general term for cancer of the lymphatic system. The lymphatic system is part of the body’s immune system, made up of a complex network of lymph organs including: bone marrow, the thymus and the spleen.
The lymphatic system is filled with fluid called lymph, which carries nutrients, waste and white blood cells (lymphocytes) around the body. When lymphocytes develop abnormally or fail to die when instructed to, they can collect in the lymph nodes and form tumours.
There are many different sub-types of lymphoma, which are divided into two main types: Hodgkin lymphoma (Hodgkin disease) and non-Hodgkin lymphoma.
Hodgkin lymphoma is a rare form of lymphoma characterised by a particular abnormal tumour cell – Reed Sternberg – not present in other forms of lymphoma. Over 62,000 people worldwide are diagnosed with Hodgkin lymphoma each year, of those 38,000 (60%) are male and 24,000 (40%) are female. Approximately 25,000 people worldwide die each year from the disease (1).
Non-Hodgkin Lymphoma (NHL)
Any lymphoma that is not Hodgkin lymphoma is classified as non-Hodgkin lymphoma. There are more than 30 different subtypes of non-Hodgkin lymphoma, which are generally classified into two equal groups, depending on the rate at which the tumour is growing
- Tumour cells divide and multiply slowly making initial diagnosis difficult. Patients may live many years with the disease, yet standard treatment cannot cure the disease in its advanced stages.
- Tumour cells divide and multiply rapidly in the body and, if left untreated, can be fatal within six months to two years. Unlike indolent NHL, treatment of aggressive NHL can lead to patients being cured.
COMMON SIGNS AND SYMPTOMS
- Painless swelling in a lymph node
- Chills/temperature swings
- Recurrent fevers and excessive sweating at night
- Unintentional weight loss
- Loss of appetite
- Persistent tiredness and lack of energy
- Breathlessness and coughing
- Persistent itch all over the body without an apparent cause or rash
- General fatigue
- Enlarged tonsils
The symptoms of lymphoma are commonly seen in other, less serious illnesses, such as influenza or other viral infection. These symptoms are often overlooked, but in cases of less serious illnesses they would not last very long. With lymphoma, these symptoms persist over time and cannot be explained by an infection or another disease.
The most common symptom is a painless swelling in a lymph node. The neck or armpits are common places noticed first, but the swelling can occur in other parts of the body including the groin (that may cause swelling in the legs or ankles) or the abdomen (that can cause cramping and bloating). Some patients with lymphoma notice no swelling at all while others may complain of night sweats, weight loss, chills, a lack of energy, or itching. There is usually no pain involved, especially when the lymphoma is in the early stage of development. Most people who have nonspecific complaints such as these will not have lymphoma. However, it is important that any person who has symptoms that persist see a doctor to confirm that no lymphoma or serious illness is present.
- In certain instances, people feel pain in the lymph nodes after drinking alcohol.
- If the lymphoma involves lymphatic tissue within the abdomen, bowel or stomach, fluid may build up causing swelling near the intestines, potentially leading to sensations of abdominal pressure, pain, diarrhea and/or indigestion.
- The enlarged lymph node sometimes causes other symptoms by pressing against a vein (causing swelling of an arm or leg), or against a nerve (causing pain, numbness, or tingling in an arm or leg).
- Some people experience lower back pain that is unexplained. It is thought that this may be caused by expanding lymph nodes pressing on nerves.
- As lymphomas progress and cancerous lymphocytes spread beyond the lymphatic system, the body loses its ability to fight infection. The generalised symptoms that develop may be confused with signs of influenza, tuberculosis, other infections such as infectious mononucleosis, or other cancers.