Lymphoma is a type of cancer that develops in the lymphatic system, which is a part of the immune system. The immune system is a vital part of the body's defenses. Cells produced in the immune system attack bacteria and viruses that get into the body. The lymphatic system is composed of cells, fluid, tissues, and organs, such as the spleen, thymus gland, the bone marrow, and the lymph nodes. Like all other cells and tissues in the body, cells in the lymphatic system can develop abnormalities and become cancerous. The lymphocytes or lymph cells are the origin of the cancer, which like leukemia, is a blood cancer. This article will look at several of the different facets of lymphoma and how it can be spotted and managed.
Types of Lymphoma
There are two main types of lymphoma: Hodgkin's and non-Hodgkin's. Both diseases start with lymphocytes.
Hodgkin's lymphoma:
- Occurs less frequently than non-Hodgkin's..
- Incidence has been decreasing in recent years.
- Hodgkin's tends to be found in younger people. Median age is 39.
- Microscopic examination of tissue reveals giant cells with multiple nuclei called Reed-Sternberg cells. They are diagnostic for Hodgkin's disease.
- The 5 year survival rate is 86-90%.
- There are only 6 varieties.
- The commonest forms are nodular sclerosis classical non-Hodgkin's and mixed cellularity classical non-Hodgkin's.
- Treatment depends on the type of Hodgkin’s lymphoma.
Non-Hodgkin's lymphoma:
- This is the 7th most common cancer diagnosed each year.
- Incidence of the disease is increasing.
- Non-Hodgkin's is a disease of older people. The median age is 66.
- No Reed-Sternberg cells.
- The 5 year survival rate is 70%.
- There are more than 60 types of non-Hodgkin's
- 85% of patients have a type of B cell lymphoma.
- Treatment depends on type.
Symptoms of Lymphoma
The symptoms of both types of lymphoma are similar. They can include the following:
- Unexplained weight loss
- Fever
- Night sweats
- Swelling of lymph nodes without pain or tenderness. Hodgkin's lymphoma tends to cause swollen lymph nodes in the upper body, in the neck and axillae and within the thorax. However, the enlarged nodes can be anywhere in both forms of lymphoma.
Treatment
The treatment of lymphoma depends on the type (Hodgkin's vs. non-Hodgkin's) and the sub-type. However, all types are initially treated with chemotherapy and radiation treatments For Hodgkin’s lymphoma, the choice of drug depends on a number of factors: the type and stage of the Hodgkin's disease; the total bulk of the disease; whether systemic symptoms (fever, weight loss, night sweats) are present; test results; and the patient's age and health. There are protocols established for each stage of the disease, including the use of radiation therapy.
Initial treatment for non-Hodgkin's disease depends on the stage, of course, and on how aggressive the lymphoma is. In some cases the first-line treatment is actually observation if the lymphoma is not growing or causing problems, depending on the age of the patient. For patients with involvement of only one lymph node, radiation therapy alone may be indicated. For more advanced patients, chemotherapy with or without immunotherapy, is first-line treatment. Protocols have been developed to match treatment with the stage and type of lymphoma. Immunotherapy is added when indicated. Sometimes, in very sick patients, immunotherapy may be the only treatment.
Treatment for lymphoma is complex and largely dependent on the expertise and knowledge of the oncologist, as well as the type and stage of the disease. Thankfully, good outcomes are in the majority in this disease.