Lymphoma

What is lymphoma?

“Lymphoma” is the general term for cancer in your lymphatic system — the network of tissues, vessels and organs that help your body fight infection. It’s considered a blood cancer because the condition starts in white blood cells (lymphocytes) in your lymphatic system.

There are two main lymphoma categories — Hodgkin lymphoma and non-Hodgkin lymphoma — and more than 70 lymphoma subtypes. Lymphomas can be aggressive (fast-growing) or indolent (slow-growing). Often, treatment can put lymphoma into remission or cure it. Children, teenagers and adults may develop lymphoma. This article focuses on lymphomas that affect adults.

Is lymphoma a common illness?

No, lymphoma isn’t common. The American Cancer Society estimates 89,000 people in the U.S. will be diagnosed with lymphoma in 2023. For comparison, 236,740 people in the U.S. will receive a lung cancer diagnosis in 2023.

Who is affected by lymphoma?

Non-Hodgkin typically affects ages 60 to 80. It’s more common in men than in women.

Hodgkin lymphoma may affect people between the ages of 20 to 39 and at or over age 65. Men are slightly more likely to develop Hodgkin lymphoma than women.

What are common lymphoma symptoms?

Many lymphoma symptoms are like symptoms of other, less serious diseases. Having these symptoms doesn’t mean that you have lymphoma. But you should consider talking to a healthcare provider whenever you have changes in your body that don’t go away within a few weeks.

Symptoms common to Hodgkin lymphoma and non-Hodgkin lymphoma can include:

• Painless swelling of one or more lymph nodes in your neck, armpits or groin that doesn’t go away within a few weeks.
• Persistent fatigue, when you feel very tired day after day even after getting enough sleep.
• Fever stays above 103 degrees Fahrenheit (39.5 degrees Celsius) for more than two days, or a fever that comes back.
• Drenching night sweats, sweating that are so intense that you wake up to find your pajamas and sheets soaking wet.
• Shortness of breath (dyspnea), when you feel as if you can’t get enough air in your lungs.
• Unexplained weight loss, when you’ve lost 10% of your total body weight over six months without dieting or exercise.

What causes lymphoma?

Lymphoma happens when the white blood cells in your lymphatic system change (mutate) into rapidly growing cancer cells that don’t die. Like most cancers, the majority of the genetic mutations that cause lymphoma happen spontaneously, without an identifiable cause. But research suggests the following conditions or issues may increase your risk of developing lymphoma:

• You have or have had viruses including HIV (human immunodeficiency virus), Epstein-Barr (mononucleosis) and Kaposi sarcoma human immunodeficiency virus.
• You have a family history of lymphoma.
• Your immune system is weakened by other conditions or medical treatments. For example, people who have organ transplants take immunosuppressant medication to keep their bodies from rejecting the transplanted organ.
• You have an autoimmune disease. An autoimmune disease happens when your immune system accidentally attacks your body instead of protecting it.

How is lymphoma diagnosed?

Healthcare providers diagnose lymphoma by doing physical examinations to evaluate potential lymphoma symptoms and biopsies to obtain tissue for examination by a medical pathologist. If laboratory tests show signs of lymphoma, providers may do certain blood and imaging tests to learn more about your condition and to plan treatment.

Blood tests

• Complete blood count (CBC) with differential to analyze different types of white blood cells.
• Erythrocyte sedimentation rate (ESR) to detect inflammation that may be a sign of lymphoma.
• Lactate dehydrogenase (LDH) to detect large amount of cell “turnover” or growth/death.
• Liver and kidney function tests.
• Serum protein electrophoresis (SPEP) to evaluate monoclonal proteins (M proteins), which are abnormal proteins that your plasma cells produce.

Imaging tests

• Computed tomography (CT) scan to look for lymphoma signs such as enlarged lymph nodes, spleen or other organs.
• Positron emissions tomography (PET) scans to detect signs of cancer. PET scans are usually combined with low-resolution CT scans and are sometimes used in addition to magnetic resonance imaging (MRI) scans.

If you have non-Hodgkin lymphoma, your provider may order laboratory tests to identify genes, proteins and other substances that are unique to specific non-Hodgkin lymphomas.

What are lymphoma treatments?

Treatments vary based on lymphoma type. For example, if you have a slow-growing lymphoma, your healthcare provider may recommend active surveillance (watchful waiting) before starting treatment. In active surveillance, providers carefully monitor your overall health and signs of lymphoma.

Common lymphoma treatments include:

• Chemotherapy.
• Radiation therapy.
• Targeted therapy
• Immunotherapy.
• CAR T-cell therapy.
• Stem cell (bone marrow) transplantation.

Your provider may recommend palliative care as part of your treatment plan. Palliative care focuses on helping you manage symptoms and treatment side effects. It also offers support. Palliative care treatment may include medication, activities to help manage stress, and emotional and spiritual support.

What are common side effects of lymphoma treatment?

Lymphoma treatments may have different side effects because people often have different reactions to the same treatment. Ask your healthcare provider about treatment side effects and what you can do to manage them.

How can I reduce my risk of developing lymphoma?

Researchers continue to identify lymphoma risk factors. There’s reason to believe certain viruses and family medical history increase the risk of developing lymphoma. Talk to your healthcare provider if you think your medical history or family medical history might increase your risk of developing lymphoma.

What can I expect if I have lymphoma?

Your prognosis is what you can expect after completing treatment. Your specific prognosis depends on your situation, such as the type of lymphoma you have, your age and your overall health. That said, treatment often puts lymphoma into remission or cures the condition. Remission means you don’t have lymphoma symptoms and tests don’t find signs of lymphoma.

Lymphoma in remission can come back (recur). If you have lymphoma in remission, you’ll have regular follow-up appointments with your healthcare provider. They may do tests to check for signs of lymphoma. Symptoms are changes that you can feel in your body and describe to others. Signs are changes in something measured, like your temperature or blood tests to check white blood cell counts.

What are the survival rates for lymphoma?

Overall, survival rate data show 89% of people with Hodgkin lymphoma and 74% of people with non-Hodgkin lymphoma were alive five years after diagnosis.

Survival rates are estimates based on the experiences of groups of people with the same disease. Survival rate estimates can’t predict how long a person may live with lymphoma. If you have questions about lymphoma survival rates, ask your healthcare provider to explain what you can expect.

How can I take care of myself if I have lymphoma?

If you have lymphoma, you might benefit by creating a plan for living with lymphoma. This plan could see you through initial treatment and any follow-up treatment. Here are some things to consider as you develop your plan:

• Find out how lymphoma treatment might affect your daily life. That way you can decide if you’ll need help at home or while you’re receiving treatment.
• Follow a healthy diet that includes lean proteins, whole grains and full-fat dairy products. Cancer treatment may affect your appetite. If it does, talk to a nutritionist about ways to make sure you’re getting enough food and drink to maintain strength during treatment.
• Take time for yourself, whether that’s writing in a journal, listening to music or spending time outside.
• Cancer is stressful. You might find activities like meditation, relaxation exercises or deep breathing exercises help to ease your stress.
• Get some exercise. Studies suggest exercise improves quality of life for people with lymphoma by reducing fatigue and stress.
• Cancer can be lonely. You might not feel comfortable talking to family and friends about your illness. Ask your healthcare provider about services and programs that might be helpful.

When should I see my healthcare provider?

Contact your healthcare provider any time you think your lymphoma symptoms are getting worse or you need help managing your treatment side effects.

When should I go to the emergency room?

Many cancer treatments affect your immune system. That means your cancer treatment might increase your risk of developing infections. Symptoms that might require an emergency room visit are:

• Fever of 100.3 degrees Fahrenheit (39.5 degrees Celsius) or above.
• Chills.
• Productive or “wet” cough.
• Belly (abdominal) pain.
• Persistent diarrhea that lasts for more than two weeks.

What questions should I ask my healthcare provider?

Cancer is a journey, and your questions will change throughout your journey. If you’re just learning you have lymphoma, here are some basic questions you might want to ask:

• How do you know I have lymphoma?
• What kind of lymphoma do I have?
• How long have I had lymphoma?
• What are my treatment options?
• What are each treatment’s side effects?
• What’s my prognosis?

Is lymphoma a serious cancer?

That depends on the type of lymphoma. For example, non-Hodgkin lymphoma may make your body more vulnerable to life-threatening infections, other kinds of cancer or heart disease. Data show about 3 in 100,000 people worldwide die of some type of non-Hodgkin lymphoma.

Does lymphoma show up in blood work (blood tests)?

Blood tests may detect issues like having a high white blood cell count that may be a sign of lymphoma, leukemia or other blood cancers. But they don’t detect lymphoma. Healthcare providers diagnose lymphoma based on biopsy and imaging tests results.

Where does lymphoma most often start?

Lymphoma can start almost anywhere you have lymphocytes. These are infection-fighting white blood cells that are found throughout your lymphatic system. You have lymphocytes in your lymph nodes, spleen, bone marrow and other areas of your body. The most common early symptom is swollen lymph nodes in your neck, upper chest, armpit, belly or groin.

How long can you have lymphoma without noticing?

You can have lymphoma for years without noticing changes in your body. Sometimes, people learn they have the condition of lymphoma because routine imaging tests detect signs of lymphoma.