Lymphoma is a serious cancer that originates in a type of white blood cell known as a lymphocyte. The good news is that with advancements in medical science lymphoma is now highly treatable, especially when detected early. However, understanding the complex nature of this disease, the diagnostic process and the available treatment options can be overwhelming for patients and their loved ones.
In this guide, we will look into the details of lymphoma, exploring the various stages, the role of screening tests, and the diverse treatment options available. Whether you or a loved one has recently been diagnosed with lymphoma, started initial treatment or you simply want to educate yourself on this important topic, this article will provide you with the knowledge and insights you need to navigate this journey with confidence.
Understanding lymphoma
The lymphatic system operates as part of the body’s immune system, which protects against infection and disease. White blood cells (lymphocytes) are an important part of your immune system to fight infection.
The lymphatic system also maintains fluid balance, aids in digestion and acts as your body’s natural detox system by clearing out waste and toxins.
Lymphoma is a type of cancer that develops when white blood cells grow out of control, multiplying, dividing and building up. These abnormal cells or cancer cells stop your body from making normal healthy cells, preventing organs in your body from working properly. The abnormal cells might spread to other areas of your body and start growing there too.
There are two main types of lymphoma:
- Hodgkin’s lymphoma (HL). Classic Hodgkin lymphoma is the most common form of this disease, typically starting above the diaphragm in the neck, armpits, or chest. It usually spreads predictably and is diagnosed at early stages
- Non-Hodgkin’s lymphoma (NHL). There are more than 60 different sub types of non-Hodgkin lymphoma and it is highly unpredictable. The two most common subtypes of non-Hodgkin lymphoma are diffuse large B-cell lymphoma and follicular lymphoma
Symptoms of lymphoma:
- Swollen lymph nodes
- Fatigue
- Night sweats
- Weight loss
- Fever
🧪 Lymphoma diagnosis
Physical examination, biopsies, blood tests and imaging tests such as PET scans, CT scans, chest X-rays and MRI scans. These are all tools used by healthcare professionals and oncology specialists to see where the lymphoma is in the body.
1️⃣➡4️⃣ Stages of lymphoma
Once a lymphoma diagnosis is confirmed, the next step is to determine the stage of the disease. Cancer staging is an important aspect of the diagnostic process, as it helps healthcare providers develop the most appropriate treatment plan.
- Stage 1 – A single group of lymph nodes affected anywhere in the body
- Stage 2 – Two or more groups of lymph nodes affected (on the same side of the diaphragm)
- Stage 3 – Two or more groups of lymph nodes affected (on both sides of the diaphragm)
- Stage 4 – lymphoma that has spread to at least one body organ outside the lymphatic system e.g. bone marrow, liver, intestine
Understanding the stages of lymphoma is essential, as it directly impacts the treatment options and the overall prognosis for the patient. Patients with early-stage lymphoma cancer often have a better chance of successful treatment and long-term survival, compared to those with more advanced stages of the disease.
💉 Lymphoma treatment
The treatment approach for lymphoma is tailored to the individual patient and the specific stage of the disease. The main treatment options for lymphoma include:
Radiation therapy (also known as radiotherapy)
Radiation therapy, either external beam radiation or internal brachytherapy, is often used in combination with chemotherapy for more advanced stages. Radiation therapy can be used as the primary treatment or as an adjuvant therapy.
Chemotherapy
Cancer cells grow and divide uncontrollably. Chemotherapy destroys the cancer cells and prevents them from multiplying. It is commonly used in conjunction with radiation therapy for the treatment of lymphoma. Chemotherapy remains a cornerstone of cancer treatment with drugs like fluorouracil, irinotecan, and oxaliplatin commonly used. Chemotherapy can help enhance the effectiveness of radiation and may also be used to treat recurrent or advanced cancer.
Targeted therapy and immunotherapy
In recent years, the development of targeted therapies and immunotherapies has expanded the treatment options for lymphoma. These newer approaches aim to target specific molecular pathways or stimulate the body’s immune system to fight cancer more effectively. Drugs such as bevacizumab and cetuximab focus on specific molecular features of the cancer by interfering with specific proteins. Immunotherapy drugs like pembrolizumab, rituximab or nivolumab may be effective.
Chimeric antigen receptor (CAR) T-cell therapy is a type of immunotherapy for some types of blood cancer. It works by turning your T lymphocytes (T cells) into more efficient cancer-fighting machines. In CAR T-cell therapy, healthcare providers introduce a new gene into your T cells that changes your cells so they can do more to detect and kill cancerous cells.
Stem cell transplants (bone marrow transplant)
This may be recommended to replace the damaged bone marrow with healthy stem cells. This can help restore damaged bone marrow following high dose chemotherapy or radiation therapy.
Palliative care
For patients with lymphoma cancer, palliative care plays a crucial role in managing symptoms and improving quality of life. Palliative care specialists work closely with the patient’s healthcare team to provide pain management, emotional support and other supportive measures.
📝 Things to consider
As you develop a treatment plan with your doctor, be sure to consider:
- The results you can expect from treatment
- The potential side effects, including long-term effects and late-term effects
- The possibility of participating in a clinical trial as part of cancer research. You may have access to advanced medical treatment that may be more beneficial to you than standard treatment
- Treatments vary based on lymphoma type. For example, if you have a low grade lymphoma, your healthcare provider may recommend waiting before starting treatment, carefully monitoring overall health and signs of lymphoma
- Regular follow ups with your healthcare provider to monitor your overall health and watch for relapse
💊 Factors influencing treatment decisions
When determining the most appropriate treatment plan for a patient with cervical cancer, health professionals consider several key factors:
- Stage of the cancer: The stage of the cancer, as determined by the diagnostic tests, is a primary driver of the treatment approach
- Tumour characteristics: Factors such as the size, location, and if it is a high-grade (fast growing) or indolent (slow growing) tumour can influence the chosen treatment strategy
- Patient’s overall general health and preferences: The patient’s age, overall health status, other risk factors and personal preferences on treatment and quality of life considerations are important factors in the decision-making process
- Availability of treatment options: The accessibility and expertise of the healthcare facility in delivering specific treatment options, such as advanced radiation therapy or minimally invasive surgery, can also shape the treatment plan
By carefully weighing these factors, the healthcare team can develop a comprehensive treatment strategy that addresses the patient’s unique needs.
📝 Conclusion
When making cancer treatment decisions there are different tools to support you to make decisions. Healthcare professionals, family, friends and support groups can help you get the information you need. Also, MacMillan Cancer Support suggest questions to ask your doctor or nurse to help you make better decisions together. These include:
- What are my options?
- What are the benefits and disadvantages of each option for me?
- How do I get support to help me make a decision that is right for me?
Sources
- Treatment options for Hodgkin lymphoma – Cancer Research UK
- Stages of non-Hodgkin lymphoma | Cancer Research UK
- Stages of Hodgkin Lymphoma – Cancer Research UK
- Lymphoma: Symptoms, Causes and Treatment
- Hodgkin lymphoma – NHS
- Non-Hodgkin lymphoma – NHS
- About Cancer – Cancer Research UK
Medical Disclaimer
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The information provided here about medications is subject to change and is not meant to include all uses, precautions, warnings, directions, drug interactions, allergic reactions, or negative effects. The absence of warnings or other information for a particular medication does not imply that the medication or medication combination is appropriate for all patients or for all possible purposes.
