Lymphoma is a type of cancer that begins in the lymphocytes. Lymphocytes are a form of white blood cells that defend the body against the antigens (foreign substance). Lymphoma affects the lymphatic system of the body (lymph glands, thymus gland, spleen, bone marrow). It may also affect the various other organ systems of the body.
Lymphoma occurs when the growth of lymphocyte is altered, and it begins to grow abnormally. Lymphoma can occur at any age, but it mostly affects children and adults between 15 to 24 years.
What is Lymphoma?
Lymphoma (a.k.a lymphatic cancer) is a type of cancer that affects the immune system. Lymphoma is usually present in the bloodstream, so it can move to different parts of the body and can develop a secondary tumor.
Types of Lymphoma:
Based on the origin of the tumor lymphoma is of two types, they are:
Non-Hodgkin lymphoma is the common form of lymphoma that accounts for 90% of lymphomas. It usually occurs when T cell or B cell (a type of white blood cells) become abnormal.
Hodgkin lymphoma is a malignant transformation of B cells (a type of white blood cells). Hodgkin lymphoma usually affects spleen, bone marrow and lymph nodes.
What Causes Lymphoma?
The exact cause of lymphoma remains unknown. However, it is believed that lymphoma occurs due to genetic mutations (sudden alterations in the gene) in the white blood cells.
This mutation causes rapid multiplication of cells and continues to grow and divide without causing cell death. This leads to the formation of ineffective and diseased lymphocytes in the lymph nodes and causes swelling.
Symptoms of Lymphoma:
In most of the cases, the person may experience signs and symptoms similar to the common cold, but these symptoms may last for a longer duration than expected. The most common symptoms of lymphoma include:
- Swelling of lymph nodes that does not go away
- Fever without any infection
- Sweating during night
- Unintentional weight loss
- Loss of appetite
- Unusual itching
- Pain in the lymph
- Shortness of breath
Risk Factors for Lymphoma:
The factors that increase the risk of different types of lymphoma include:
The risk of non-Hodgkin lymphoma may increase due to certain factors like:
- Age: This type of lymphoma is very common in people with 60 years or older.
- Ethnicity and location: Non-Hodgkin lymphoma is very common in developed countries, and it mostly affects white Americans than compared with African-Americans and Asian-Americans.
- Chemicals and radiation: Exposure to nuclear radiation and use of certain chemicals in the agriculture increases the risk of non-Hodgkin lymphoma.
- Immunodeficiency: Weak immune system due to certain medical conditions, such as HIV AIDS, or use of certain medications that suppresses the immune system after an organ transplant increases the risk of non-Hodgkin lymphoma.
- Autoimmune disease: Having an autoimmune disease, such as rheumatoid arthritis, and celiac disease increases the risk of non-Hodgkin lymphoma.
- Infection: Infections, such as glandular fever caused due to Epstein-Barr virus (EBV) transforms the lymphocytes and increase the risk of lymphoma.
- Breast implants: Breast implants can cause large cell lymphoma in the breast tissue.
- Obesity: Being obese increases the risk of lymphoma.
The risk of Hodgkin lymphoma increases with:
- Age: Individuals between the age of 20 to 30 years and individual over the age of 55 years are at increased risk of Hodgkin lymphoma.
- Gender: Males are at increased risk of Hodgkin lymphoma as compared to females.
- Family history: Individuals having a family history of Hodgkin lymphoma are at increased risk.
Diagnosis of Lymphoma:
The doctor initiates the diagnosis by reviewing the family history, medical history and signs and symptoms of the individual. The doctors perform a physical examination to check for the inflammation in the abdomen, chin, neck, armpits and groin region.
The doctor recommends certain diagnostic tests to confirm the presence of lymphoma, this include:
Blood Tests and Biopsies:
Blood tests and biopsies are done to evaluate the presence of lymphoma. A biopsy is done by taking a small sample of lymph tissue by using a sterilized needle and is examined under a microscope. In most of the cases, a bone marrow biopsy is performed. The biopsy is done under the influence of a local anesthetic, a sedative or a general anesthetic.
Biopsies and blood tests are used to evaluate the stage of cancer and to determine if the lymphoma has invaded other part of the body.
Computerized Tomography (CT) Scan:
CT scan is a specialized X-ray that helps in viewing the internal organs of the body. In lymphoma, a CT scan helps to:
- Define the stage of the lymphoma
- Determine the site of a tumor
- Determine the involvement of spleen
Magnetic Resonance Imaging (MRI):
An MRI scan is performed to capture the detailed images of the internal organs. In lymphoma, it is used to determine the proliferation of lymphoma to the brain, spinal cord or other regions of the body, such as head and neck.
X-rays are non-invasive diagnostic procedures that use rays for producing the images of internal organs of the body. In lymphoma, a chest X-ray is used to view the enlarged lymph nodes.
An abdominal ultrasound is a painless diagnostic procedure that uses high-frequency sound waves to examine the internal parts of the body. In lymphoma, an abdominal ultrasound is used to examine the enlarged lymph nodes in the abdomen.
Positron Emission Tomography (PET) Scan:
PET scan uses radiation to assess the activity inside the body. In this procedure, a radiotracer consisting of radioactive material is inserted inside the body to determine the activity of the cells. PET scan is also performed in patients undergoing treatment for cancer to determine the treatment response.
Treatment for Lymphoma:
The treatment is initiated depending upon the type and the stage of lymphoma. The main target of the treatment is to destroy the cancer cells and bring the disease to remission.
Treatment options for Lymphoma include:
Chemotherapy is used along with radiation therapy to treat the lymphoma. Chemotherapy is a drug therapy that involves the use of anti-cancer agents (drugs that kills cancer cells) to destroy the cancer cells.
Radiation therapy uses high-energy rays to shrink and kill the cancer cells. Radiation therapy mainly focuses on small regions of cancer.
Stem-cell transplantation is usually performed to replace the diseased bone marrow with new bone marrow. The transplantation may involve the use of patient’s stem cells (autologous transplantation) or stem cell of another person (allogeneic transplantation).
Stem-cell transplantation is an option if the lymphoma recurs after treatment. In stem-cell transplantation, the patient is initially exposed to whole-body external beam radiation along with chemotherapy for eliminating the lymphoma.
Radio-immunotherapy is also known as radiolabeled monoclonal antibody therapy. In this therapy, a monoclonal antibody is paired with a radioactive substance. The radioactive substance travels and binds to cancer cells and destroys it by delivering high dose radiation directly to a tumor.
Biological therapy is a drug therapy in which a living microorganism is inserted inside the body to stimulate the immune system and to destroy the cancer cells.
Antibody therapy involves the administration of synthetic antibodies inside the bloodstream to fight against cancer’s antigen.
Monoclonal Antibody Therapy:
Monoclonal antibody therapy is also known as targeted therapy. The monoclonal antibodies produced in the laboratory detect the cancer cells and destroys them.
The doctor recommends surgery for removing the spleen or any other organs if a tumor has spread to different part of the body.