Lymphoma: Symptoms, Diagnosis, Treatment

Lymphoma is a blood cancer that occurs when white blood cells called lymphocytes grow out of control. As lymphocytes help the body to fight infection, lymphoma is sometimes referred to as the cancer of the immune system.

Non-Hodgkin lymphoma is relatively common in Malaysia, as it was ranked eighth among new cancer cases diagnosed in 2020 and attributed to 4 in every 100 patients newly diagnosed with cancer. The other type of lymphoma, Hodgkin lymphoma, was found in 5 in every 1,000 new cancer patients.

Types of lymphoma

There are more than 60 different types, broadly classified into two main types:

• Hodgkin lymphoma
• Non-Hodgkin lymphoma
• Slow-growing (‘low-grade’ or ‘indolent’)
• Fast-growing (‘high-grade’ or ‘aggressive’)

Risk factors of lymphoma

Common risk factors for both lymphomas include being a male, having weakened immune system, and having family history of respective lymphomas.

Other risk factors that may increase the risk of Hodgkin lymphoma are:

• In early adulthood (in 20s) or late adulthood (after age 50)
• Epstein-Barr virus infection/mononucleosis

Non-Hodgkin lymphoma may be more common in individuals with these factors:

• Above age 60
• Overweight
• Having certain autoimmune diseases
• Exposure to certain chemicals (for example benzene) and certain herbicides and insecticides
• Exposure to radiation due to nuclear accidents or radiation therapy for other cancers

Signs and symptoms of lymphoma

Symptoms that are suggestive of Hodgkin lymphoma are:

• Itchy skin
• Feeling tired (fatigue)
• Loss of appetite
• Cough, trouble breathing, chest pain

Meanwhile, general symptoms for non-Hodgkin lymphoma may appear as:

• Enlarged lymph nodes
• Chills
• Feeling tired (fatigue)
• Swollen abdomen
• Feeling full after only a small amount of food
• Cough, trouble breathing, chest pain
• Severe or frequent infections
• Easy bruising or bleeding

Some people with lymphoma may experience B symptoms:

• Fever without an infection, which comes and goes for several days or weeks
• Drenching night sweats
• Losing weight of at least 10% of body weight over 6 months without trying

Diagnosis of lymphoma

A complete medical history and physical examination, as well as a blood test, will help the doctor to understand the status of your health and the disease.

Other tests that may be ordered include:

• Biopsy to remove lymph nodes that remain persistently enlarged or continue to grow and sent to the laboratory for examination under the microscope.
• Imaging tests to make pictures of the inside of the body to determine the possible causes of certain symptoms and the stage of the disease, as well as to monitor treatment effectiveness and signs of cancer coming back. Common tests used are x-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI), and positron emission tomography (PET) scan.

Learn more about the different types of screening and diagnostic procedures performed to diagnose lymphoma.

Treatment options for lymphoma

Considerations when creating a treatment plan include the stage (extent) of the disease, type, and location of the tumour, as well as the person’s age and general health. Chemotherapy remains the cornerstone in the treatment of lymphoma and may be used in combination with radiotherapy or other treatment methods.

The following are common treatments for lymphomas:

• Chemotherapy uses drug to destroy cancer cells.
• Radiation therapy uses high-energy rays (or particles) to kill cancer cells.
• Immunotherapy uses medications to help the immune system recognise and destroy cancer cells.
• Stem cell transplant utilises blood-forming stem cells from the blood or the bone marrow. This is often used for hard-to-treat cases that does not go away completely with chemotherapy and/or radiation, or in relapse cases.

Learn more about the different types of treatment technologies to treat lymphoma.

Prevention of lymphoma

Actions that can be taken to lower the risk of lymphomas are:

• Stay away from known risk of HIV, which can weaken the immune system
• Maintain healthy immune system through lifestyle changes
• Achieve or maintain a healthy weight
• Stay physically active
• Adopt healthy eating habits

Detect to Protect!

At this moment, there are no widely recommended screening tests for lymphoma.

Nonetheless, it is imperative to pay attention to possible signs and symptoms, such as enlarged lymph nodes (usually on the side of the neck, in the armpit, or in the groin) or other general symptoms of lymphoma. Although physical discomfort may result from something else other than lymphoma, it is still important to consult a doctor, especially if they persist or worsen.

Make an appointment at Gleneagles Hospitals

If you are experiencing any of the symptoms of lymphoma, get in touch with us to find out more about our Haemato-Oncology Services at your nearest Gleneagles Hospital.

Gleneagles Hospital works with oncologists to assist patients through cancer treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.