Lymphoma

Blood, Cancer and Neoplasms

Lymphoma is one of the blood cancers that target the lymphatic system. Lymphoma occurs when the white blood cells (lymphocytes) start to change and act differently than normal cells. These abnormal cells have a faster rate of growth and fail to shed at the end of their life cycle. Lymphocytes fight off infection, but in lymphoma, they make you sick. Cancer tends to grow in parts of the lymphatic system such as the spleen, the bone marrow, and the lymph nodes. It also affects the blood and can spread to other organs in your body. Lymphoma accounts for only 9.4% of over one-million cancer cases but is still the cause of over 55,350 deaths each year. This article will help you understand the causes, symptoms, and treatments of lymphoma and provide helpful tips to help with the management of symptoms.

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Symptoms

Since lymphoma is a type of blood cancer, it can cause symptoms anywhere in the body and affect any system. The most common symptoms include:

  • Swollen lymph nodes
  • Neck swelling, underarm swelling, or groin swelling
  • Enlarged spleen
  • Abdominal pain
  • Abdominal discomfort
  • Fever
  • Shortness of breath
  • Chest pain
  • Abdominal fullness after eating
  • Abdominal swelling
  • Lymph node enlargement
  • Night sweats
  • Unexplained weight loss
  • Extreme fatigue
  • Low blood counts
  • Itching

It is important to understand these symptoms can be due to many different conditions or diseases, and not just lymphoma. Any sudden onset could be an infection in the body. If your symptoms do not go away, then it is important to see a doctor.

Types

There are two types of lymphoma, Hodgkin lymphoma and non-Hodgkin lymphoma.

Hodgkin lymphoma. Prevails in young adults. This is a rare type of lymphoma characterized by lymph nodes that contain a lot of normal immune cells with a small number of large abnormal lymphocytes known as Reed-Sternberg cells. These cells are damaged and odd-looking B lymphocyte cells that may cause swelling and inflammation. This type of cancer spreads in an orderly fashion from one group of lymph nodes to the next.

Non-Hodgkin lymphoma. This is the more common type of lymphoma and has no evidence of Reed-Sternberg cellular activity. The cancer spreads in a non-orderly fashion throughout the lymphatic system.

Risk Factors

Certain risk factors can increase the chances for lymphoma but this does not necessarily mean you will get lymphoma. Risk factors include:

Immunosuppressant medications. These are medications that lower your immune response. If you have had an organ transplant or take medications for an autoimmune disorder you have a higher risk.

Viral infections. Certain viral infections can trigger lymphoma. These include the Epstein-Barr virus (EBV) and HIV (human immunodeficiency virus). Some people also have H. pylori (a bacteria) in their stomach when diagnosed with non-Hodgkin lymphoma.

Ionizing radiation. People exposed to high levels of ionizing radiation have a higher risk of getting non-Hodgkin lymphoma. Medical x-rays, electrical power generators, and working with radioactive materials are all exposure sources of ionizing radiation.

Environmental exposure. Household chemicals and chemicals on the job may increase the risk of lymphoma. This is especially high with pesticide use.

Genetics. There are cases where a parent and child develop lymphoma, as well as siblings.

Diagnosis

If you have lingering symptoms that appear to be an issue with the lymphatic system, you will need a thorough medical workup. The doctor will take a health history, family medical history, and ask about any medications you are taking. If the doctor suspects lymphoma, the following tests may be done:

Blood testing. Complete blood count to check for low blood cells.

Imaging. Computerized tomography (CT)  and PET (positron emission tomography) scans are used to check for the spread of cancer.

Biopsy. A piece of lymph node tissue will be removed and tested for abnormal cells.

Bone marrow biopsy. The doctor will puncture a bone and take a sample of the bone, including bone, marrow to look for cancer cells.

Once a diagnosis is confirmed, the doctor will proceed to stage the cancer to determine the best treatment.

Treatments

Depending on the stage, you and your doctor will come up with the best treatment plan for you. Treatments include:

Chemotherapy. Drugs will be given to kill off the cancer cells in your blood and body. They come in either pill form or intravenous treatments. If you are at an early stage, the doctor may choose to also use combination radiation therapy with chemotherapy. There are side-effects including; loss of appetite, hair loss, nausea, problems with fertility, lung damage, and heart damage. Chemotherapy can also make you have a higher risk for leukemia.

Radiation. Radiation is directed at the body to kill off the cancer cells. In Hodgkin lymphoma, only radiation may be used, but in most cases, it follows chemotherapy. In early lymphoma, radiation may be the only treatment. Side-effects of radiation include hair loss, red skin, fatigue, thyroid issues, stroke, heart disease, and infertility. It can also put you at higher risk for breast cancer and lung cancer.

Stem cell transplants. Stem cell transplants are healthy stem cells that hopefully grow into healthy bone marrow. They will take your stem cells out and store them. You will go through chemotherapy and radiation to treat the cancer completely, then the stem cells are put back to hopefully grow into new and healthy bone marrow. This can also be given from a donor.

Alternative Treatments and Home Remedies

Research shows that alternative medicine may not cure lymphoma, but your doctor may be okay with certain complementary treatments to help your body fight cancer and improve your immune response. These include:

Probiotics. Helps replenish good bacteria and strengthen the immune system.

Omega-3 fatty acids. Reduces inflammation in the body. Not recommended for people on blood thinners.

Melatonin. May improve sleep during treatments.

Some cancer treatment centers have naturopathic physicians that may integrate herbal therapies or homeopathy into your treatment plan while working with your oncologist. They can recommend the best natural therapies for your case.

Hydrotherapy. Water therapy may help stimulate the lymphatic system to eliminate toxins.

Acupuncture. May help with pain relief, improve immune response and detoxify the body.

Talk to your physician before starting any alternative medicine for cancer. There can be drug interactions or something that may not fit with your treatment plan and cause unwanted side-effects.

Lifestyle Changes

Healthy lifestyle changes can help make managing cancer easier on your body and mind. Try these changes for an easier recovery and comfort:

See a nutritionist. During chemo and radiation, you may feel nauseous. Lymphoma can also reduce your appetite. To prevent malnutrition or weight loss, see a dietician for a specialized meal plan to help you meet your nutritional needs.

Quit smoking. If you smoke, quit as soon as possible after your diagnosis. If you don’t smoke, avoid secondhand smoke from others.

Reduce alcohol intake. Enjoy alcohol in moderation or on special occasions. Too much drinking will weaken your body and make it harder to recover.

Manage stress. Research has shown that stress can make cancer worse or cause recurrence. Try to find ways to manage stress like; take up a hobby, meditate, or talk to someone you trust. Don’t be afraid to ask for help around the house and take time for yourself every day.

References

American Cancer Society. (2018, May 01). What is Hodgkin lymphoma? Retrieved from American Cancer Society: https://www.cancer.org/cancer/hodgkin-lymphoma/about/what-is-hodgkin-disease.html

Appleby, A., Costello, M. & Rose, S. (1996, November 3). What are the sources of ionizing radiation? Retrieved from nj.gov: https://www.nj.gov/dep/rpp/llrw/download/fact03.pdf

Centers for Disease Control and Prevention. (2018, May 29). Lymphoma. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/cancer/lymphoma/index.htm

Douketis, J. D. (2020, November 20). Overview of the lymphatic system. Retrieved from Merck Manual: https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/lymphatic-disorders/overview-of-the-lymphatic-system

Gopas, J., et. al.  (2016, November 10). Reed-Sternberg cells in Hodgkin’s lymphoma present features of cellular senescence. Cell Death and Disease, 7(e2457). Retrieved from Nature: https://www.nature.com/articles/cddis2016185

Leukemia & Lymphoma Society. (2020).  Facts and statistics. Retrieved from Leukemia and Lymphoma Society: https://www.lls.org/facts-and-statistics/facts-and-statistics-overview/facts-and-statistics

Mayo Clinic Staff. (2018, April 10). Non-Hodgkin lymphoma. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/non-hodgkins-lymphoma/symptoms-causes/syc-20375680

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