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Lymphoma


What is Lymphoma?

Lymphoma is a very treatable cancer that forms in the lymphocytes, the cells of the immune system. These cells are found in lymph nodes, spleen, thymus, bone marrow, and other parts of the body.

Although leukemia and lymphoma have some similarities (e.g. they result from problems with white blood cells), there are differences. For instance, cancer cells are found in the bone marrow and blood in leukemia patients. In lymphoma patients cancer cells are found in the lymph nodes and other tissues.

Types of Lymphoma

Hodgkin Disease

Hodgkin disease can start almost anywhere in the body. The most common sites are in the chest, the neck, or under the arms near lymph node sites. The cancer rarely enters the bloodstream or spreads to the liver, lungs, and bone marrow.

Hodgkin disease is marked by the presence of Reed-Sternberg cells, which are mature, but malignant, B cells.

Non-Hodgkin Lymphoma (NHL)

More common than Hodgkin disease, non-Hodgkin lymphoma may be derived from B cells or T cells and can arise in the lymph nodes and spread to other organs. Types of NHL include:

  • Diffuse large b cell lymphoma
  • T-cell lymphoma
  • Follicular lymphoma
  • Mantle cell lymphoma
  • Large cell lymphoma
  • Small cell lymphoma

Signs and Symptoms

Warning signs of lymphoma include:

  • Enlarged lymph nodes in the abdomen, groin, neck or under the arms.
  • Enlarged spleen or liver
  • Unexplained fever
  • Unexplained weight loss
  • Sweating and chills
  • Fatigue

Diagnosis of Lymphoma

Screening Tests

  • Lymph node biopsy: A small piece of tissue or an entire lymph node is removed and examined under a microscope for abnormalities.
  • Immunophenotyping: Cells from lymph nodes, blood or bone marrow are examined under a microscope to determine what type of non-Hodgkin lymphoma cells is present.
  • Imaging tests: Tests include X-rays, CAT scans, PET scans and MRI scans.

Additional screening options and tests that your doctor may perform include:

  • Echocardiogram and pulmonary function test
  • Bone marrow biopsy
  • Liver and kidney function tests
  • Blood tests

Talking with your doctor

Your primary care physician may refer you to a hematologist or medical, radiation or hematology oncologist for treatment. However physician assistants (PAs), nurse practitioners (NPs), nurses, nutrition specialists, social workers, and other health and hospital professionals may be a part of your treatment team.

Some questions you might consider asking a health care professional include:

  • What kind of non-Hodgkin lymphoma do I have?
  • Are there other types of doctors that I will see?
  • What stage is my lymphoma? What does each stage mean?
  • Has a pathologist who’s an expert on lymphoma reviewed my biopsy?

Causes and Risk Factors of Lymphoma

Several factors that increase your risk of getting Hodgkin and non-Hodgkin lymphoma include:

  • Age and gender: Most cases occur in people in their 60s or older however other types of non-Hodgkin lymphoma are more likely to occur in younger people. Also, the risk of NHL is higher in men than in women however other types of NHL are more likely to occur in women.
  • Race, ethnicity, and geography: In the United States, whites are more likely to develop non-Hodgkin lymphoma than other races. Non-Hodgkin lymphoma is more common in developed countries, with the highest rates found in the United States and Europe.
  • Radiation exposure: Patients treated with radiation therapy for some other cancers, such as Hodgkin disease, have a slightly increased risk of developing NHL. This risk increases for patients treated with both radiation therapy and chemotherapy.
  • Immune system deficiency
  • Autoimmune diseases
  • Exposure to certain chemicals

Prevention of Lymphoma

There’s no way to protect against lymphoma, as most of the factors that cause it cannot be changed. Reducing the causes of and opportunities for immune deficiency is the best prevention.

Stages of Lymphoma

  • Stage I: The cancer is found in one lymph node region.
  • Stage II: The cancer is in two or more lymph node regions; or, the cancer is found in an organ and its nearby lymph nodes, with or without any cancer in other lymph node regions.
  • Stage III: The cancer is in areas on both sides of the diaphragm (i.e. above and below).
  • Stage IV: The cancer cells have spread throughout more than one area of the body.

Treatment Options for Lymphoma

Because there are so many different types of lymphoma, treatment is customized to a patient’s personal needs. Examples include:

  • Chemotherapy
  • Immunotherapy
  • Targeted therapy
  • Radiation
  • Stem cell transplant
  • Surgery, in rare cases

Prognosis of Lymphoma

When discussing patients with Stage I, II, III or IV Hodgkin lymphoma, the five-year survival rate for each is:

  • Stage I: The 5-year survival rate is around 90%.
  • Stage II: The 5-year survival rate is around 90%.
  • Stage III: The 5-year survival rate is around 80%.
  • Stage IV: The 5-year survival rate is around 65%.

When discussing patients with Stage I, II, III or IV non-Hodgkin lymphoma, the five-year survival rate for each is:

  • Stage I: The 5-year survival rate is around 91%.
  • Stage II: The 5-year survival rate is around 78%.
  • Stage III: The 5-year survival rate is around 60%.
  • Stage IV: The 5-year survival rate is around 53%.

Learn more about the Shawnee Mission Cancer Center.

SHAWNEE MISSION HEALTH LOCATIONS
Shawnee Mission Medical Center
9100 West 74th Street
Shawnee Mission, Kansas 66204
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Main Number
913-676-2000
Prairie Star
23401 Prairie Star Parkway
Lenexa, Kansas 66227
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913-676-8500
Overland Park
7820 W. 165th Street
Overland Park, KS 66223
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913-373-1100