Lymphoma - what you need to know

This September 15 is World Lymphoma Awareness Day and the Lymphoma Coalition will be running events aimed at educating people across the world as to the signs and symptoms of the disease in order to achieve early diagnoses and a greater rate of treatment success.


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What is lymphoma?
Lymphoma is a cancer of the lymphatic system, a network of vessels and glands spread throughout the body. This complex network forms part of the immune system, holding clear fluid called lymph, which in turn contains white blood cells known as lymphocytes that fight infection. The lymphatic system also drains waste products and excess fluid from the tissues in the body, and absorbs fats from the gut, transporting them to the bloodstream.

A change in the structure of DNA in the lymphocytes causes them to multiply uncontrollably, typically in one area of the body such as the neck or groin. Left untreated, these abnormal cells can spread to other organs such as the bone marrow, spleen, liver, skin and lungs.

Though there are many different types of lymphoma, the disease is classified as either Hodgkin's or non-Hodgkin's lymphoma. Approximately 80% of lymphomas are diagnosed as the latter.

What causes lymphoma?
The exact cause of lymphoma is unconfirmed but it is thought some people may be at higher risk of developing the disease.

Known risk factors include having an existing medical condition such as HIV, where the immune system is already weakened, exposure to viruses such as Human T-cell lymphotropic virus or Epstein-Barr virus or to the bacteria Helicobacter pylori. Those who have undergone chemo or radiotherapy for a previous cancer are also at a slightly higher risk, as are those with coeliac disease.

The most common symptom of both Hodgkin's and non-Hodgkin's lymphoma is a painless swelling in one of the lymph nodes, often in the neck, armpit or groin, caused by the increase in lymphocytes.

As the disease advances, sufferers may also experience unexplained fatigue, fever, poor appetite and weight loss, difficulty fighting infection, and unexplained itching all over the body.

Depending on where the lymphoma occurs, there may also be pain where the lymph glands are enlarged.

A persistent cough or breathlessness may also occur in those with Hodgkin's lymphoma, and some may experience excessive bleeding (ie nosebleeds or heavy periods) and spots of blood under the skin.

Diagnosis and treatment
If lymphoma is suspected, a doctor will take a biopsy to confirm the presence of the abnormal cells. Blood tests, bone marrow samples, x-rays and CT, MRI and PET scans are often required to determine how far the lymphoma has spread within the body.

If non-Hodgkin's is caught early and the cancer is small enough to be removed, it may be that no further treatment is necessary. Similarly a watching brief is often recommended if the disease is at an early stage.

However, with both types of the disease, chemotherapy (often in conjunction with steroids), radiotherapy and biological therapy, which involves using genetically engineered antibodies that target antigens on lymphoma cells.

Hodgkin's, though an aggressive form of cancer, is one of the most treatable. According to the NHS, the majority of young people who develop the disease are fully cured with treatment, and for those over the age of 50, the success rate if around 75 to 80 per cent.

Non-Hodgkin's lymphoma varies in its treatment. Where the cancer is high-grade (has developed quickly and aggressively), an intensive course of treatment cures around 30% of people. Low-grade non-Hodgkin's is generally not curable, but with treatment, many sufferers stay well for many years.

If you are worried that you may be experiencing some of the symptoms of lymphoma, do not delay - visit your doctor.