Lymphoma | Symptoms | Staging | Treatment Options

Lymphoma is a type of blood-borne disease that starts in white blood cells (lymphocytes). Although lymphoma is normally a term used to define the cancerous types, there are actually two types of lymphomas: Hodgkin and non-Hodgkin. By far, the most common lymphoma is non-Hodgkin. This is different than other lymphomas based on prognosis and pathologic factors. Non-Hodgkin lymphomas are all lymphomas that are not Hodgkin lymphomas. There are innumerable types and classifications of non-Hodgkin lymphomas which will not be discussed in this article. The possible development of non-Hodgkin lymphomas normally increases with age.

Symptoms of Lymphoma

  • Common symptoms of lymphoma include:
  • Enlarged lymph nodes (usually painless).
  • Fever.
  • Drenching sweats (most common at night).
  • Unintended weight loss.
  • Itching.
  • Constant tiredness.

Staging in Lymphoma

Stage I is used to refer to cancerous disease within a lymph node. Stage II is used to refer to cancerous disease found in more than one lymph node. Stage III is used to refer to cancerous disease involving both sides of the diaphragm. Stage IV is used to refer to the cancerous spread of the disease in areas other than the lymph nodes. Lymphomas normally start in lymphocytes that fight infection as compared with leukemia which starts in blood-forming cells within the bone marrow.

Treatment Options for Lymphoma

Current treatment options for lymphomas are currently:

  • Chemotherapy.
  • Radiotherapy.
  • Immunotherapy.
  • Watchful waiting.
  • Clinical trials.
  • Palliative and hospice care.

Chemotherapy 

This involves the administration of chemically derived drugs and is the most common treatment option. Patients normally receive a combination of drugs with as many as six different drugs at a time per intravenous administration.

Radiotherapy 

This is another typical form of lymphoma treatment but not yet proven to be as effective as chemotherapy for lymphomas. It is mostly used for treatment of solid tumors. In patients with large tumors commonly in the neck and chest, radiotherapy may be administered following of in conjunction with chemotherapy. Some studies have found that radiologists can focus the radiation beam on a single tumor or group of tumors with attempts made not to damage any healthy tissue.

Immunotherapy

This is growing in popularity as a new option for treatment for a wide variety of cancers. Patients receiving the drug Rituxan, given as a single agent for lymphomas following the lack of success with chemotherapy and radiotherapy, have found some increase in lifespan.

Watchful Waiting

This is a common treatment for lymphomas. Many patients develop more indolent, slowly progressing disease without direct intervention with the above treatments. This simply involves the patient and physician closely monitoring the patient’s health and well-being when the lymphoma has been discovered but causing no problems. Regular review by a physician can then determine which of the three interventions explained above would best suit the patient.

Clinical Trials 

Some forms of lymphoma are able to be treated with the interventions explained above. However, more often than not, lymphomas may return during or shortly after typical interventions. Clinical trials are not normally recommended for treatment of any cancer much less lymphoma. Patients are often hesitant to receive continued intervention based on the exhausting and painful side effects caused by all previously described interventions.

Palliative and Hospice Care

This care is administered in cases where the patient has exhausted all forms of treatment. Starting palliative and hospice care should be gently but firmly be discussed with the patient by the physician to make their remaining life as comfortable as possible.