Lymphoma
Lymphoma begins in the lymphatic system, the network that helps your body fight infection. With proper treatment, symptoms can be reduced — and in many cases, patients are cured.
About lymphoma
Lymphoma is a cancer that originates in the lymphatic system — a network of tiny vessels running through the body that helps fight infection and disease. It falls into two broad groups.
Hodgkin lymphoma is named for Dr. Thomas Hodgkin, who first described the condition in 1832. It starts in the central lymph nodes, at the main points where blood vessels return from the hands and legs: the neck, armpit, groin and abdomen. This form is very treatable, with about 80 percent of patients who are diagnosed going on to live for 10 or more healthy years.
Non-Hodgkin lymphoma (NHL) is not one disease but a category covering about 30 types of lymphoma. Because it takes so many forms, it is much more common than Hodgkin lymphoma. All variations of NHL are treatable, and often curable with treatment.
Lymphoma is staged in four steps. In Stage I, a single lymph node or non-lymph node region is affected. In Stage II, two or more regions are affected on the same side of the diaphragm. In Stage III, regions above and below the diaphragm are affected. In Stage IV, the cancer has spread outside the lymph nodes to organs such as the liver, bones or lungs, or to distant lymph nodes. Your physician will perform a biopsy to identify the stage, then build a personalized treatment plan with you.
Signs and symptoms
Both Hodgkin and non-Hodgkin lymphoma start in the lymph nodes, and the most common symptom is an enlarged node — usually a bump you can feel under the skin. Other signs include:
- An enlarged lymph node, felt as a bump under the skin
- Fever
- Night sweats
- Itchy skin
- Trouble sleeping
- Loss of appetite
- Cough and chest pain
- Trouble breathing
When to call
These symptoms have many possible causes, most of them not cancer. But they are worth a conversation. If something has changed and hasn't resolved, contact your primary care physician — early evaluation is what makes treatment straightforward.
How we treat it
Lymphoma is typically treated with chemotherapy, radiation therapy, biologic therapy, or a combination of the three. The right approach depends on your type of lymphoma, its stage and your own health. Because these treatments are their specialty, we recommend consulting both a radiation oncologist and a medical oncologist.
External beam radiation therapy
Radiation therapy exposes the affected area to targeted beams of radiation generated by a machine outside the body. The radiation damages cancer cells and takes away their ability to multiply. A small amount of healthy tissue around the cancer is also affected, but those healthy cells repair themselves during a short recovery period while the cancer cells die off. The intensity and frequency vary with your needs.
Chemotherapy
Chemotherapy uses drugs to treat lymphoma throughout the body rather than in one location. It is frequently the backbone of a lymphoma plan and is often combined with radiation therapy. Your medical oncologist determines the regimen and the schedule.
Biologic therapy (immunotherapy)
Biologic therapy does not attack cancer cells directly. Instead it strengthens your immune system so your body is better able to find and destroy them. The degree and frequency of this treatment is determined by your medical oncologist.
What treatment involves
Your treatment plan begins with a biopsy to identify the type and stage of the lymphoma. Once your physician knows what is being treated and where, the two of you build a plan around it.
If radiation therapy is part of that plan, treatment is delivered by an external machine and the intensity and frequency are set to your case. Your physician will tell you how many sessions to expect and how long the course will run before you begin.
Caring for yourself during treatment
- Rest when you need to, and don't hesitate to ask for help.
- Follow your care team's advice — and ask when anything is unclear.
- Tell us about every medication, vitamin and supplement you take.
- Eat a balanced diet and drink plenty of fluids.
- Treat skin in the treatment area gently: no sun, no hot or cold packs, and only lotions your team has approved.
- Lean on support groups, family and friends. Coping is part of treatment.
Trusted resources
- Leukemia and Lymphoma Society — www.lls.org
- Lymphoma Information Network — www.lymphomainfo.net
- Lymphoma Research Foundation — www.lymphoma.org
- RT Answers (patient brochures) — www.rtanswers.org
Clinical background adapted from materials by the American Society for Radiation Oncology (rtanswers.org) and the American Cancer Society.
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