Lymphoma Cancer, Lymphoma Symptoms and Lymphoma Treatment

Lymphoma is the name for a group of cancer cells that develop in your lymphatic system. Lymphoma is one of the most common causes of death from cancer in the United States. Nearly 50,000 new cases of lymphoma are diagnosed each year. It is estimated that about $5 billion is spent in the United States every year on the treatment for lymphoma.

Lymphoma - Where It Begins

Lymphoma begins in your lymph system or lymphatic system. Your lymph system is the network of organs, lymphoid tissue, lymph nodes, lymph ducts and lymph vessels that produce and transport lymph from lymphoid tissues to your bloodstream. Your lymph system is the main part of your immune system and is your body's defense against infection.

Lymph is a clear fluid that is made of chyle (proteins and fats) from your intestines and white blood cells, especially lymphocytes, the cells that attack bacteria in your blood.

Lymphoma starts with a change to a lymphocyte (a type of white blood cell). This change to your lymphocyte causes it to become a lymphoma cell. The lymphoma cells build up and form masses that collect in your lymph nodes and other areas of your lymphatic system.

Lymphocytes are a type of white blood cell that make up most of the cells in lymphoid tissue. The two main lymphocytes are B lymphocytes (B cells) and T lymphocytes (T cells) and both types can mutate into lymphoma cells. B-cell lymphomas are more prevelant in the U.S. than T-cell lymphomas.

Lymphoid tissue is found throughout your body which means that lymphomas can begin almost anywhere. The major organs and sites that contain lymphoid tissue include the lymph nodes, spleen, thymus gland, tonsils, digestive tract, and bone marrow.

What Is A Lymph Node?
Your lymph node is a small, round soft nodule that usually can not be seen or easily felt. Groups of lymph nodes are found in your neck, underarms, chest, abdomen, and groin. Lymph nodes produce immune cells that help your body fight infection. Lymph nodes also filter lymph fluid and remove bacteria and cancer cells. When bacteria is detected in your lymph fluid, the lymph nodes produce more white blood cells to fight the bacteria. This causes your lymph nodes to swell.

Types of Lymphoma

The two main types of lymphoma are Hodgkin lymphoma and Non-Hodgkin lymphoma (NHL). Lymphoma, including both Hodgkin and Non-Hodgkin lymphoma represents about 5 percent of all cancers in the United States. Even though Hodgkin lymphoma is the better known, the incidence of Hodgkin lymphoma is much lower than that of Non-Hodgkin lymphoma.

Hodgkin lymphoma has features that differentiate it from other types of lymphomas. One main characteristic is the presence of large, malignant cells called Reed-Sternberg cells. These cells are found in the Hodgkin lymphoma tissues.

Doctors don't know what causes most cases of Hodgkin lymphoma. A majority of the cases occur in people that do not have any identifiable risk factors. There are however a few risk factors that are associated with Hodgkins lymphoma.

People infected with human T-cell lymphocytotropic virus (HTLV) or human immunodeficiency virus (HIV) have an increased probablility of developing Hodgkin lymphoma.

A history of confirmed infectious mononucleosis gives an increased risk of developing young-adult Hodgkin lymphoma.

As with other cancers, there are cases of clustering within families. There is an increase of incidence of Hodgkin lymphoma in siblings of patients with the disease.

Due to improvements in the treatment of Hodgkin lymphoma, the mortality rate has decreased greatly over the past 25 years. Although the incidence rate for whites has declined slightly during this period, the rates for African Americans have increased.

Non-Hodgkin lymphoma is a diverse group of diseases that are distinguished by the characteristics of cancer cells associated with each different type of disease. Non-Hodgkin lymphoma can occur in both adults and children. The treatment for children is different than treat for adults.

Children can have four major types of childhood non-Hodgkin lymphoma. These include B-cell non-Hodgkin lymphoma, Diffuse large B-cell lymphoma, Anaplastic large cell lymphoma, and Lymphoblastic lymphoma.

B-Cell Lymphomas account for 80-90% of all Non-Hodgkin's Lymphomas. The B-cell is a type of lymphocyte that prodcues antibodies to fight infection. B-cell lymphocytes are the most common lymphocytes in your bloodstream and are crucial in building a strong immune system.

There are many different types of B-cell lymphomas that can be either fast or slow growing. Some of the more common types of B-cell lymphomas include Diffuse large B-cell lymphoma (DLBCL), Follicular lymphoma, Chronic lymphocytic leukemia (CLL), Small lymphocytic lymphoma (SLL), Mantle cell lymphoma, Marginal zone B-cell lymphomas, Burkitt lymphoma, Primary mediastinal B-cell lymphoma, Lymphoplasmacytic lymphoma, Hairy cell leukemia, and Primary centeral nervous system (CNS) lymphoma.

B-Cell Lymphoma occurs when your B-cells mutate and become cancerous. As your cancerous B-cells clone themselves, the cancer spreads. The cause of B-Cell Lymphoma is not understood and doctors suggest reviewing the risk factors.

T-Cell lymphomas account for less than 15% of the non-Hodgkin lymphomas. There are Precursor T-lymphoblastic lymphoma and Peripheral T-cell lymphomas.

Inherited syndromes can predispose individuals to later development of Non-Hodgkin lymphoma. These inherited disorders are uncommon, but the concept of predisposition in genes is currently being studied to determine if they are involved in the sporadic occurrence of Non-Hodgkin lymphoma in healthy individuals.

The non-Hodgkin lymphoma rate has increased greatly in the past two decades. Incidence and mortality rates are higher for whites than other ethinc groups.

Lymphoma Classification

Lymphomas are graded as low, intermediate and high depending on the type of lymphoma cells that are present and how they affect the chromosomes and lymph nodes. Classifying lymphomas is complex because many different types of lymphocyte cells can be involved.

Low-Grade Lymphoma

These lymphomas grow slowly and patients can live for many years without symptoms, although some patients may experience pain from an enlarged lymph gland. Within 5 to 10 years, the low-grade lymphomas tend to progress quickly and become high-grade lymphoma.

Intermediate-Grade Lymphoma

Without treatment, this type of lymphoma can progress rapidly. With treatment, between 50-75% of the cases can go into remission. Initial treatment has been so successful that people that stay in remission for 3 years after diagnosis are often cured. Stage 1 disorders are treated with radiotherapy.

High-Grade Lymphoma

Withouth treatment, these lymphomas can progress rapidly regardless of stage and they have to be treated aggressively. With treatment, between 50-75% of patients enter remission. Patients that stay in remission one year can look forward to a life free from recurrence. Treatment usually consists of intensive combination chemotherapy, which is often supplemented with radiation therapy. Drugs are determined based primarily on results of tissue studies.

Lymphoma Symptoms

Patients should consult their doctors if they have painless swelling in the neck, armpits, abdomen or groin. Often the swelling or tumor can occur in other organs such as the stomach (extranodal lymphoma) or the skin, either as a first symptom or a sign that appears later with the cancer. As with most cancers, lymphoma is best treated when found early.

Lymphoma Symptoms include:

- Loss of weight, nausea, vomiting, or pain in the abdomen

- Loss of appetite

- Feeling like you are bloating

- Fatigue and flu-like body aches

- Fatigue resulting from anemia

- Itching, pain in the bone, headaches, constant coughing, abnormal pressure and congestion in the face, neck and upper chest

- Night sweats, a recurring high-grade fever or a constant low-grade fever

Lymphoma Risks Factors

The actual cause of lymphoma is not known, but it isn't considered to be hereditary. A majority of the lymphomas occur between the ages of 40 and 70. Possible factors that can cause lymphoma are:

- Infections or environmental factors

- Genetic factors

- Certain viruses

- Exposure to herbicides and high doses of radiation

- Acquired Immunodeficiency Syndrome (AIDS)

- Abnormalities in chromsomes and the body's immune response

Lymphoma Diagnosis

In order to determine if a patient has lymphoma, doctors will take your medical history, conduct an examination to detect enlarged lymph nodes, liver or spleen, order blood tests to check the function of the liver and kidney, conduct a biopsy of the suspected area to determine if lymphoma is present.

Lymphoma Treatment

The preferred treatment for patients with stage 1 or 2 lymphomas is radiotherapy because it successfully produces long-term remissions and even cures in many cases.

For treatment of stage 3 or 4 low-grade lymphomas, some suggest intensive therapy right after diagnosis to try and achieve and maintain complete remission. Treatment usually involves high-dose radiotherapy, chemotherapy or a combination of the two. Although intensive treatment always involves risks, recent research suggest that such treatment with lymphoma may result in high rates of remission.

The use of bone marrow transplant is also being studied as a treatment for low-grade lymphoma.

Advances in Lymphoma Research

- A recent study found that U.S. veterans infected with hepatitis C virus have a higher risk of developing certain lymphomas.

- National Cancer Institute researchers found that mutations in the signaling pathway gene CARD11 can cause diffuse B-cell lymphoma (DLBCL).

- The ATM kinase protein, which plays a role in repairing double-strand DNA breaks, also helps prevent cells with this type of DNA damage from dividing. This blocks the passage of persistent DNA damage to daughter cells, which could otherwise lead to the development of lymphoma.

- National Cancer Institute researchers have successfully used genomic technology to reliably distinguish Burkitt lymphoma from DLBCL.