Updated 10 September 2023 | Approved By Dr. Umberto Russo
What is non-Hodgkin's lymphoma?Non-Hodgkin's lymphoma is a type of cancer that starts in the lymphatic system, an important part of our immune system. This involves the abnormal growth of lymphocytes, a type of white blood cell. There are various types of non-Hodgkin’s lymphoma that can affect the lymph nodes, the spleen, and other body parts.
Types of Non-Hodgkin’s LymphomaNon-Hodgkin's lymphoma (NHL) is a collection of various cancers that arise in the lymphatic system, a vital component of our immune defense. These types each require specific treatment approaches based on factors such as type, stage, and individual health. These cancers are grouped into different types , each with unique characteristics. Some common types include:
- Diffuse Large B-Cell Lymphoma: The most frequent type, it grows rapidly.
- Follicular Lymphoma: This type usually grows slowly and often occurs in lymph nodes.
- Mantle Cell Lymphoma: A more aggressive subtype that starts in specific parts of the lymph nodes
- Marginal Zone Lymphoma: This type has different forms depending on where it begins.
- Burkitt lymphoma is a rapidly growing type that's more common in young individuals.
- T-Cell Lymphoma: Unlike most non-Hodgkin’s lymphoma, this type starts in a different kind of immune cell. It has various subtypes.
- Cutaneous T-Cell Lymphoma: This type mainly affects the skin and causes skin problems.
- Anaplastic Large Cell Lymphoma: A rare type with different variations based on a genetic marker
- Lymphoplasmacytic Lymphoma: Also known as Waldenström macroglobulinemia, it involves plasma cells and can lead to excessive antibody production.
Non-Hodgkin's Lymphoma SymptomsNon-Hodgkin's lymphoma can lead to various symptoms, but it's important to know that these symptoms can be caused by other health issues too. Some common signs and symptoms include:
- Swollen lymph nodes
- Fever and constant night sweats
- Fatigue and tiredness
- Coughing or breathing issues
- Skin problems (e.g., itchy skin, rashes, etc.)
- Abdominal and stomach pain
- Loss of appetite
- Unexplained weight loss
Non-Hodgkin's lymphoma causesThe exact cause of non-Hodgkin's lymphoma isn't completely clear, but there are some things that might increase the chance of developing it. Remember, having one or more of these risk factors doesn't mean someone will definitely develop lymphoma . Common risk factors include:
- Older individuals, particularly those over the age of 65,
- Those with a weakened immune system (e.g., those with autoimmune disease, people taking immunosuppressants, etc.)
- Infections, such as the Epstein-Barr virus
- Having family members with non-Hodgkin’s lymphoma
- Being around certain chemicals or having lots of radiation exposure
- Those with autoimmune conditions
Non-Hodgkin's Lymphoma Diagnosis and TestingDiagnosing non-Hodgkin's lymphoma involves a range of testing and assessments . These procedures encompass analysing medical histories, conducting physical examinations, and evaluating blood samples to detect potential irregularities. These combined diagnostic measures provide healthcare professionals with a comprehensive understanding of the lymphoma's nature, extent, and characteristics, forming the basis for informed treatment decisions.
Clinical AssessmentA doctor starts by examining the patient's medical history and conducting a physical examination. They look for symptoms like swollen lymph nodes, fever, weight loss, and night sweats.
Blood TestsBlood samples are taken to check for abnormal levels of blood cells, proteins, and other markers that might indicate the presence of non-Hodgkin's lymphoma.
BiopsyIf suspicious lymph nodes or masses are found, a biopsy is performed. A biopsy involves taking a small sample of tissue from the affected area, usually a lymph node. This sample is then examined under a microscope to determine if cancer cells are present. There are different biopsy methods, such as needle biopsy or surgical biopsy. In some cases, a sample of bone marrow is taken from the hipbone using a needle. This helps determine if the cancer has spread to the bone marrow.
Imaging TestsImaging scans like CT scans, PET scans, and MRI scans are used to visualise the body's internal structures and identify any areas of abnormal growth or tumors. These scans help determine the extent of the cancer's spread.
Lumbar Puncture (Spinal Tap)This procedure involves collecting a small amount of cerebrospinal fluid from the spinal canal to check for the presence of cancer cells. It's mainly done if NHL is suspected to have spread to the central nervous system.
Non-Hodgkin's lymphoma treatmentTreating non-Hodgkin's lymphoma involves different approaches, and the choice depends on factors like the type of lymphoma, its stage, and the person's health. The right treatment plan depends on many things, so doctors work closely with patients to figure out what's best for them. It's important to remember that everyone's situation is unique, and treatment can be a mix of these options. Common treatments include :
- Chemotherapy: powerful medicines that target and kill cancer cells It can be given through pills, injections, or IVs.
- Radiation Therapy: high-energy rays that aim at cancer cells to destroy them or slow their growth.
- Immunotherapy: drugs that help the body's immune system fight cancer cells more effectively
- Targeted Therapy: Medications that focus on specific features of cancer cells to stop them from growing.
- Stem Cell Transplant: In some cases, healthy stem cells are used to replace damaged ones after intense treatment.
- Surgery: Sometimes, removing a tumour is an option, though it's less common in this condition.
- Wait-and-see approach: For certain slow-growing types, doctors might closely monitor the cancer without starting treatment right away.
Non-Hodgkin’s Lymphoma ComplicationsNon-Hodgkin's lymphoma can bring about some complications that can affect a person's health. If left untreated, the following complications can occur, including:
- Spread of Cancer: Non-Hodgkin’s Lymphoma can spread to other parts of the body, making treatment more challenging.
- Infections: The immune system might be weaker due to non-Hodgkin’s lymphoma or its treatments, making infections more likely.
- Side Effects of Treatment: Treatments like chemotherapy can cause side effects such as fatigue, hair loss, and nausea.
- Nutrition Issues: Non-Hodgkin’s Lymphoma can affect the body's ability to absorb nutrients, leading to weight loss and weakness.
- Bowel Problems: Certain types of non-Hodgkin’s lymphoma can cause issues with digestion and bowel movements.
- Emotional Impact: Dealing with cancer can be emotionally challenging, leading to stress, anxiety, and depression.
- Body Changes: Surgery or other treatments might cause changes in appearance or daily routines.
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