lymphoma
Understanding the causes and symptoms of lymphoma for effective treatment and prevention to improve the survival rate
Lymphoma is one of the top ten cancers in Hong Kong and is a type of blood cancer that affects lymphocytes. Lymphocytes are white blood cells that are spread throughout the body and are part of the immune system, which means lymphoma can occur in any part of the body. The causes of lymphoma include genetic disorders, environmental pollution, viral and bacterial infections, and immune system dysfunction. Early symptoms of lymphoma may not be obvious, often leading to it being overlooked or discovered only in later stages when it may have already spread to the bone marrow and other organs. Currently, lymphoma is mainly classified into two categories: Hodgkin lymphoma and non-Hodgkin lymphoma, with non-Hodgkin lymphoma being more prevalent in Hong Kong. Early diagnosis and treatment are crucial; patients who receive treatment early generally have a higher survival rate. There are various clinical methods for treating lymphoma, and the best treatment approach depends on the specific condition of the patient.
According to the latest analysis from the Hong Kong Cancer Registry, the mortality rate for non-Hodgkin lymphoma patients ranks eighth among the top ten cancers, and most patients have a relatively high survival rate. Among the ten most common cancers, non-Hodgkin lymphoma has a higher incidence in men (ranked eighth) than in women (ranked tenth) in Hong Kong. Clinically, non-Hodgkin lymphoma can be categorized into three main types: indolent (slow-growing), aggressive, and highly aggressive lymphomas. As the name suggests, indolent lymphomas are slower-growing tumors, and most patients can survive for 5 to 10 years even without treatment, though there is currently no definitive cure. In contrast, aggressive and highly aggressive lymphomas progress rapidly; without appropriate treatment, patients can lose their lives within months.
Symptoms of Lymphoma
The most common symptom of lymphoma is swelling of the lymph nodes in the neck, armpits, or groin areas. This swelling is usually painless and appears as a lump under the skin that patients may not notice. In addition, lymphoma can cause unexplained fever and night sweats. Other symptoms of lymphoma include:
- Chest pain, bone pain or allodynia
- Cough and shortness of breath
- Swelling of lymph nodes
Swelling, which is usually painless, can occur in a single or multiple lymph nodes, mostly in the neck, followed by the armpits and groin (the area between the lower abdomen and thighs). - Fever
- Loss of appetite
- Unexplained weight loss
- Excessive sweating, especially at night
- Persistent fatigue or tiredness
- Skin irritation or itching
Other diseases such as tuberculosis and autoimmune disease may exhibit the same symptoms. Therefore, if you notice any of the above symptoms, seek immediate medical advice to check for the presence of lymphoma.
Causes of Lymphoma
Lymphatic vessels and lymph nodes run all over the body, while the lymphocytes circulate in various organs and tissues to fight infections. When lymphocytes develop malignant lesions, they divide and grow uncontrollably, and then gradually replace the normal cells, weakening the immune system’s defence mechanisms. At the same time, the lymph nodes become larger and form painless tumors, which are lymphoma.
Certain risk factors that contribute to lymphoma include:
- Genetic disorders (Wiskott-Aldrich syndrome)
- Environmental carcinogens, such as radiation
- Viruses, such as HIV and Epstein-Barr virus (EBV)
- Bacterial infections (such as Helicobacter pylori)
- Chemical drugs
- Immune system disorders
Survival Rate of Lymphoma
Screening of Lymphoma
The doctor will first examine the patient’s neck, armpits, chest, or groin for signs of swelling, followed by initial testing such as the most commonly used biopsy. There are two ways of conducting a biopsy: needle biopsy and excisional biopsy.
- Needle biopsy: Tissue samples will be extracted from the tumor using a needle.
- Excisional biopsy: The patient will receive local or general anaesthesia to have the entire lump removed. The lump will then be examined under a microscope to identify the presence of cancer cells.
Individuals at high risk for lymphoma are advised to undergo regular check-ups to identify early cancerous cells, which can lead to earlier detection and treatment, thereby improving survival rates.
Diagnosis of Lymphoma
If a patient is diagnosed with lymphoma, the doctor will conduct further clinical testing and tumor diagnosis to determine the position of cancer cells.
- Blood Test
A blood sample is taken to examine the number of red blood cells, white blood cells and platelets. A low blood count may indicate the lymphoma has spread to the bone marrow. The analysis of blood count also enables the doctor to diagnose if the liver and kidneys have been affected by the cancer cells.
- Chest X-ray
X-rays are taken to see if the lymphoma has spread to the lymph nodes in the chest or lungs.
- Throat examination
Check the tonsils and other parts of the throat to look for the swelling of lymph nodes.
- Bone marrow biopsy
After giving the patient local anaesthesia, the doctor will extract samples of bone and bone marrow to test for the presence of lymphoma cells under a microscope.
- Ultrasound scan
An ultrasound probe will be used to emit high-frequency sound waves and collect the echoes bouncing off the organs, which will then be converted into images by a computer to visualize any abnormalities in the body.
- Computed tomography (CT) scan
It is another type of X-ray diagnosis. Multiple pictures of the patient's chest and abdomen are taken and imported into the computer to generate detailed images of the body.
- Positron Emission Tomography (PET) Scan
A PET scan is a functional imaging test that offers detailed information about a particular organ or system of the body. It is commonly used to evaluate and diagnose cancer, neurological disorders in the brain, and cardiovascular disease. Before the scan, a radiologist will inject a radiopharmaceutical into the patient’s body. During the scan, a specialized camera will be used to detect the amount of radiation emitted by the radioisotope, and a multidimensional image of the examined area will be constructed by a computer. The radiopharmaceutical usually accumulates in cancer tissues rather than in healthy tissues.
- Lumbar puncture
The doctor will insert a thin needle into the patient’s spine and extract samples to look for any lymphoma cells in the central nervous system.
Doctors will determine the type and stage of lymphoma based on the location of the lymphoma, the number of affected lymph nodes, and whether it has spread to other lymph nodes or tissues, and will then decide on the most suitable treatment method for the patient.
Treatment of Lymphoma
- Chemotherapy
- Radiology
- Targeted Therapy
- Peripheral blood stem cell transplantation (PBSCT)
Recovery and Rehabilitation of Lymphoma
After receiving treatment, patients need to undergo regular check-ups, initially perhaps once a month, with the frequency gradually decreasing. In addition to maintaining a balanced diet, moderate exercise, and rest, patients should also pay attention to personal hygiene, minimize exposure to crowded places, and avoid further viral infections. If any abnormalities or symptoms arise, they should seek medical attention promptly.
Lymphoma Prevention
Maintain your body’s normal function not to create a gap for tumors to grow.
- Exercise moderately
Choose the appropriate exercise according to your physical condition without exhausting yourself.
- Maintain a healthy diet
Choose foods that are easy to digest and absorb. Avoid picky and binge eating.
- Stay optimistic
Relieve stress moderately to ease mental tension.
Lymphoma FAQ
Q: What would happen when you have lymphoma?
Common symptoms of lymphoma include swollen lymph nodes in the neck, armpits, or groin. These are usually, but not always, painless and may be associated with fever, unexplained weight loss, night sweats, occasional chills, and persistent fatigue. The symptoms of lymphoma can be difficult to detect, and since lymphatic tissue is present in various organs throughout the body, tumors can potentially develop in any organ. Therefore, individuals at high risk for lymphoma should be particularly vigilant and undergo regular check-ups to identify early cancerous cells, enhancing the likelihood of early detection and treatment, thus improving survival rates.
Q. What type of lymphoma has the highest survival rate?
The 5-year survival rate for patients with Hodgkin's lymphoma is 87%. If the cancer is detected at its earliest stage, the 5-year survival rate will be 91%.
Q: What are the methods for treating lymphoma?
Currently, there are various methods for treating lymphoma. First-line treatments often involve chemotherapy drugs, which may also be combined with radiation therapy. Traditionally, chemotherapy has been the primary treatment, and some patients may undergo autologous stem cell transplantation after high-dose chemotherapy. Additionally, some patients may also use targeted drugs, with anti-CD20 targeted drugs being common.
