Health Tips

Have you ever heard about lymphoma? In conjunction with World Lymphoma Awareness Day 2021, let us bring you five facts about this medical condition!

1. Lymphoma is a type of cancer

Lymphoma consists of the word ‘lymph’ (refers to the lymphatic system) and ‘oma’ (which means abnormal cell growth, i.e. cancer). Therefore, lymphoma is a cancer of the lymphocytes, which are immune cells that are commonly found in our lymphatic system. 

Image credit to: https://cfch.com.sg/lymphoma/

When people have lymphoma, their lymphocytes become abnormal and grow out of control. These cells can travel to different parts of the body. Often, the abnormal cells collect in small, bean-shaped organs called lymph nodes, which is where most of the lymphoma starts. This causes the lymph nodes to swell. Lymphoma, however, can also start in other parts of the body, such as stomach, skin, mouth and the throat (called extranodal disease). 

Stage IV adult lymphoma; drawing shows four panels: (a) the top left panel shows cancer in the liver; (b) the top right panel shows cancer in the left lung and in two groups of lymph nodes below the diaphragm; (c) the bottom left panel shows cancer in the left lung and in a group of lymph nodes above the diaphragm and below the diaphragm; and (d) the bottom right panel shows cancer in both lungs, the liver, and the bone marrow. Also shown is primary cancer in the lymph nodes and a pullout of the brain with cerebrospinal fluid.

Image credit to: © 2019 Terese Winslow LLC via CDC

2. There are many types of lymphoma

There are more than 60 specific types of lymphomas. The two most common types of Lymphoma are Hodgkin Lymphoma (HL) and Non-Hodgkin Lymphoma (NHL). Both types of lymphoma’s cells look differently under the microscope, and that’s how the doctor differentiate and diagnose lymphoma (called histology study).

The main difference between Hodgkin lymphoma and Non-Hodgkin lymphoma is in the specific lymphocyte affected. There is an abnormal cell called a Reed-Sternberg cell which is present in Hodgkin lymphoma, but absent in Non-Hodgkin Lymphoma.

Ed Uthman, MD, CC BY-SA 2.0 , via Wikimedia Commons

3. The exact causes of both lymphomas were unclear 

How lymphomas come about exactly is not entirely clear, but the following increases one’s risk of developing lymphoma:

• Exposure to Epstein-Barr virus (glandular fever) increases the risk of developing Hodgkin lymphoma

• The state of immunosuppression, such as those with HIV/AIDS

• Obesity 

• Genetics

• Smoking

It turns out that adopting a healthy lifestyle can help you stay away from lymphoma.

4. Lymphoma’s treatments include chemotherapy, radiotherapy, biological therapy or stem cell transplant

Just like most cancers, lymphoma patients may also benefit from chemotherapy and radiotherapy. 

Patients with early stages of Hodgkin lymphoma are treated with two to four cycles of chemotherapy known as ABVD, which is the combination of doxorubicin (Adriamycin), bleomycin, vinblastine and dacarbazine; in addition to field radiotherapy. While each patient may have a different prognosis, the cure rate for the early stage of Hodgkin lymphoma is very high. Whereas for non-Hodgkin lymphoma, depending on the aggressiveness of the lymphomas, it may run a slow course or results in deaths within months if untreated. 

5. The side effects of chemotherapy can be debilitating

Battling cancer is difficult, and the side effects of chemotherapy certainly does not make it any easier. Some of the common side effects associated with chemotherapy are:

• Nausea and vomiting — This is the most distressing and most feared side effect of chemotherapy. Medications to stop vomiting can be prescribed to minimize the side effects.

• Bone marrow suppression — Bone marrow is an important part of the body in producing white blood cells, red blood cells and platelets. Chemotherapy may suppress the functions of bone marrow, leading to:

  • Less white blood cells, hence higher risk of infection. This is why cancer patients should avoid people with infections and immediately seek medical help if there’s any signs of infections (such as fever)

  • Less red blood cells, which can make one tired

  • Less platelets, which affect blood clotting and can cause unexplained bruises on the body or bleeding 

• Mucositis — Mucositis is the inflammation or damage of the surface of the entire food tract. In the mouth, this may lead to painful ulcers, local infection or difficulty in swallowing. Mucositis is a common side effect associated with doxorubicin. Depending on the severity of mucositis, patients may require painkillers ranging from benzydamine mouthwash to systemic opiates. It’s also important for the patient to ensure good oral hygiene to prevent infection.

• Loss of hair — Fortunately, hair usually regrows on completion of therapy

• Damage of nerves (called neuropathy) — This can present as tingling sensations or difficulty with buttons, constipation, jaw pain or stiffness. This is because some of the chemotherapy used can be toxic to the nerves.

Photo by National Cancer Institute on Unsplash

A word from DOC2US

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Reference

1. 1. Whittlesea C, Hodson K. Clinical pharmacology and therapeutics. 6th ed. Amsterdam: Elsevier; 2019. P.891-980.

2. UpToDate

Cover image credit: Blausen Medical Communications, Inc., CC BY 3.0 , via Wikimedia Commons

Written By

Ms Joyce Toh

Reviewed By

Doc2us Medical Board