What Is Lymphoma?

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Lymphoma is cancer that begins in infection-fighting cells of the immune system, called lymphocytes. These cells are in the lymph nodes, spleen, thymus, bone marrow, and other parts of the body. When you have lymphoma, lymphocytes change and grow out of control.

There are two main types of lymphoma:
• Non-Hodgkin: Most people with lymphoma have this type.
• Hodgkin
Non-Hodgkin and Hodgkin lymphoma each affect a different kind of lymphocyte. Every type of lymphoma grows at a different rate and responds differently to treatment.

Even though lymphoma is cancer, it is very treatable. Many cases can even be cured. Your doctor can help you find the right treatment for your type of the illness.

Lymphoma is different from leukemia. Each of these cancers starts in a different type of cell.
• Lymphoma starts in infection-fighting lymphocytes.
• Leukemia starts in blood-forming cells inside bone marrow.
Lymphoma is also not the same as lymphedema, which is a collection of fluid that forms under the skin when lymph nodes are damaged.

Causes of Lymphoma
Scientists don't know what causes lymphoma in most cases.
You might be more likely to get it if you:
• Are in your 60s or older
• Are male
• Have a weak immune system from HIV/AIDS, an organ transplant, or because you were born with an immune disease
• Have an immune system disease such as rheumatoid arthritis, Sjögren's syndrome, lupus, or celiac disease
• Have been infected with a virus such as Epstein-Barr, hepatitis C, human T-cell leukemia/lymphoma (HTLV-1), or human herpesvirus 8 (HHV8)
• Have a close relative who had lymphoma
• Were exposed to benzene or chemicals that kill bugs and weeds
• Were treated for Hodgkin or non-Hodgkin lymphoma in the past
• Were treated for cancer with radiation
• Are overweight

Symptoms of Lymphoma
Warning signs that you might have lymphoma include:
• Swollen glands (lymph nodes), often in the neck, armpit, or groin
• Cough
• Shortness of breath
• Fever
• Night sweats
• Stomach pain
• Fatigue
• Weight loss
• Itching
Many of these symptoms can also be warning signs of other illnesses. See your doctor to find out for sure if you have lymphoma.

Getting a Diagnosis
Before you have any tests, your doctor will want to know:
• How have you been feeling?
• When did you first notice changes?
• Do you have pain? Where?
• How is your appetite?
• Have you lost any weight?
• Do you feel tired or weak?
• Have you ever been treated for lymphoma or another cancer?
• Do you have any infections or illnesses?
• Do any cancers run in your family?

Your doctor will check you for signs of lymphoma and will feel for swollen lymph nodes. This symptom doesn't mean you have cancer. Most of the time, an infection -- unrelated to cancer -- causes swollen lymph nodes.

You might get a lymph node biopsy to check for cancer cells. For this test, your doctor will remove all or part of a lymph node, or use a needle to take a small amount of tissue from the affected node.

You might also have one of these tests to see how far the lymphoma has spread:
• Blood test. It checks the number of certain cells in your blood.
• Bone marrow aspiration or biopsy. Your doctor uses a needle to remove fluid or tissue from your bone marrow -- the spongy part inside bone where blood cells are made -- to look for lymphoma cells.
• Chest X-ray. It uses radiation in low doses to make images of the inside of your chest.
• MRI. It uses powerful magnets and radio waves to make pictures of organs and structures inside your body.
• PET scan. It uses a radioactive substance to look for cancer cells in your body.
• Molecular test. It looks for changes to genes, proteins, and other substances in cancer cells to help your doctor figure out which type of lymphoma you have.

Questions for Your Doctor
• What type of lymphoma do I have?
• What stage is my cancer?
• Have you treated people with this kind of lymphoma before?
• What treatments do you recommend?
• How will the treatments make me feel?
• What will help me feel better during my treatment?
• Are there any complementary treatments I could consider, along with the usual medical care? Are there any I should avoid?

The treatment you get depends on what type of lymphoma you have and how far it has spread.
The main treatments for non-Hodgkin lymphoma are:
• Chemotherapy. It uses drugs to kill cancer cells.
• Radiation therapy. It uses high-energy rays to destroy cancer cells.
• Immunotherapy. It uses your body's own immune system to attack cancer cells.

The main treatments for Hodgkin lymphoma are:
• Chemotherapy
• Radiation therapy

If these treatments don't work, you might have a stem cell transplant. First you'll get very high doses of chemotherapy. This treatment kills cancer cells, but it also destroys stem cells in your bone marrow that make new blood cells. After chemotherapy, you will get a transplant of stem cells to replace the ones that were destroyed.

Two types of stem cell transplants can be done:
• An autologous transplant uses your own stem cells.
• An allogeneic transplant uses stem cells taken from a donor.

Taking Care of Yourself
Lymphoma treatment can cause side effects. Talk to your medical team about ways to relieve any symptoms you have.
Also ask your doctor about changes to your diet and exercise that will help you feel better during your treatment. Ask a dietitian for help if you're not sure what types of food to eat. Exercises like walking or swimming can relieve fatigue and help you feel better during treatments like chemotherapy and radiation. You might also try alternative therapies like relaxation, biofeedback, or guided imagery to relieve pain.

What to Expect
Treatments have improved a lot, and many types of lymphoma can now be cured. Your outlook depends on:
• The kind of lymphoma you have
• How far the cancer has spread
• Your age
• The type of treatment you get
• What other health problems you have

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