Lymphoma
Lymphomas are cancers which start in the body's lymphocytes, which are types of white blood cells of the immune system and lymphatic system, and they help to fight infections and diseases. There are 2 main types of lymphocytes - B cells (which make antibodies) and T cells (which can destroy microbes and damaged body cells, including cancer cells).
There are many different types of lymphoma, and knowing which type is important because it can affect the types of treatment options best suited for each type. There are 2 main types of lymphomas include the following (Lymphoma Australia, 2017):
Symptoms of lymphomas can vary, depending on where the lymphoma is located, and can include the following (Lymphoma Australia, 2017; Osieki, 2012, pp464-467):
The risk factors of lymphoma include the following (Lymphoma Australia, 2017; American Cancer Society, 2017; Osieki, 2012, pp464-467; Swerdlow et al. 2014):
There are many different types of lymphoma, and knowing which type is important because it can affect the types of treatment options best suited for each type. There are 2 main types of lymphomas include the following (Lymphoma Australia, 2017):
- Hodgkin lymphoma (HL) - is identified by the presence of Reed-Sternberg cells which are derived from B-lymphocytes, and only found in this type of lymphoma. This is a rare type of cancer, accounting for only about 0.5% of all cancer types or 10% of all lymphoma diagnoses, and is most likely to occur between the ages of 15-25 years or in those older than 65 years.
- Non-Hodgkin lymphoma (NHL) - is diagnosed in about 90% of all lymphomas. There are over 60 types of NHL which can affect B-lymphocytes or T-lymphocytes, to cause them to multiply in an uncontrolled way. This causes tumours in lymph nodes and other parts of the body. In the last 20 years the rate of NHL has doubled.
Symptoms of lymphomas can vary, depending on where the lymphoma is located, and can include the following (Lymphoma Australia, 2017; Osieki, 2012, pp464-467):
- Enlarged lymph nodes - causing lumps under the skin of about 2cm in size, with the most common sites being in the neck, underarm or groin. These are often painless.
- Fevers, night sweats, tiredness, weight loss - lymphoma can trigger an immune response, hence similar symptoms to when your body is fighting an infection.
- Widespread itching - caused by immune system cells releasing histamine.
- Nausea, vomiting or abdominal pain - if the lymphoma is affecting the digestive tract.
- Shortness of breath or coughing - if the lymphoma is affecting the chest or respiratory tract.
- Headaches, vision changes or seizures - if the lymphoma is affecting the brain.
- Anaemia - if the lymphoma is affecting the red blood cells.
- Red or purple areas under the skin - these can appear as bumps or lumps and can also be itchy.
- Susceptibility to infections - as the lymphocytes are affected, this can reduce the function of the immune system to prevent infections.
The risk factors of lymphoma include the following (Lymphoma Australia, 2017; American Cancer Society, 2017; Osieki, 2012, pp464-467; Swerdlow et al. 2014):
- Age - Hodgkin's is high in two age groups, 15-40 and over 55 years. NHL risk increases with age, especially from 20-79 years.
- Gender - in both types of lymphoma, men are affected more than women.
- Geography - lymphomas are more common in developed countries such as the USA and Europe having the highest rates.
- Infections - many chronic viral or bacterial infections are linked to different types of lymphoma, including Epstein-Barr virus (EBV), Helicobacter pylori, HIV, malaria, hepatitis C, and others, including animal viruses.
- Medical conditions – Many autoimmune conditions are linked to different types of lymphoma, including rheumatoid arthritis, Coeliac disease, Hashimoto's thyroiditis, lupus (SLE), inherited immunodeficiency syndromes, and other diseases.
- Immune system suppression or immunodeficiency - some types of lymphoma can result from the suppression of the immune system from medications for post-organ transplants, or long-term use of anti-inflammatory drugs (NSAIDs), or from having immunodeficiency conditions including HIV and others.
- Environmental chemicals and medications – exposure to certain chemicals can develop some types of lymphoma including benzene and other solvents, herbicides and pesticides, black hair dye, use of some medications (infliximab, methotrexate, and more), dioxins, chemotherapy and radiation therapy.
- Genetics and ethnicity – some forms of lymphoma are more prevalent in certain ethnic backgrounds. Also, first generation relatives of someone with lymphoma have a 2-4 fold increased risk. There is also an increased risk in Jewish populations.