Lymph cancer (lymphoma) is the cancerous and uncontrolled growth of lymphocytes which are the body’s defense cells. The most common occurring point of this disease is lymph nodes. These nodes are simply filters and are some of the most important actors of our immune system. When this system gets cancer, the lymphocytes (cells of the lymphatic system) break down and multiply, creating more abnormal cells.

 

Types of the disease

Lymphoma is basically divided into two groups: Hodgkin’s and non-Hodgkin’s. Although the symptoms of both can be similar, the type of the disease is determined by tests. It is very important to determine the type of lymphoma in order to determine treatment options.

 

Symptoms

The disease can cause different symptoms but the most common ones are:

• Painless, enlarged and proliferating lymph nodes
• Fever of unknown origin,
• Unexplained weight loss,
• Annoying night sweats,
• Constant fatigue,
• Cough, breathing problems and chest pain,
• Abdominal swelling, bloating, a feeling of fullness or pain,
• Itching.

Having the above symptoms does not necessarily mean that a person has the disease. Microbial diseases and other health problems can also cause most of the symptoms above. However, if the symptoms do not get better within 2 weeks, it is advised to consult a doctor and investigate the cause.

 

Risk Factors

Although the causes have not yet been fully identified, Hodgkin’s type is more common in men than in women. Also, people aged between 15 and 34 or above 55 are at higher risk. Other risk factors are as follows:

• Family history
• Epstein-Barr virus (EBV) infection
• HIV infection

 

Non-Hodgkin’s lymphomas are much more frequent in higher aged population. Some identified risk factors for this type are as follows:

• EBV infection
• HIV infection
• HTLV (human T-cell leukemia virus) infection
• Helicobacter Pylori infection (especially in gastric lymphomas)
• HHV-8 (human herpes virus type 8) infection
• Hepatitis C virus infection
• Certain chemicals (especially pesticides and chemicals used in the heating and cooling industry)
• Chemotherapy drugs used to treat some cancers
• Some genetic diseases such as Klinefelter, Chediak-Higashi syndromes
• Some rheumatologic diseases such as Sjögren’s syndrome, celiac disease, systemic lupus

 

Diagnosis Methods

If a patient has complaints about enlarged lymph nodes and has additional symptoms, the physician will start with a detailed physical examination and learn the individual’s health and family history. The neck, armpit, elbow, groin and the hollow behind the knee will be examined for the presence of enlarged lymph nodes. Examining the spleen and liver can also give clues about presence and severity of the disease. Next step will be at least one of these tests:

• Blood tests to check blood count and biochemical levels (such as LDH, uric acid).
• Lung X-ray to see lymph node size and other problems
• Biopsy from the entire lymph node if possible or bone marrow biopsy to determine the extent of the disease.
• Computerized tomography (CT) to examine neck, lungs and the entire abdomen in detail.

Lymph Cancer Treatment Methods

The treatment process will depend on the stage of the disease, the rate of growth and spread level, the age of the patient and other health problems if any. If cancerous progress is slow and have no symptoms, the patient can be checked at regular intervals for monitoring the progress. Chemotherapy, biological therapies (monoclonal antibodies) and radiotherapy can be used in slow progressing lymphomas with symptoms.

Chemotherapy and biological (monoclonal antibodies) therapies are generally preferred in the treatment of cases with rapid course. Radiotherapy can be added to the treatment when necessary.
When the disease is resistant to treatment or relapse develops after treatment, chemotherapy, biological therapies, radiotherapy, high-dose therapy, stem cell or bone marrow transplants and Car T Cell therapy are the treatment options used. Car-T Cell therapy is currently an approved treatment for B-cell lymphoma. This type of treatment is based on changing the genetics of T cells that do not recognize cancer into cancer-aware and cancer-fighting cells.

After the lymphoma treatment is completed with success, the patients will be closely followed up for up to 5 years, and more frequently in the first 2, to check possible recurrence.