Lymphomas are cancers that develop in the lymphatic system. A key part of the body’s immune system, the lymphatic system is a vast network of tissues, vessels and organs that work together to help rid the body of waste and toxins. Its primary function is to transport lymph, a fluid that contains infection-fighting white blood cells, throughout the body.
Lymphomas originate in certain white blood cells known as B lymphocytes (B cells) and T lymphocytes (T cells). Due to DNA damage—the cause of which is often unknown—some of these cells may become cancerous and begin to grow and divide at a very rapid pace. Eventually, the cancerous cells will crowd out healthy lymphocytes, impairing the function of the immune system and leaving the body more susceptible to infection. As the lymphoma cells grow, they may also bind together and form tumors.
Lymphomas can affect any component of the lymphatic system, including the bone marrow, lymph nodes, spleen and thymus, as well as other areas of the body where lymphoid tissue is found.
Types of lymphomas
There are more than 70 different lymphoma types, which range from slow-growing to highly aggressive. In general, lymphomas can be categorized into two broad groups—Hodgkin lymphoma and non-Hodgkin lymphoma—which differ in terms of how the tumors behave, spread and respond to treatment.
Named for Dr. Thomas Hodgkin, the first physician to diagnose a cancer of the lymph nodes, Hodgkin lymphoma is relatively uncommon. Typically, the malignancy originates in lymph nodes in the neck, chest or underarm area, then travels from one group of lymph nodes to the next. Because Hodgkin lymphoma usually progresses in a predictable path, it can often be detected and treated in an early stage.
During the diagnostic process, Hodgkin lymphoma can be distinguished from non-Hodgkin lymphoma by the presence of Reed-Sternberg cells. These cancerous cells, which are named for the scientists who first identified them, are very large—much larger than both Hodgkin cells and healthy lymphocytes—and may contain more than one nucleus. Reed-Sternberg cells can usually be identified when a pathologist views a tissue sample under a microscope.
If Reed-Sternberg cells are not detected during the diagnostic process, the lymphoma is classified as non-Hodgkin lymphoma. In addition to lymph nodes in the neck, chest and underarms, non-Hodgkin lymphoma can develop in other parts of the body, such as the stomach cavity and groin. Because its path of progression tends to be unpredictable (unlike that of Hodgkin lymphoma), most cases are diagnosed at an advanced stage. With that said, non-Hodgkin lymphoma is more common than Hodgkin lymphoma, although both types of cancer are still considered to be relatively rare.
Lymphoma symptoms can vary depending on the area of the body affected. Some common signs include:
- Swollen lymph nodes – Painless lumps in the neck, chest, armpits or groin
- Overwhelming fatigue – Feeling physically, mentally or emotionally exhausted for no apparent reason
- Unexplained weight loss – Dropping several pounds very quickly without trying
- Drenching night sweats – Waking up with soaking wet nightclothes and bedding
- Itchiness – Itchy skin without a visible rash
The causes of lymphoma are largely unknown. Through research, scientists have identified some possible triggers, which include:
- Genetic abnormalities
- Human retroviruses such as HTLV-1
- Exposure to herbicides
- Exposure to high doses of radiation
- Acquired immunodeficiency syndrome (AIDS)
Some factors that are believed to increase the risk of lymphoma include:
- Age – Some lymphomas are more common in young adults, while others are most often diagnosed in people over 55.
- Gender – As compared to females, males are slightly more likely to develop lymphoma.
- A weakened immune system – Lymphomas are more prevalent in people with immunodeficiencies and those who take immunosuppressant drugs.
- Certain infections – The Epstein-Barr virus and Helicobacter pylori infections are associated with a heightened risk of lymphoma.
Lymphoma treatment can vary based on the type and stage of the cancer as well as the patient’s overall health and preferences. Some options include:
- Active surveillance – Some forms of lymphoma are known to be very slow-growing. Together, a patient and physician may decide to defer lymphoma treatment until the cancer begins to cause symptoms that interfere with the patient’s daily activities. In the meantime, the patient may be scheduled for periodic testing to allow the physician to monitor the cancer and its progression.
- Chemotherapy – Powerful medications are administered intravenously or swallowed in pill form to target and destroy fast-growing cells, such as cancer cells, throughout the body.
- Radiation therapy – High-powered energy beams, such as X-rays or protons, are precisely delivered to a tumor site to damage the cancerous cells.
- Bone marrow transplantation – After high doses of chemotherapy or total body irradiation, healthy bone marrow stem cells derived from the patient or a donor are infused into the patient’s bloodstream, where they can travel to the bones and help rebuild lost bone marrow.
- Immunotherapy – Targeted drugs are administered to help the patient’s immune system destroy cancerous cells. A specialized treatment known as chimeric antigen receptor (CAR)-T cell therapy involves taking a sample of the patient’s germ-fighting T cells, reengineering those cells in a lab to help them fight cancer, then infusing the altered T cells back to the patient.
Treatment for lymphomas at Moffitt
The multispecialty team in the Malignant Hematology Program at Moffitt Cancer Center represents a wide variety of disciplines, each of which focuses on lymphoma treatment. Our team includes:
- Board-certified surgeons and physicians
- Medical oncologists
- Radiation oncologists
- Supportive care specialists
After diagnosing a patient with a specific type and stage of lymphoma, these specialists work together to design a comprehensive and individualized treatment plan. In a single location, our patients have access to the latest breakthroughs in lymphoma treatment, including new therapies available exclusively through our robust clinical trials program.
If you are concerned about lymphoma symptoms or interested in receiving a second opinion on your lymphoma diagnosis, you can request an appointment with an oncologist at Moffitt Cancer Center by calling 1-888-663-3488 or completing our new patient registration form online.