Lymphoma is a type of cancer that develops in the lymphocytes, which are white blood cells that fight infection. Lymphocytes—which are part of the lymphatic system, a key contributor to the body’s immune system—can be found throughout the body, including within lymph nodes, the spleen, the thymus and bone marrow. There are two main types of lymphoma: Hodgkin and non-Hodgkin lymphoma. While Hodgkin and non-Hodgkin lymphoma progress at different rates and each grow in their own specific type of lymphocyte, the stages of lymphoma are the same. Both types are classified on a scale from one to four, with higher numbers representing more extensive cancers.
How is lymphoma diagnosed?
Lymphoma diagnosis typically begins with a physical examination. Your physician will review your medical history and learn about any symptoms you’ve been experiencing (swollen lymph nodes, unexplained fatigue and unexplained weight loss are common). Then, your physician will order testing to determine if lymphoma is the cause. You may undergo one or more of the following tests:
- A biopsy, such as an excisional lymph node biopsy, pleural fluid biopsy, bone marrow aspiration or image-guided biopsy using computed tomography (CT) and ultrasound
- Imaging scans, such as a CT scan, X-ray, MRI scan or PET scan
- Blood draws, such as a complete blood cell (CBC) count
If your tests are conclusive for lymphoma, your cancer will then be staged and classified.
The four stages of lymphoma
Staging helps oncologists explain how far the cancer has spread into the lymph nodes and whether it has metastasized into any nearby tissues or organs. The main stages of lymphoma are as follows:
- Stage 1 lymphoma – Cancer is found in one lymph node, a lymphoid organ such as the thymus or one area of a single organ outside of the lymphatic system.
- Stage 2 lymphoma – Cancer is found in two lymph nodes (both on the same side of the diaphragm) or extends from one lymph node into a nearby organ.
- Stage 3 lymphoma – Cancer is found in several lymph nodes, both above and below the diaphragm, and may also have spread to the spleen.
- Stage 4 lymphoma – Cancer is found outside of the lymphatic system or in two or more distant organs such as the liver or the lungs.
The five categories of lymphoma
In addition to staging lymphoma, many physicians will also further categorize the cancer using letters. These letters explain whether or not a patient is experiencing certain symptoms and how far the cancer has spread beyond the lymph nodes:
- A – No symptoms have developed.
- B – The patient is experiencing unexplained weight loss, night sweats or fever.
- X – The tumor is in the chest region and is considered bulky (greater than 10 cm in size).
- E – This describes an extranodal cancer that has spread to other tissues or organs.
- S – The cancer has spread to the spleen.
Treatment for lymphoma
Once a physician has determined the stage of a patient’s cancer, he or she can then create a targeted treatment plan. For instance, the earlier stages of lymphoma are often treated with short cycles of chemotherapy, followed by radiation therapy to the affected lymph nodes. The later stages of lymphoma may be treated with different types of chemotherapy drugs along with prescription steroids for symptom management.
What is the most aggressive form of lymphoma?
Non-Hodgkin lymphoma is the more common type of lymphoma and it can be more aggressive. In fact, Non-Hodgkin lymphoma can be broken down into two subcategories: aggressive and indolent. Aggressive lymphomas grow at a much faster rate than indolent lymphomas, and comprise 60% of cases. The most common aggressive lymphoma is diffuse large B-cell lymphoma (DLBCL).
Is lymphoma curable?
Lymphoma is a treatable form of cancer in general. However, patient outlooks can vary greatly depending on the following factors:
- The type of lymphoma a patient has
- The stage of the cancer and if it has spread to organs or tissues outside the lymphatic system
- The patient’s age, overall health and treatment decisions
- The level of lactate dehydrogenase (LDH) in the body—an enzyme that will typically increase as the amount of lymphoma increases
Moffitt Cancer Center’s approach to lymphoma treatment
At Moffitt Cancer Center, the cancer’s stage is just one of the factors that we evaluate when creating a patient’s lymphoma treatment plan. Our oncologists individualize every aspect of treatment based on the size and location of the cancer, as well as the patient’s age and overall health. Additionally, all of our treatments are available in a single location, streamlining the process for our patients.
Our Hodgkin and non-Hodgkin lymphoma patients are treated by specialists in our Malignant Hematology Program who represent a wide range of disciplines. Our team consists of board-certified surgeons, medical and radiation oncologists, radiologists, supportive care specialists and other professionals who work together to provide well-rounded care to our patients. All of our patients receive individualized treatment plans that are regularly reviewed and updated, and have access to the latest breakthroughs in cancer treatment through our robust clinical trials program.
For more information about the stages of lymphoma and the appropriate treatment options, call 1-888-663-3488 or complete a new patient registration form online. We provide cancer expertise in one day, as your cancer diagnosis is our top priority.