Lymphoma

Lymphoma is a cancer that develops in the lymphatic system, which is an important part of the immune system.

What is lymphoma?

The lymphatic system includes the various lymph glands around the body. Lymphocytes, a type of white blood cell, play an important role in your body’s resistance to disease. Lymphoma refers to the rapid and uncontrolled growth of abnormal lymphocytes.1

The two main types of lymphoma are Non-Hodgkin lymphoma and Hodgkin’s lymphoma. Depending on the type of lymphoma, the disease may appear differently, progress at a different rate or cause mild to severe symptoms.

Lymphoma is the 5th most common male cancer and the 6th most common cancer for females in Singapore.1

Types of lymphoma

Non-Hodgkin lymphoma

Non-Hodgkin lymphoma accounts for approximately 90% of all lymphoma cases.2 The risk of being diagnosed with Non-Hodgkin lymphoma increases with age, with people aged 60 and over more at risk.

There are many different sub types of non-Hodgkin lymphoma which are divided into ‘B-cell’ or ‘T-cell’ lymphomas. Both sub-types are cancers of the lymphatic system after the B or T lymphocytes (type of white blood cell) undergo a malignant change and multiply in an uncontrolled manner. These abnormal cells eventually form as tumours, most commonly in the lymph nodes of the body.

Hodgkin lymphoma

Hodgkin lymphoma is a rare cancer which is marked by the presence of Reed-Sternberg cells.2 Reed-Sternberg cells are malignant, mature B cells and are unusually large.    Hodgkin’s lymphoma accounts for around 10% of lymphoma diagnoses in Singapore.

Hodgkin lymphoma tends to progress quite predictably through lymph nodes and is commonly diagnosed in early stages.

A biopsy is the only way for doctors to confirm a Hodgkin lymphoma diagnosis.2

Signs and symptoms of lymphoma

A common symptom of both forms of lymphoma is the painless swelling of one or more lymph glands. Hodgkin lymphoma is more likely to appear in the neck, underarms and chest, while non–Hodgkin can arise in lymph nodes throughout the body.

Other symptoms include:

  • Swollen abdomen
  • Abnormal sweating, especially at night
  • Ongoing fatigue/tiredness
  • Loss of appetite
  • Bruising or bleeding easily
  • Losing weight without trying
  • Rash or itching.

Having one or all of these symptoms does not mean you have lymphoma, as many conditions can cause these symptoms. However, it is important if you do experience any of the above, to see your doctor. 2

Stages of lymphoma

The most common system used to stage lymphoma is the Ann Arbor Staging system, which includes 4 stages;5

  • Stage I– cancer cells have been found in only one group of lymph nodes
  • Stage II– two or more lymph node groups have been affected; however, they are localised to either the top or bottom half of the body (above and below the diaphragm – the large muscles below the lungs)
  • Stage III– two or more lymph node groups have been affected in both sides of the diaphragm
  • Stage IV – lymph node groups are affected as well as one or more organs (such as bone marrow or liver).

 

Treatment

Frequently asked questions

Is lymphoma hereditary?

There does appear to be a slightly increased risk for developing lymphoma (both non-Hodgkin’s and Hodgkin’s) if there is a family history of the disease. 3

However, gene mutations that result in lymphoma seem to be acquired (happen over the course of a person’s life through exposure to virus’s and chemicals) rather than inherited. 3,4

Are there risk factors for lymphoma?

Hodgkin Lymphoma:

  • Being young (in your 20s) and also being slightly older (over 55 years)
  • Males have a slightly increased risk over females
  • Being infected with the virus which causes AIDS (HIV) or Epstein Barr virus which can cause glandular fever)
  • Family member (such as mother, father or sibling) with Hodgkin lymphoma

Non-Hodgkin lymphoma:

  • Being older (over 60 years)
  • Being male, although there are some types of Non-Hodgkin’s lymphoma which is more common in females
  • High intakes of fat and meat in the diet
  • Chemical exposure such as exposure to herbicides or pesticides and benzene
  • Autoimmune diseases such as rheumatoid arthritis
  • Infection with some viruses such as the HIV, Epstein Barr or HTLV-1 virus (Human T-cell leukaemia/lymphoma virus)

References

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