Lymphomas are cancers that affect the lymphatic system. Lymphomas arise when developing lymphocytes (a type of white blood cell) undergo a malignant change and multiply in an uncontrolled way. Increasing numbers of abnormal lymphocytes, called lymphoma cells accumulate and form collections of cancer cells called tumours in lymph nodes (glands) and other parts of the body. Over time, lymphoma cells replace normal lymphocytes, weakening the immune system's ability to fight infection.
Types of lymphomas
There are many different types of lymphoma which are broadly divided into two main groups:
- Hodgkin lymphoma (also known as Hodgkin disease)
and all other types of lymphoma, which grouped together and called
- B-cell or T-cell lymphomas (also known as non-Hodgkin lymphomas).
Each year in Australia, around 4300 people are diagnosed with lymphoma* making it the fifth most common cancer in Australia (sixth most common type of cancer in men and the fifth most common type of cancer in women). Of these, at least 89% of these people have non-Hodgkin Lymphoma.
Lymphomas are seen in all age groups but are more common in people aged 50+. The peak age for diagnosis of Hodgkin Lymphoma is between 15 and 30 years.
The incidence of lymphoma is increasing every year. In most cases we don't know what causes lymphomas but there are likely to be a number of factors involved. Like all cancers, lymphomas may result from damage to (or mutation of) special proteins called genes that control the growth and division of cells. We know that people with a weakened immune system (either due to an immunodeficiency disease or drugs that suppress the function of the immune system) are at an increased risk of developing lymphomas. Certain types of viral infections may also play a role, especially in people with a weakened immune system.
Lymphomas commonly present as a firm painless swelling of a lymph node (swollen glands), usually in the neck, under the arms or in the groin. Other symptoms may include:
- Recurrent fevers
- Excessive sweating at night
- Unintentional weight loss
- Persistent lack of energy
- Generalized itching
Lymphoma may develop in the lymph nodes in deeper parts of the body like those found in the abdomen (causing bloating), or in the chest (causing coughing, discomfort in the chest and difficulty breathing).
In some cases people don't have any troubling symptoms and the disease is picked up during a routine chest x-ray.
Treatment will vary depending on the exact type of lymphoma a person has, and how fast it is likely to grow and cause problems in the body. It will also depend on the extent of disease at diagnosis, the person's age and their general health.
Some lymphomas grow slowly and cause few troubling symptoms, and may not need to be treated urgently. Others grow more quickly and need to be treated as soon as they are diagnosed.
The main treatments are chemotherapy and radiotherapy. This is given to destroy the leukaemic cells and allow the bone marrow to function normally again. Other types of treatment are also used.
Occasionally, a stem cell transplant is given to treat disease which has relapsed (come back), or where there is a high likelihood that the disease will relapse in the future.
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