A 24-year-old girl noticed an enlarged lymph node under her left arm. She didn't pay much attention to it, since these things usually resolve on their own after a few days, plus she didn't feel any pain.
A 25-year-old dude got drunk and had a one-night stand. When he woke up, he had trouble breathing. Since he didn't smoke, he figured that the second hand smoke caused dyspnea, and went on to act as if nothing happened.
A 59-year-old man suddenly felt a sharp, piercing pain in the upper right quadrant of his abdomen. He took some pain meds and went to see the doctor the day after. The doctor said that the pain came from a gallbladder stone, and he was scheduled for surgery.
What I would usually do, when writing these types of articles, is list all the definitions related to an illness I'm writing about, while keeping things fairly clinical. This time, I'll take a different, more personal, approach, because lymphoma is personal to me.
The girl's lymph node didn't get smaller after a few days, so she went to see the doctor, who scheduled a biopsy. It turned out to be lymphoma.
The guy's breathing problems didn't resolve after a few days, so he went to see the doctor. After some blood tests, and imaging, it turned out that the dyspnea was caused by lymphoma.
The man with the gallbladder stone went on to have a surgery. But to everyone's surprise, when they opened him up, they found 14 tumors inside his abdomen, one of which was pressing on the gallbladder, and causing the pain.
What is lymphoma?
Lymphoma is a term used to describe several different, albeit closely related types of cancers. These types of cancer affect white blood cells, or, to be more specific, a subset of white blood cells called lymphocytes. This type of cancer is spread worldwide, and can strike people regardless of social status, race, gender, or geographical region. Lymphoma affects hundreds of thousands of people each year (in 2012, 566,000 cases were reported, while 305,000 people died because of this illness).
As mentioned previously, the term "lymphoma" refers to a number of different types of cancer coming from lymphocytes. Lymphocytes are themselves a sub-type of white blood cells, but there are also several sub-types of these cells. So, depending on the sub-sub-type of the white blood cell, and the maturity of the said cell, the prognosis of lymphoma can range from good to, well, not really good. And there are over 50 different types of lymphoma.
Can lymphoma be cured?
Yes. Some types of lymphoma can be cured. Depending on the type of cancer, the doctor might opt for surgery, radiation, chemotherapy, and sometimes even watchful waiting, wherein the cancer is thoroughly monitored and no active treatment is (yet) administered.
Some types of lymphoma cannot be cured, but can be treated — or rather, managed — as a chronic condition, and the patient's life expectancy may not be lower than one of a healthy person.
Sadly, some types of lymphoma are incurable, and the only thing doctors can do is offer supportive care. What type of therapy will be used depends on the type of the cancer, the speed at which the cancer is spreading, as well as how far the cancer has spread.
Hodgkin vs Non-Hodgkin lymphoma
One of the main classifications of lymphomas, and the first one you'll run into while searching the internet, is whether the lymphoma is of Hodgkin or non-Hodgkin type. This classification was named after a doctor Thomas Hodgkin, who first described the illness we now know as Hodgkin lymphoma, or Hodgkin disease, in 1832.
There are several differences between these two types of lymphomas:
- Non-Hodgkin lymphoma is more common, and about 90 percent of all lymphoma cases fall under this category
- Hodgkin lymphoma usually starts in the upper parts of the body, and is usually diagnosed in early stages, as opposed to non-Hodgkin lymphoma, which can start anywhere in the body and is usually discovered later, when the disease has spread.
- Hodgkin lymphoma contains certain types of cells (Reed-Sternberg cells), while non-Hodgkin lymphoma doesn't.
- Non-Hodgkin lymphoma patients are usually older, where as Hodgkin lymphoma patients are typically aged between 20 and 40.
What are the symptoms of lymphoma?
I was present at an autopsy of a man who died of a heart attack. During the autopsy, the pathologist discovered several large tumors inside this man's abdomen (one being approximately 10cm or 4in long, if I recall it right). The man didn't suffer from any symptoms, and didn't know that he had cancer.
The most common symptoms of lymphoma include:
- Swelling of lymph nodes
- Fever
- Night sweating
- Weight loss
- Loss of appetite
- Itching
- Dyspnea
- Fatigue
What causes lymphoma?
This question is, sort of, difficult to answer since different types of this illness can result from different causes, and for others, we don't really know the cause yet.
What we do know is that almost half of Hodgkin lymphoma cases are caused by the Epstein-Barr virus. Non-Hodgkin lymphomas have been associated with other viruses, such as human T-lymphotropic virus, HTLV-1 and hepatitis C, as well as some autoimmune diseases. Pesticides, red meat, and tobacco are also known to increase the risk of lymphoma. Last, family history should also be considered, which tells us that, in a way, some people are just genetically more prone to this illness.