Lymphoma Symptoms: Early Signs of Blood Cancer

Lymphoma Symptoms & Causes: How to Detect and Manage Blood Cancer

Lymphoma symptoms can vary depending on the type and subtype of lymphoma. It is a cancer of the lymphatic system, which usually spreads throughout the body. Common symptoms include fatigue, unexplained weight loss, and frequent infections. Doctors usually administer 2-8 cycles of chemotherapy, along with immunotherapy, to treat lymphoma at Stages III or IV.

Lymphoma is a type of blood cancer that attacks the lymphatic system, causing uncontrolled growth of lymphoma cells. It is broadly classified into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), with more than 70 different subtypes. Both HL and NHL can affect children and adults, though HL is more common in older children and teenagers.

According to the Indian Cancer Society, more than 50,000 new childhood cancer cases occur annually. However, NHL tends to occur more often in younger children. Understanding the lymphoma symptoms is crucial to receiving the right treatment as early as possible.

What are the symptoms of lymphoma?

Both Hodgkin's lymphoma and non-Hodgkin's lymphoma show similar kinds of symptoms. Lymphoma symptoms such as lymph node swelling, fatigue, and night sweats can occur in early stages and are not limited to advanced disease. Here, we will discuss these symptoms in detail to understand the complications of these conditions:

• Swollen Lymph Nodes: Lymphoma primarily invades your lymphatic system, which is a network of vessels and nodes that helps in fighting infection and filtering out waste. Lymphocytes, or white blood cells, grow abnormally and uncontrollably and accumulate in the lymph nodes, resulting in swelling and enlargement.
• Unexplained Weight Loss: Cancer cells in the body generally consume a lot of your body’s energy, leading to a significant calorie deficit and weight loss. Additionally, lymphoma can affect your lymphatic system and other organs, disrupting normal digestion and appetite, further contributing to weight loss. Unexplained weight loss is a common symptom of lymphoma, but BMI <18.5 is not a standard marker for diagnosis.
• Fatigue: Lymphoma cells can disrupt normal bodily functions, leading to inflammation, anaemia, and a weakened immune system. All of these factors contribute to chronic fatigue and lack of energy. Additionally, lymphoma cells can disrupt normal metabolism, leading to nutrient deprivation and affecting energy production. Frequent fatigue is one of the most common lymphoma symptoms in both adults and children.
• Night Sweats: Night sweats are one of the common Hodgkin’s lymphoma symptoms, which occur due to a combination of various factors. These include chemicals from lymphoma cells, which irritate nerve endings, potentially causing rash and itching, leading to night sweats. Additionally, hormonal changes in the body can cause night sweats.
• Shortness of Breath: Lymphomas, especially Hodgkin’s lymphoma and some types of non-Hodgkin lymphoma, can start or spread to lymph nodes in the chest. These enlarged lymph nodes can press the trachea (windpipe) or bronchi (airways), making it difficult to breathe and leading to coughing or chest pain.
• Abdominal Pain or Swelling: HL or NHL can cause acute abdominal pain or swelling due to the enlargement of lymph nodes, spleen and liver in the gastrointestinal tract. These enlarged organs or tumours within the gastrointestinal tract can create pressure on surrounding tissues, causing pain or swelling.
• Frequent Infections: Lymphoma directly invades the entire lymphatic system, causing complete disruption in the immune system. Abnormal lymphocytes can disrupt the body’s ability to fight off infections, making individuals more susceptible to various viral, bacterial and fungal diseases. Furthermore, treatments like chemotherapy or radiation therapy can further weaken the immune system, increasing the risk of infections.
   

What Causes Lymphoma?

Lymphoma arises due to genetic mutations in lymphocytes (white blood cells) that cause them to grow uncontrollably and evade natural cell death. Although the exact cause of these mutations is still under investigation, several factors can increase the risk. Here we will discuss those factors in detail:

• Genetic Mutations: Lymphoma arises from non-functional mutations in lymphocytic DNA, leading to metastasis. These cells become immortal due to that mutation, leading to rapid multiplication and thriving in acidic and anoxic environments. Accumulation of these abnormal cells leads to the development of lymphoma.
• Weakened Immune System: Immunocompromised individuals are at higher risk of developing lymphoma than normal individuals. Individuals suffering from HIV/AIDS and taking immunosuppressant medications can develop lymphoma in the later stages of life. Additionally, individuals suffering from autoimmune diseases are at higher risk due to a weakened immune system.
• Infections: Certain bacterial and viral infections have a direct link to an increased risk of lymphoma development. HIV, or Epstein-Barr virus (which causes mononucleosis), can develop Hodgkin’s lymphoma in adults and children. Additionally, human herpesvirus 8, which causes Kaposi sarcoma, can also increase the risk of lymphoma.
• Environmental Factors: Frequent exposure to certain chemicals, toxins, and radiation can also increase the risk of lymphoma. Pesticides and solvents can damage lymphocytic DNA, leading to hormonal disruption, which can increase the risk of lymphoma. Additionally, constant radiation exposure can cause permanent DNA damage, leading to lymphoma symptoms or other types of cancer.
• Family History: A family history of lymphoma can also increase the risk of an individual getting lymphoma. Hodgkin’s lymphoma or other types of non-Hodgkin lymphoma have a certain genetic predisposition. The increased risk is likely due to a combination of shared genetic factors and potentially shared environment or lifestyle factors within families.

What are the treatments for lymphoma?

Lymphoma treatment generally varies depending on the specific type and stage of the disease, as well as the patient’s overall health. In this section, we will highlight some treatment approaches for lymphoma symptoms. These include:

• Chemotherapy: Doctors use various kinds of drugs to kill cancer cells throughout the body. It is a common treatment for both Hodgkin and non-Hodgkin lymphoma. Doctors usually administer the drugs in 2-8 cycles throughout treatment, depending on the types of lymphoma, and allow the body to rest. After that, they measure its effectiveness through PET or CT scans.
• Radiation Therapy: In this procedure, doctors use high-energy rays or particles to destroy cancer cells and shrink tumours. It can be beneficial to cure lymphoma, particularly in the early stages, and also for palliative care to control symptoms in advanced stages. Sometimes, doctors combine this with chemotherapy, especially for aggressive lymphoma cases, to enhance treatment effectiveness and reduce the risk of relapse.
• Immunotherapy: Immunotherapy for lymphoma uses the body’s immune system to target and destroy lymphoma cells. It offers various treatment options, including checkpoint inhibitors and bispecific antibodies. These are usually effective in both adults and children with different types of lymphoma. Immunotherapy includes checkpoint inhibitors, CAR T-cell therapy, and monoclonal antibodies. Radioimmunotherapy is a separate modality using radiolabeled antibodies.
• Targeted Therapy: Targeted therapies for lymphomas use drugs that specifically target molecules on or inside lymphoma cells to disrupt their growth. This procedure highly focuses on destroying the cancer cells without harming normal cells. These therapies can be monoclonal antibodies, antidote-drug conjugates, or small-molecule inhibitors.
• Stem Cell Transplant: Stem cell transplant, or bone marrow transplant, is common for treating lymphoma, in which doctors replace damaged bone marrow with healthy stem cells. It is done when lymphoma does not respond to initial treatment or relapses. The procedure involves high-dose chemotherapy to eliminate lymphoma cells.
   

Final Words

Many lymphoma symptoms are similar to those of other underlying serious conditions. Thus, it is important to consult a doctor if you are experiencing any symptoms that are getting worse gradually. Early diagnosis and treatment of lymphoma can significantly improve outcomes, as it can lead to serious complications if it is left untreated.