Lymphoma

What Is Lymphoma?

Lymphomas are cancers of the lymphatic system

When you have lymphoma, some of your lymphocytes (specialised white blood cells that normally fight infection) are ‘out of control’. They divide in an abnormal way, or do not die when they should. These abnormal lymphocytes can collect in the lymph nodes, which are small oval swellings arranged in groups at various points along the course of the lymphatic drainage system.

Lymphoma can affect lymph nodes in all parts of your body. It can also involve other organs, such as the spleen (part of the immune system) or your bone marrow.

Like other cancers, lymphoma can affect the function of the tissue involved. For example, if the lymphoma is in your bone marrow (where your blood is made) you might not be able to make new blood cells.

Although lymphoma is a disease of the lymphatic system, it can also arise in other parts of your body. For example, lymphoma can affect your breast, stomach, bowel, skin or liver. Lymphoma that occurs in areas such as these is said to be ‘extranodal’, meaning ‘outside of lymph nodes’.

Lymphoma: Types & Stages

The two main forms of lymphoma are Hodgkin lymphoma (HL) and non­Hodgkin lymphoma (NHL). Lymphoma occurs when lymphocytes, a type of white blood cell, grow abnormally. The body has two main types of lymphocytes that can develop into lymphomas: B­lymphocytes (B­cells) and T­lymphocytes (T­cells).

Staging helps to describe where the Hodgkin lymphoma is located, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to find out the cancer’s stage, so staging may not be complete until all tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient’s prognosis. There are different stage descriptions for different types of cancer.

When staging Hodgkin lymphoma, doctors evaluate the following:

  • The number of cancerous lymph node areas
  • Whether the cancerous lymph nodes are localized or generalized. Localized means they are located only in one area of the body. Generalized means they are located in many areas of the body
  • Whether the cancerous lymph nodes are on one or both sides of the diaphragm, the thin muscle under the lungs and heart that separates the chest from the abdomen
  • Whether the disease has spread to the bone marrow, spleen, or extralymphatic organs (organs outside the lymphatic system; noted using an “E” below), such as the liver, lungs, or bone

Lymphoma stage groupings

The stage of lymphoma describes the extent of the spread of the tumor, using the terms stage I through IV (1 through 4). Each stage may also be subdivided into “A” and “B” categories, based on the presence or absence of specific symptoms.

Stage I. The cancer is found in 1 region of a lymph node.

Stage II. Either one of these conditions:

  • The cancer is in 2 or more lymph node regions on the same side of the diaphragm (stage II).
  • The cancer involves a single organ and its regional lymph nodes (lymph nodes located near the site of the lymphoma), with or without cancer in other lymph node regions on the same side of the diaphragm (stage IIE).

Stage III. There is cancer in lymph node areas on both sides of the diaphragm, meaning above and below it (stage III). In addition, there may be involvement of an extralymphatic organ (stage IIIE), involvement of the spleen (using the letter “S,” stage IIIS), or both (stage IIIES).

Stage IV. The lymphoma has spread throughout more than one area of the body. Common places Hodgkin lymphoma usually spreads include the liver, bone marrow, or lungs.

Recurrent. Recurrent lymphoma is lymphoma that has come back after treatment. Lymphoma may return in the area where it first started or in another part of the body. Recurrence may occur shortly after the first treatment or years later. If the lymphoma does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

Lymphoma Treatment Options

Orange County CyberKnife offers the most comprehensive array of advanced radiation therapies in Southern California and is your best choice for the radiation therapy you may need to treat Lymphoma. The lymphatic system is made up of a web of tissues and organs connected throughout the body by tiny vessels. Its primary purpose is to assist the body in removing toxins, waste and other unwanted materials. By transporting lymph, a clear fluid with infection-fighting white blood cells called lymphocytes, from the extremities and organs back to the blood for circulation, the lymph system also fights infection and prevents disease. When cancerous abnormal cells grow in the lymphocytes, it’s called lymphoma, a type of cancer.

Types of Lymphoma

There are two primary types of lymphoma. With each, the cancer grows differently and they are treated differently so it is important to know which type of lymphoma you’ve been diagnosed with.

Hodgkin’s Lymphoma.

This type of lymphoma can occur at any age with an average age at diagnosis of 39, but is very treatable and often curable. It can start almost anywhere in the body but often starts in the upper parts of the body including chest, neck, or under the arms. It is named for the British doctor Thomas Hodgkin, who first described the disease in 1832. According to the American Cancer Society, there will be more than 9000 people diagnosed with Hodgkin’s lymphoma each year. With advanced treatments, such as those at Orange County CyberKnife, the survival rate has been increasing and is now at 86 percent for a five-year survival and 80 percent for ten-year.

Non-Hodgkin’s Lymphoma (NHL).

This type of lymphoma is eight times more common than Hodgkin’s lymphoma with more than 72,000 people expected to be diagnosed this year. NHL can start in many different parts of the body, depending on which type of NHL it is. There are about 30 different types of NHL types and the type can also affect at what rate the cancer grows and which symptoms you may have. All types are treatable and many are curable.

Lymphoma Treatments Available In Southern California

Treatment options depend on the type of lymphoma, its stage and your overall health. Treatment may include biologic (also called immunotherapy therapy), targeted therapy, stem cell transplant, chemotherapy or radiation therapy, either alone or in combination with other treatments. Surgery is rarely used. At Orange County Cyberknife, our team of oncology specialists will work with your medical team to develop the best plan for your individual case. Treatment options for lymphoma include:

Chemotherapy

This treatment uses special combinations of different drugs to shrink or kill the cancer. It’s most often injected into a vein or taken as a pill. The drugs then travel throughout the bloodstream to kill the cancerous cells. Chemotherapy is often followed by radiation therapy.

Biologic Therapy

Also called immunotherapy, biologic therapy works with your immune system to fight disease. Biologic therapy is like chemotherapy. The difference is that chemotherapy attacks the diseased cells directly, and biologic therapy helps your immune system fight the disease.

    • Monoclonal antibodies work by targeting certain molecules in the body and attaching themselves to those molecules.This causes some cells to die and makes others more likely to be destroyed by radiation and chemotherapy
    • Radiolabeled antibodies are monoclonal antibodies with radioactive particles attached. These antibodies are designed to attach themselves directly to the diseased cells and damage them with small amounts of radiation without injuring nearby healthy tissue

External Beam Radiation Therapy

With the most advanced radiation therapies in Southern California and the highly trained and skilled medical oncology staff, you will find several different radiation therapy options at Orange County CyberKnife. From CyberKnife to Clinac iX, each of these technologies are used to give your specific type of lymphoma the best treatment possible. This external beam radiation therapy delivers radiation to the diseased cells accurately and is proven to be very successful at treating and curing lymphoma. For example, the CyberKnife Robotic Radiosurgery System is the only technology in the world that synchronizes direct beams of radiation with the movement of your tumor during natural breathing and continually verifies the Cyberknife is on target automatically. Other radiation therapy tools can deliver radiation to all the lymph nodes in the body to destroy cells that may have spread to other lymph nodes. Radiation therapy may be used alone or in combination with chemotherapy or biologic therapy. You will work with your Orange County CyberKnife radiation oncologist to agree on a treatment plan that is best for you.

Contact Your Orange County Cancer Experts For More Information

Our medical oncology experts are here to help you understand every facet of your lymphoma treatment. Please contact us today at (714) 962-7100 – your first phone consultation is absolutely free! We will answer all of your questions about the types of treatment available to you. Or, use our convenient online appointment form to make your first appointment. We look forward to caring for you in our comfortable outpatient environment and helping you on the road to recovery.

Lymphoma: FAQs

Answer :

Lymphoma is a type of cancer. It starts in the infection­fighting lymphatic system. There are 2 main types of lymphoma. They are Hodgkin and non­Hodgkin. With either type, cells in lymphoid tissue grow out of control.

Answer :

The lymphatic system is part of the immune system. It helps the body fight disease and sickness. The lymphatic system consists of a series of thin tubes and clusters of lymph nodes throughout the body. These tubes carry fluid, called lymph, through the lymph nodes and back into the bloodstream. This colorless, watery fluid is rich in white blood cells. Lymphocytes are the main type of cells. They help the body fight off infection. A lymph node is about the size of a pea and has large numbers of lymphocytes. Groups of lymph nodes are found in the stomach, chest, groin, and neck. Some of the body’s internal organs are also part of the lymphatic system. These organs include the bone marrow, spleen, thymus, and tonsils. Other organs,like parts of the digestive tract, also contain lymph tissue. Lymphoma can start in any part of the body where there is lymphatic tissue.

Answer :

The cells of each of these diseases look different under a microscope. They also spread differently. Hodgkin tends to spread in a more predictable way and typically not as much as non­Hodgkin.

Answer :

A fine needle aspiration (FNA) is a type of biopsy. A biopsy is a test to check for cancer. To do an FNA, the healthcare provider takes a small sample of cells from the tumor or suspicious place. For an FNA, the healthcare provider inserts a very thin, hollow needle into the tumor to collect cells. Then the cells are looked at under a microscope for cancer cells. With lymphoma, sometimes an FNA doesn’t give the healthcare provider enough cells to look at for a clear diagnosis. Because of this, healthcare providers often prefer to use other types of biopsies to diagnose lymphoma.

Answer :

An excisional biopsy is when a surgeon takes out the whole lymph node. An incisional biopsy is when a surgeon takes out only a part of the lymph node or tumor. In both cases, a specialized healthcare provider called a pathologist looks at the cells under a microscope to check for cancer cells. Both of these types of biopsies almost always give the pathologist enough tissue to confirm whether there is cancer, as well as what type it is.

Answer :

One of the most common symptoms of lymphomas is swelling of the lymph nodes in the neck, groin, and/or underarms. If the lymphoma is in other organs or tissues, you may have other symptoms, like headaches, cough, shortness of breath, swelling in the stomach, or nausea. You may also experience generalized symptoms, like fever, itchy skin, night sweats, and unexplained weight loss. People may have only some of these symptoms. It is important to remember that all of these symptoms can be caused by other medical problems. But if you have any of these, see your healthcare provider.

Answer :

There are many different types of non­Hodgkin lymphoma. The treatment of any lymphoma depends on the type of lymphoma and on its stage, which is how far the cancer has spread. In a very early stage, radiation may be the main treatment. A combination of chemotherapy drugs is the most common treatment. There are many different regimens available. There’s also immunotherapy. This uses drugs like monoclonal antibodies, as well as other drugs called targeted therapies. Often, several types of treatment are used together. In rare cases, a surgeon may take out a diseased spleen. In cases when treatment stops working, a healthcare provider may suggest high­dose chemotherapy and stem cell transplantation. This is also called bone marrow transplant.

Answer :

There are many reasons someone might want to ask for a second opinion. Here are some:

  • A person is not comfortable with the treatment decision.
  • The type of cancer is rare.
  • There is more than 1 way to treat the cancer.
  • A person is not able to see a cancer expert.
Answer :

Here are ways to find someone for a second opinion:

Ask the healthcare provider for the name of a specialist. Call the Cancer Information Service. The number is 800­4­CANCER (800­422­6237). Callers can learn about centers and programs supported by the National Cancer Institute. Get names of healthcare providers from the local medical society. Get names of healthcare providers from a hospital, medical school, or cancer advocacy group. Ask people who have had the same kind of cancer for healthcare providers’ names.

Remember, it is more important to make an informed decision about your healthcare team and treatment than to make a quick decision. Give yourself time to get all the information you need to make the best choice for yourself.