There are two main types of lymphoma: Hodgkin's lymphoma and non-Hodgkin's Lymphoma. Treatment depends on the type of lymphoma, the stage of the cancer when you were first diagnosed, your age and overall health and your symptoms, including weight loss, fever and night sweats.
About Hodgkin's Lymphoma
Hodgkin's lymphoma is a cancer of lymph tissue found in the lymph nodes, spleen, liver, bone marrow and other sites.
The first sign of Hodgkin's lymphoma is often a swollen lymph node, which appears without a known cause. The disease can spread to nearby lymph nodes and later may spread to the spleen, liver, bone marrow and other organs.
If you have Hodgkin's lymphoma, staging ranges from I to IV. The higher the staging number the more advanced the cancer. Stages I and II (limited disease) can be treated with radiation therapy, chemotherapy or both. Stage III is treated with chemotherapy alone or a combination of radiation therapy and chemotherapy. Stage IV (extensive disease) is most often treated with chemotherapy alone.
Non-Hodgkin's lymphoma is cancer of the lymphoid tissue, which includes the lymph nodes, spleen and other organs of the immune system. White blood cells called lymphocytes, found in lymph tissues, help prevent infections. Most lymphomas start in a type of white blood cells called B lymphocytes, or B cells.
The many different types of non-Hodgkin's lymphoma are classified according to how fast the cancer spreads. The cancer may be low grade (slow growing), intermediate grade or high grade (fast growing).
Burkitt's tumor is an example of a high-grade lymphoma. Follicular lymphoma is a low-grade form of the disease. Non-Hodgkin's lymphoma is further sub-classified by how the cells look under the microscope, for example, if there are certain proteins or genetic markers present.
With non-Hodgkin's lymphoma, radiation therapy ;may be used if the disease is confined to one area of the body, but chemotherapy is the main type of treatment. Most often, we use multiple drugs in combination with each other. Rituximab (Rituxan) is often used to treat B-cell non-Hodgkin's lymphoma.
Radioimmunotherapy may be used in some cases of non-Hodgkin's lymphoma. This involves linking a radioactive substance to an antibody that targets the cancerous cells and injecting the substance into the body.
People with either type of lymphoma that returns after treatment or does not respond to treatment may receive high-dose chemotherapy followed by an autologous bone marrow transplant using your own stem cells. Additional treatments depend on your symptoms. They may include transfusion of blood products, such as platelets or red blood cells, and antibiotics to fight infection, especially if a fever occurs.
Diagnosis of Lymphoma
Doctors diagnose lymphoma after biopsy of suspected tissue, usually a lymph node biopsy, or bone marrow biopsy. If tests reveal you have lymphoma, additional tests will be done to determine whether the cancer has spread. Staging the disease helps guide future treatment and follow-up and gives you some idea of what to expect in the future.
Procedures for staging include:
- blood chemistry tests, including protein levels, liver function tests, kidney function tests and uric acid level
- CT scans of the chest, abdomen and pelvis
- Gallium scan
- complete blood count to check for anemia and white blood count
- PET scan