Lymphoma is a type of cancer that affects the body’s lymphatic system. The lymphatic system is part of the body’s immune system made up of a network of tissues, vessels and organs that work together to fight germs and rid the body of toxins, waste and unwanted materials. The lymphatic system transports lymph, a fluid containing infection-fighting white blood cells, throughout the body.
Patients with lymphoma often notice a swelling of their lymph nodes caused by the formation of painless lumps or tumours. Large clusters of lymph nodes can be found in the neck, armpits and groin. Lymphoma can also occur in other organs as small amounts of lymph and lymph tissue pass through virtually all organs in the body.
Lymphoma can be broadly divided into two categories:
Lymphoma is the fifth most common cancer in males and sixth in females in Singapore. Over a five-year period from 2014 to 2018, 4,176 cases were reported in Singapore.
Some of the symptoms of lymphoma include:
The symptoms above can be caused by a number of reasons and may not indicate the presence of cancer. However, make an appointment with your doctor if you have any signs or symptoms that worry you.
At present there is no routine screening for lymphoma. Individuals should seek medical attention if they have any of the symptoms above.
Currently there are also no proven preventive strategies for lymphoma. However, adopting a healthy lifestyle may help to prevent disease. This includes:
There is no specific cause for lymphoma, but some factors that can increase the risk of lymphoma include:
A common symptom of lymphoma is painless swelling of the lymph nodes in the neck, underarm or groin. Benign conditions can also cause swelling, so tests and procedures are needed to diagnose lymphoma and develop an effective treatment plan.
These may include:
Treatment for lymphoma depends on several factors including the stage of the lymphoma and whether it is slow growing or aggressive.
An individual with lymphoma should be assessed by a specialist to determine which modality of treatment is best suited for them. It is important to discuss all the possible treatment choices, including what to expect and possible side effects, to help you make an informed decision.
Types of approaches and treatments
As some forms of low-grade lymphoma are slow growing with patients being entirely unaffected by them, patients may not need immediate treatment. Doctors may advise to monitor and observe to see if the cancer progresses, before starting any treatment at an appropriate time point. Periodic tests will be conducted to monitor the condition.
Chemotherapy is the use of anti-cancer drugs to eradicate cancer cells or prevent their growth. Treatment is given orally or injected through a vein to kill cancer cells. The drugs circulate throughout the body to reach cancer cells even when they are widespread. Chemotherapy is given at regulated intervals to allow the body to recover between each treatment course.
Radiation therapy or radiotherapy, is the use of high-energy radiation (rays or particles) to kill or damage cancer cells. The area covered may just be the lymph nodes or organs affected by lymphoma or, in some cases, to a wider area encompassing the lymph nodes in the neck, chest and under both armpits. Radiation therapy may be given alone or combined with chemotherapy.
Stem cell or bone marrow transplant
A stem cell or bone marrow transplant involves the use of high doses of chemotherapy and/or radiation to suppress unhealthy bone marrow. Healthy stem cells from the bone marrow or from a donor, which are capable of producing new blood cells, are extracted and infused into the patient’s blood and reintroduced into the body to help rebuild the immune system.
Other treatments such as immunotherapy are used to treat lymphoma when conventional treatments are deemed ineffective.
One such example is
chimeric antigen receptor (CAR) T-cell therapy, an innovative approach which involves extracting a patient’s T-cells, training them to recognise the lymphoma and then administering them back into the body to kill the cancer cells.
Another example is the use of monoclonal antibodies. These antibodies attach themselves to B cells, making cancerous B cells more visible so that the body’s immune system can destroy them. Although non-cancerous B cells will be targeted as well, the body is capable of replacing them.