Lymphomas are a group of cancers which start in the lymphatic system and usually spread via the lymph nodes which are situated in the neck, armpits, the middle of the chest and in the abdomen. Some lymphomas are slow-growing (low grade) and others progress very quickly (high grade): if untreated the latter can cause serious problems within a few months. Others fall somewhere between the two extremes. The lymphomas generally start in the lymph nodes, and may also involve the bone marrow depending on how aggressive the cancer is. High grade non-Hodgkin’s lymphoma is often completely curable.
Symptoms you might notice include a painless but persistent swelling in your lymph nodes, usually in the neck, armpit or groin. In fact, enlarged lymph nodes often result from straightforward viral infections and are very common – but these clear up within a few weeks. Enlarged lymph nodes which are not accompanied by any infection, which do not disappear on their own and which are not tender to the touch, should be regarded seriously and checked by your doctor. Of course, there may be a perfectly innocent cause but the check-up can do you no harm. More general symptoms which tend to accompany lymphoma as it progresses are a general tiredness, loss of appetite and of weight and unusual sweating at night.
Lymphoma is usually diagnosed by means of a biopsy of the enlarged lymph node, which will help to determine the type of lymphoma in question: there are several dozen and the classification of lymphoma is a very complex area. Once the type of lymphoma is established, further tests will be carried out to establish how far it has spread and these may include a chest X-ray, lymphogram and scans. Both the type and spread of a lymphoma are important factors in determining the nature and extent of treatment you will undergo.
If your lymphoma is the slow-growing, low-grade type, then you may experience periods of time where no treatment at all is considered necessary. However, you are likely to undergo some chemotherapy at certain stages to keep the effects and symptoms of your cancer manageable – and this type of treatment may last for some years. In some cases, radiotherapy might be helpful to relieve problems if an enlarged lymph node is, for example, blocking another organ and causing trouble.
Treatment for the higher grades of lymphoma differs in that the cancer is faster and more steadily growing, and therefore cannot be left untreated for periods of time as the lower-grade lymphomas can. Chemotherapy is commonly used and it can lead to a cure. Radiotherapy may be used at the same time to treat localized areas of tumour.
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