Lymphoma: Understanding Types, Treatment Options, and Care Decisions
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What is Lymphoma?
Lymphoma is a type of blood cancer that begins in the lymphatic system including your lymph nodes, spleen, and thymus gland, which plays an essential role in immune defense. Lymphoma is the result of a mutation in the white blood cells which is called lymphocytes, and this causes uncontrolled growth of cancer cells that develop into malignant tumors in the lymph glands.
A lymphoma diagnosis can be unsettling, but it’s important to know that many forms of lymphoma are highly treatable, and outcomes have improved significantly over the years.
Treatment is not the same for everyone. Some lymphomas grow slowly and may not require immediate treatment, while others need prompt therapy. Understanding the type of lymphoma is the most important first step.
What are the types of Lymphoma?
Lymphoma is broadly divided into Hodgkin lymphoma and non-Hodgkin lymphoma, but within these groups are many subtypes with different behaviors and treatments.
Hodgkin Lymphoma (Hodgkin’s disease)
Hodgkin lymphoma starts in the immune cells called B lymphocytes (B cells). These cells produce proteins called antibodies that fight the disease. Hodgkin lymphoma is characterized by the presence of Reed–Sternberg cells on biopsy.
Key points:
- Often affects younger adults but can occur at any age
- Usually spreads in an orderly pattern
- Considered one of the most curable cancers, especially when diagnosed early
Treatment commonly involves chemotherapy, sometimes combined with radiation therapy.
Non-Hodgkin Lymphoma (NHL)
It is cancer which multiplies T-lymphocytes, B-lymphocytes or their cellular predecessors. It is one of the most common types of cancer and is life-threatening. Non-Hodgkin’s lymphoma occurs in a single lymph node, a group of lymph nodes, or an organ and can spread to any part of the body. Non-Hodgkin’s lymphoma is more common than Hodgkin’s lymphoma.
Indolent (Slow-Growing) Lymphomas
Examples include follicular lymphoma and small lymphocytic lymphoma.
Features:
- May remain stable for years
- Symptoms can be mild or absent initially
- Treatment may be delayed until disease progression
In many cases, active monitoring (watchful waiting) is appropriate and does not worsen outcomes.
Aggressive (Fast-Growing) Lymphomas
Examples include diffuse large B-cell lymphoma (DLBCL) and mantle cell lymphoma.
Features:
- Symptoms develop more quickly
- Treatment usually starts soon after diagnosis
- Many patients respond very well to initial therapy
Aggressive lymphomas are often highly treatable when managed promptly.
How is Lymphoma Diagnosed and Staged?
Diagnosis usually requires:
- Lymph node biopsy (excisional biopsy preferred)
- Imaging tests such as CT or PET scans or MRI to get an internal view of your chest, abdomen, or pelvis. These tests will help them to check for abnormal lymph nodes and tumors.
- Blood tests and sometimes bone marrow evaluation
Staging helps doctors understand how far the disease has spread and guides treatment planning.
What are the treatment options for Lymphoma?
Treatment depends on lymphoma type, stage, symptoms, and overall health.
Chemotherapy and Immunotherapy
Most lymphomas are treated with combinations of chemotherapy and immunotherapy drugs. Many patients achieve long-term remission with these treatments alone.
Targeted Therapy
Targeted treatments focus on specific characteristics of lymphoma cells and are increasingly used in certain subtypes.
Radiation Therapy
Radiation may be used:
- In early-stage disease
- To treat localized areas
- For symptom relief in selected cases
Bone Marrow (Stem Cell) Transplant — in Selected Situations
Transplant is not first-line treatment for most lymphomas. It may be considered when:
- Lymphoma returns after initial treatment
- Disease does not respond adequately to standard therapy
The decision is individualized and based on response to earlier treatments.
Important Note: Hodgkin lymphoma treatment is primarily chemotherapy, radiation therapy, or both. These treatments can cure the disease. Non-Hodgkin lymphoma treatment includes chemotherapy, radiation therapy, stem cell transplant, and targeted therapy.
Living With and Beyond Lymphoma
Many people treated for lymphoma return to normal or near-normal life. Follow-up care focuses on:
- Monitoring for recurrence
- Managing long-term side effects
- Supporting physical and emotional recovery