What is lymphoma?

Lymphoma is a type of cancer that affects your lymphatic system.

Your lymphatic system is part of your immune system. It helps defend your body against infections and keep fluid balance. Your lymphatic system is made up of several parts, including:

• lymph — a clear fluid that contains white blood cells that fight infection
• lymph vessels — small tubes that carry lymph
• lymph tissue — including your spleen, bone marrow and tonsils
• lymph nodes (lymph glands) — filter your lymph to remove waste and harmful substances

You have lymph nodes throughout your body, including in your neck, armpits and groin.

Lymphoma occurs when healthy cells in your lymphatic system become abnormal. They start to grow and multiply in an uncontrolled way.

There are 2 main types of lymphoma:

1. Hodgkin lymphoma
2. non-Hodgkin lymphoma

What are the symptoms of lymphoma?

Symptoms of lymphoma can include:

• a lump or swelling in a lymph node, often in your neck, armpit or groin
• tiredness or fatigue
• night sweats or fever
• poor appetite
• weight loss
• bruising or bleeding easily
• trouble getting over infections

Other symptoms can include:

• pain in your chest or tummy
• a swollen tummy
• a persistent cough
• shortness of breath
• red patches on your skin, a rash or itching

What causes lymphoma?

The cause of lymphoma is not fully understood.

The risk of developing lymphoma can be increased by:

• a weakened immune system from conditions such as an inherited immune disorder or an autoimmune disease
• taking medicines that suppress your immune system
• some infections, including Epstein-Barr virus (which causes glandular fever) or HIV infection
• a family history of lymphoma
• being exposed to radiation or some toxins

Even if you have one or more of these risk factors, it doesn't mean you will develop lymphoma.

When should I see my doctor?

If you have a lump or other symptoms of lymphoma, see your doctor as soon as possible.

How is lymphoma diagnosed?

Your doctor will ask about your symptoms and do a physical examination. This includes feeling for the lymph nodes in your neck, underarms and groin.

You may be asked to have some general tests, such as:

• blood tests
• urine tests
• x-rays

If you have a swollen lymph node or lump, you will probably be asked to have a biopsy.

A biopsy involves taking a tissue sample, which is looked at under a microscope. If cancerous cells are found, the type of lymphoma (Hodgkin or non-Hodgkin) will also be confirmed.

If lymphoma is diagnosed, more tests may be advised to work out the stage of the lymphoma. The stage means how much it has spread in your body. These extra tests may include a:

• CT scan
• bone marrow biopsy
• MRI scan
• PET scan

This information is important to help work out the best treatment for you.

How is lymphoma treated?

If you have lymphoma, the type of treatment your doctors recommend will depend on:

• the type of lymphoma you have
• where the cancer is
• the stage of lymphoma — how much the disease has spread to other areas of your body
• how fast it's likely to grow
• your symptoms

The main treatment options for lymphoma are:

• chemotherapy
• radiotherapy
• targeted therapy (such as monoclonal antibodies)
• cancer immunotherapy, which uses your own immune system to fight the lymphoma

These treatments can be used on their own or in combination.

In some cases, you may need a stem cell transplant.

Your treatment may be managed by a group of health professionals called a multidisciplinary team. This team may include:

• your doctor (GP)
• a haematologist (specialist in diseases of the blood and lymphatic system)
• an oncologist (cancer specialist)
• a radiation oncologist (specialist in radiotherapy)
• a cancer nurse
• a social worker

In some people with slow-growing lymphomas, doctors may suggest a watch and wait approach. This means that you will get regular check-ups and are only treated if the lymphoma starts to grow faster.

What are the complications lymphoma treatments?

Like all cancer treatments, lymphoma treatments can cause a wide range of side effects and complications. But not everyone experiences the same side effects.

If you are being treated for lymphoma, some of your treatments may cause side effects. Here are some examples of side effects your treatment may cause:

• lose some or all of your hair
• feel nauseous (feel sick)
• vomit (be sick)
• feel very tired and washed out
• have a sore mouth
• have sore skin from radiation
• have an increased risk of infection

These side effects are temporary. You can talk to your healthcare team about things you can do to manage them.

Infections

Lymphoma treatments can weaken your immune system, increasing your risk of infection.

If you are being treated for lymphoma and think you have an infection, tell your doctor straight away. Untreated infections can be very serious for people having cancer treatment.

Cancer treatment and fertility

Some lymphoma treatments can cause problems with fertility.

Ask your treatment team if you're at risk. In some cases, males may be able to store samples of their sperm, and females may be able to freeze their eggs to use after treatment is over.

Second cancer

People who've had lymphoma and some lymphoma treatments may be at greater risk of getting another cancer.

Other problems

Some lymphoma treatments can cause peripheral neuropathy (nerve damage). This is when you have tingling, numbness or pain in your arms or legs.

Can lymphoma be prevented?

Currently, there is no way to prevent lymphoma and no routine screening tests.

Resources and support

You may feel scared, upset, anxious or overwhelmed if you have been diagnosed with lymphoma.

You can get support from your doctor and family and friends. Support and information are also available from:

• Cancer Council Australia, including the Cancer Council telephone support service on 13 11 20 and information in other languages.
• Canteen, which provides support for young people (aged 12 to 25 years) living with or affected by cancer. They also have resources for parents and carers.
• Lymphoma Australia, which has information and an online patient forum.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.