Lymphoma: What symptoms are warning signs?

marcom@healthxchange.com.sg (healthxchange.sg)
·3-min read

September marks Lymphoma Awareness Month. The National Cancer Centre Singapore (NCCS) explains the two types of lymphoma and symptoms to look out for.

It is said too much of a good thing can be bad for you. This holds true for the body's immune system. In the case of lymphoma, the body’s immune system cells start to multiply uncontrollably and do not die.

In Singapore, lymphoma ranks as a top ten cancer (fifth most common cancer among men and sixth most common cancer among women).

Symptoms of lymphoma

  • Painless swelling of the lymph nodes in the neck, underarm or groin is the most common symptom

  • Persistent fever

  • Drenching night sweats

  • Unexplained weight loss

  • Patchy red skin and itching

  • Lack of energy, tiredness or fatigue

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Diagnosis of lymphoma

“Lymphoma is diagnosed with a biopsy. Once the lymphoma is confirmed, additional scans, a bone marrow biopsy and blood tests may be needed to see how widespread the cancer is. Heart function tests may also be required to see if a patient is fit for lymphoma treatment,” says Professor Lim Soon Thye, Deputy Medical Director (Clinical) and Senior Consultant from the Division of Medical Oncology at National Cancer Centre Singapore (NCCS), a member of the SingHealth group.

Tests used to diagnose lymphoma include:

  • Physical exam: The doctor will check for swollen lymph nodes as well as an enlarged spleen or liver

  • Blood tests: For testing blood cell, kidney and liver performance. A blood test can also detect lactase dehydrogenase (LDH), a chemical associated with the aggressive form of non-Hodgkin’s lymphoma

  • Bone marrow biopsy: Bone marrow samples are usually taken from the hip and examined for abnormal white blood cells

If the lymphoma is confirmed, it is then classified according to its stage, Stage 1 being the earliest phase while Stage IV is the disease at its most widespread.

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Two types of lymphoma: Hodgkin's vs non-Hodgkin's

1. Hodgkin’s lymphoma (also called Hodgkin’s disease)

Patients diagnosed with Hodgkin’s lymphoma often have large abnormal cells called Reed-Sternberg cells in their lymph nodes. This disease is highly curable and accounts for about 10 per cent of all lymphoma cases.

Although lymphoma cancer can occur at any age, Hodgkin’s disease is most prevalent in two particular age groups:

  • People between 15 and 40 years of age

  • People aged 55 years and above

2. Non-Hodgkin's lymphoma

Non-Hodgkin’s lymphoma is more common. There are mainly two types of non-Hodgkin’s lymphoma:

  • Aggressive (high grade): Tends to grow and spread quickly and cause severe symptoms. If left untreated, it can be fatal within a few months or sooner

  • Slow-growing (low-grade): Tends to grow and spread slowly and cause few symptoms. It is harder to treat and carries a higher risk of relapse

The risk of developing non-Hodgkin’s lymphoma increases with age, with most patients being diagnosed in their 60s.

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