Lymphoma

Lymphoma is a cancer of lymphocytes, immune cells that travel through the lymphatic system.

Lymphocytes are found in lymph nodes, bone marrow and other tissues. Lymphoma is commonly grouped into Hodgkin lymphoma and non-Hodgkin lymphoma, with further subtypes that can have different patterns and treatments. Accurate classification is central to planning care.

Night sweats are a very common presentation of lymphoma, and fever, unexplained weight loss, or lumps in the neck or armpit can occur. Some people notice fatigue, itching, breathlessness or a feeling of pressure from enlarged lymph nodes. These changes have several possible causes; a lump that persists or grows, fever without an explanation, drenching night sweats, or worsening breathlessness should be assessed.

Lymphoma begins when a lymphocyte acquires changes that allow it to grow and survive abnormally. In many people, there is no clear single cause. The subtype, cell features and where disease is found help specialists understand its behaviour; lymphoma is not contagious.

Some lymphomas grow slowly and may be monitored before treatment, while others need treatment soon after diagnosis. Disease can involve lymph nodes, blood, bone marrow or organs outside the lymphatic system. Staging and subtype give a more useful picture than symptoms alone.

A weakened immune system, certain infections, autoimmune conditions and some medicines that suppress immunity can be associated with particular lymphoma types. Most people with these factors do not develop lymphoma, and many people diagnosed have no known risk factor.

A biopsy of an affected lymph node or other tissue is usually needed to identify lymphoma and its subtype. Blood tests, examination and imaging then help assess extent. A PET-CT scan can show areas of active disease and may be used to check response after treatment. Ask how results will be shared and whether another sample is needed.

Treatment is chosen according to lymphoma subtype, extent, symptoms, general health and treatment goals. Chemotherapy and immunotherapy use medicines to treat lymphoma throughout the body, while radiotherapy may target a defined area. For lymphoma that returns or does not respond as hoped, options can include an autologous stem cell transplant or CAR T-cell therapy for selected situations.

Treatment and the condition can affect energy, infection risk, sleep, mood and work. Keep a record of temperature changes and new symptoms, follow any infection-prevention advice, and ask about nutrition, fertility, vaccinations and emotional support before treatment starts. A named contact at the cancer service can make it easier to raise concerns.

Enlarged nodes can sometimes press on nearby structures. Superior vena cava obstruction is one possible complication when pressure affects a large vein in the chest. Facial or neck swelling, prominent chest veins, severe headache, dizziness or increasing breathlessness needs urgent assessment. Treatment can also lower blood counts, so fever during treatment should be reported immediately.

There is no proven way to prevent every lymphoma. Managing immune-suppressing treatment with the prescribing specialist, attending follow-up, and seeking assessment for persistent concerning symptoms are sensible protective steps. Do not stop prescribed medicines without medical advice.

A haematologist or medical oncologist often leads care alongside specialist nurses, pathologists, radiologists, transplant teams and supportive-care professionals. Ask which subtype you have, what the treatment goal is, whether fertility preservation is relevant, and who should be contacted outside clinic hours.