Lymphoma - Hodgkins and non-Hodgkins

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Lymphoma refers broadly to a group of cancers of the immune system. Lymphoma occurs when white blood cells called lymphocytes grow abnormally, sometimes multiplying very quickly or living longer than they should. Lymphomas are often (but not always) diagnosed in patients who may have swollen or enlarged lymph nodes in one or more areas of the body. Sometimes, lymphomas are diagnosed after finding abnormal blood counts or in patients experiencing unusual immune symptoms. There are many types of lymphomas, but often lymphomas are divided into categories of Hodgkin’s and Non-Hodgkin’s Lymphomas. 

The Swedish Cancer Institute (SCI) offers patients with all types of lymphoma – both Hodgkin’s and non-Hodgkin’s – the expertise of physicians specializing in lymphoma. At SCI, patients with lymphoma are supported by a multidisciplinary approach to care, the latest diagnostic techniques, state-of-the-art treatment options and a wide selection of quality support services.

Hodgkin’s Lymphoma (HL)

Hodgkin’s lymphoma is seen in both younger and older adults. It typically begins in the lymph nodes in one region of the body and then spreads through the lymph system in a predictable manner. It may also spread outside the lymph system to other organs such as the lungs, liver, bone and bone marrow. Typically, Hodgkin’s lymphoma is diagnosed when a specific type of large abnormal cancer cell called a Reed-Sternberg Cell is present.

Non-Hodgkin’s Lymphoma (NHL)

There are more than 60 types of non-Hodgkin’s lymphoma. Clinically, they are organized into slow growing (indolent) and fast growing (aggressive) types. NHL can also be divided generally by the type of abnormal lymphocyte the cancer comes from, either B-cell NHL (more common) or T-cell NHL (rare). NHL can occur at any location throughout the body, but commonly involve lymphatic tissues such as lymph nodes, the blood and bone marrow, the spleen, liver, or skin. As there are many types of NHL with differing treatment types, diagnosis of the exact type of NHL is important to delivering the best care. At SCI our team works closely with expert pathologists with specific experience in diagnosis of lymphomas to provide the most precise diagnosis possible.

Symptoms

Lymphomas can present in a number of different ways. Amongst more common symptoms of lymphomas are:

  • Enlarged or swollen lymph nodes
  • Unexplained fevers
  • Drenching night sweats
  • Unintended weight loss
  • Fatigue that prevents or makes daily activities very difficult 
  • Abnormal blood counts
  • Enlarged or swollen spleen or liver

Some rare types of lymphomas can primarily involve the skin and cause persistent skin rashes, nodules, or other skin changes. Rarely, lymphomas can present in the brain or eyes causing headaches, vision changes, or weakness in a specific part of the body. 

Diagnosis

As there are numerous types of lymphomas, accurate diagnosis usually involves a biopsy of an entire lymph node (excisional biopsy) or numerous needle biopsies (core needle biopsies) of suspected areas of lymphoma. Sometimes, lymphomas that primarily affect the blood may be diagnosed via specialized blood tests or sampling of the bone marrow, the organ where all blood cells are made. 

As lymphomas are cancers of immune cells that can normally travel throughout the body, many lymphomas are present in multiple parts of the body at the time of diagnosis. Usually imaging tests such as  CT scans or PET-CT scans are used to aid staging. Sometimes MRI images or a bone marrow biopsy might be useful in staging. Staging for many common types of lymphomas is done using the Ann Arbor staging system:  

Stage I – Involvement of one lymph node region
Stage II - Involvement of two or more lymph node regions and both are either above or below the diaphragm
Stage III - Involvement of lymph node regions above and below the diaphragm (for example, neck, chest and abdomen)
Stage IV – Involvement of non-lymphatic organs as well as lymph nodes or involvement of bone marrow

Treatments and Procedures

Some lymphomas are treated with the intent to cure the disease. Others may be incurable, but treatment can achieve a long term remission during which patients may require no or minimal treatment.

Swedish lymphoma physicians utilize state-of-the-art treatments for lymphomas including:

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Research and Clinical Trials

If your physician believes you are a good candidate to participate in a clinical trial evaluating a new treatment or more effective combinations of treatments — and you agree — you will have access to the very latest in research treatments.

At any given time, the Swedish Cancer Institute offers patients more than 140 clinical-research studies involving most types of cancers. At SCI patients with lymphoma have access to a broad variety of clinical trials encompassing early stage (Phase 1 or first in human) to later stage (Phase 3) trials. Our clinical trials provide unique access to scientifically novel therapies including a variety of cellular therapies, immunotherapies, and new targeted therapies.  Additionally, our physician specialists collaborate with other regional and national research groups, including  Southwest Oncology Group, National Cancer Institute, Puget Sound Oncology Consortium and Fred Hutchinson Cancer Research Center.

Education and Support for Patients and Families

Beyond physical health, the Swedish Cancer Institute is committed to the emotional well-being of our patients and their families. We offer:

Complementary therapies include:

See Patient Support and Resources and Services for the Body, Mind and Spirit at Swedish.

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