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Lymphoma
Lymphomaisacancerthatbeginsinthelymphaticsystem.Therearetwomaintypesof lymphoma:non-Hodgkinslymphoma(NHL)andHodgkinslymphoma(sometimescalledHodgkins disease). ThecellsofHodgkinslymphomalookaparticularwayunderamicroscope.Lymphomacellsthat donotlooklikethisareanon-Hodgkinslymphoma.Itisimportantfordoctorstobeabletotellthe differencebetweenthecellsofHodgkinsandnon-Hodgkinscellsbecausetheyaretwodifferent diseases.Theyarequitesimilarinmanywaysbutthetreatmentforeachisdifferent. Non-HodgkinslymphomaisoneofthemostcommoncancersinVictoria,affectingover1,000 peopleayear.Itcanoccurinchildrenbutismorecommoninadults.Hodgkinslymphomaismuch lesscommon.About120Victoriansareaffectedeachyear. The lymphatic system and lymphoma Thelymphaticsystemispartoftheimmunesystem,whichhelpsprotectourbodyagainst infection.Itconsistsoflymphnodesconnectedbylymphvessels,whichbranchoutintoallpartsof thebodyexceptthebrainandspinalcord.Thelymphaticsystemalsoincludesthebonemarrow, spleen,thymusglandandtonsils.Itsmainjobsareto: Drainfluidsbackintothebloodstreamfrombodytissues Filterthebloodandlymph Fightinfection.

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Thelymphaticsystemcarriesaclearfluidcalledlymph,whichcontainsmanywhitebloodcells calledlymphocytes.Thelymphocytesmaturewithinthebloodandbonemarrow,andarestoredin thelymphnodes.Lymphnodesarefoundinvariousareasofthebody,includingtheneck,armpits, chest,abdomenandgroin.Lymphfluidisfilteredthroughthelymphnodesandanyforeign organisms(suchasbacteria)aretrappedandattackedbythelymphocytes. Inapersonwithlymphoma,largenumbersofabnormallymphocytesaremade,whichreplace someofthenormallymphocytes.Thiscanaffecttheimmunesystemandthewaythebodyfights infections.Thelymphnodesalsobecomeswollen,formingpainlesslumps. Thelymphaticsystemrunsthroughmostofthebody.Thismeansyoucangetlymphomaalmost anywhere.Itismostcommonlyfirstseeninthelymphnodesintheneck,butitisalsofairly commontofinditintheliverorspleen.Otherplacesyoumayfindlymphomaareinthebowel, stomach,brain,skin,testiclesandeye. Symptoms Themostcommonsymptomoflymphomaisaswellingofthelymphnodesintheneck,armpitor groin.Theseswellingsareusuallypainless.Othergeneralsymptomsinclude: Weightloss(morethanone-tenthofyourtotalweight) Feverthatcomesandgoeswithoutanyobviouscause Heavysweatingespeciallyatnight Somepeoplehaveunexplaineditching.

DoctorscallthisgroupofsymptomsBsymptoms.Somepeoplewithlymphomamayhavethem, butmanydont.Sometimeslymphomagetsintothebonemarrow,causingproblemswithlow bloodcounts. Mostpeoplewhohaveanyofthesesymptomswillnothavelymphoma.Theywillbesufferingfrom amuchlessseriousproblemsuchasathroatinfection.However,itisalwaysimportanttoseeyour doctorifyouhavesymptoms.

Lymphoma

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Risks and causes Wedontknowwhymostpeoplegetlymphoma.Therearemanydifferenttypesoflymphomaand itisunlikelythatthereisonesinglecauseofalllymphoma.Therearesomeknownriskfactors, whichinclude: Exposuretoradiation Exposuretocertainchemicals Infectionsandviruses,includingthehumanimmunodeficiencyvirus(HIV)andtheEpsteinBarrvirusinpeoplewhoseimmunesystemissuppressed. Thereareotherpossiblecausesbutmoreresearchisnecessarytofindotherdefiniterisk factors.

Diagnosis MostpeoplebeginbygoingtoseetheirGPwithsymptoms.Ifyourdoctorhasconcernsthatyou mayhavelymphoma,theywillreferyoutothehospitaltohaveabiopsy.Thismeanshavingoneof theswollenlymphnodestakenoutandexaminedunderamicroscopetoseeifitcontainscancer cells. Ifitdoes,youwillneedtohavefurtherteststoseewhereandhowfarthelymphomahasspread. Thesetestsmayinclude: Physicalexaminationandbloodtests. Chestx-ray. Bonemarrowbiopsysomefluidisremovedfromthebonemarrowandexaminedfor cancercells. CTscanaspecialisedx-rayforbuildingupthree-dimensionalpicturesofthebody. Galliumscanashort-lived,radioactiveformofgalliumisinjectedintothebody,and outlinesorgansinthebodywhenviewedwithaspecialgammacamera. PETscanasmallamountofradioactivematerialisinjected,whichhighlightscancerous areaswhenviewedwithaspecialscanner.

Testresultscantakeafewdaystocomeback.Itisverynaturaltofeelanxiouswhilewaitingto getyourresults.Itcanhelptotalktoaclosefriendorrelativeabouthowyouarefeeling.Youcan alsocontactyourlocalcancerinformationandsupportservice. The stages of the disease Thediseaseisstagedaccordingtoitslocationandspread.Thisisimportanttodeterminethetype oftreatmentyouwillneed. Stage Icancerisfoundinonelymphnodeareaoronearea/organoutsidethelymph nodes. Stage IIcancerisfoundintwoormorelymphnodeareasonthesamesideofthe diaphragm.Cancerisfoundinonearea/organoutsideofthelymphnodesandinthelymph nodesaroundit.Otherlymphnodeareasonthesamesideofthediaphragmmaybe involved(thediaphragmisasheetofmuscleslungbeneaththelungsthatenables breathing). Stage IIIcancerisfoundinlymphnodeareasonbothsidesofthediaphragm.Itmay havespreadtoanarea/organnearthelymphnodearea,ortothespleen,orboth. Stage IVcancerhasspreadtomorethanonespotwithinoroutsidethelymphatic system.

Treatment Treatmentforlymphomadependsonthelocationandseverityofthecancer.Treatmentfor Hodgkinslymphomaisoftenverysuccessful,withmanypeoplebeingcured.Non-Hodgkins lymphomaisalsocurablebutitcanbehardertotreat. TreatmentregimesareslightlydifferentforHodgkinslymphomaandnon-Hodgkinslymphoma. Somepeopleonlyneedonetreatment.Otherswillneedacombination.Optionsinclude: Watchful waitingsomeformsofslow-growingnon-Hodgkinslymphomamaynotneed activetreatmentwhenfirstdiagnosed.Regularcheck-upswillbenecessary. Chemotherapyeithertabletsorinjectionsofanti-cancerdrugsareused.

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Radiotherapyx-raysareusedtotargetandkillcancercells.Thisisusedinadults,but rarelyusedtotreatchildrenwithlymphoma. Steroids astabletsorinjectionstoimprovehowwellyourchemotherapyworks. Immunotherapy (biological therapy) with antibodies treatmentsthatusenatural bodysubstancesordrugsmadefromnaturalbodysubstances.Onetreatmentavailablein AustraliatotreatNHLiscalledrituximab.Severalmoreantibodytreatmentsarebeing developed. Stem cell (or bone marrow) transplantationstemcellsarethecellsthatbloodcells evolvefrom.Highdosesofchemotherapycandamagestemcellsso,duringthistreatment, stemcellsareremovedfromthebonemarrowbeforehigherdosesofchemotherapyare given.Theyarethentransplantedbackafterthechemotherapyhasfinished.This treatmentmaybesuggestedifthediseasecomesbackordoesnotrespondtothefirst treatment.

Alltreatmentshavesideeffects.Thesewillvarydependingonthetypeoftreatmentyouare having.Manysideeffectsaretemporarybutsomemaybepermanent.Yourdoctorwillexplainall thepossiblesideeffectsbeforeyourtreatmentbegins. Where to get help Yourdoctor Specialist TheCancerCouncilVictoriaInformationandSupportServiceTel.131120 MultilingualCancerInformationLine,Victoria-seetheCCVwebsiteforcontactdetails LeukaemiaFoundationofVictoriaTel.(03)96201815

Things to remember

Lymphomaisagroupofcancersthataffectthelymphaticsystem. Symptomsmayincludeswellingofthelymphnodes,weightlossandnightsweats. TheyareoneofthemorecommontypesofcancerinVictoria.

This page has been produced in consultation with, and approved by:

CancerCouncilVictoria

Copyight 1999/2009StateofVictoria.ReproducedfromtheBetterHealthChannel(www.betterhealth.vic.gov.au)at nocostwithpermissionoftheVictorianMinisterforHealth.Unauthorisedreproductionandotherusescomprisedinthe copyrightareprohibitedwithoutpermission. ThisBetterHealthChannelfactsheethaspassedthrougharigorousapprovalprocess.Forthelatestupdatesandmore informationvisitwww.betterhealth.vic.gov.au.

Lymphoma

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