Lymphomas are a type of blood cancer that begins in the lymphatic system, a vital part of the immune system that protects us from diseases, helps maintain fluids, absorbs nutrients, and removes waste. There are two main types: Hodgkin lymphoma and non-Hodgkin lymphoma. While both are types of lymphoma, their treatments and prognosis are different.
What is Hodgkin Lymphoma?
Hodgkin lymphoma occurs when white blood cells called lymphocytes grow out of control, causing swollen lymph nodes and growth throughout the body. It usually affects the lymph nodes in the upper body – such as the neck, chest, and armpits. Hodgkin lymphoma typically affects men ages 30-50 more than women. It’s slow growing and is often treatable with a positive outcome.
There are only a few subtypes of Hodgkin lymphoma. The diagnostic criteria for Hodgkin lymphoma involve looking for mutated cells called Reed-Sternberg cells. Hodgkin lymphoma is less common than non-Hodgkin lymphoma, accounting for about 10% of all lymphomas diagnosed.
What is Non-Hodgkin Lymphoma?
Non-Hodgkin lymphoma (NHL) is more complex than Hodgkin lymphoma. This type of cancer usually begins growing in the lymphocyte cells responsible for fighting infection. It more commonly starts in the lymph nodes or lymphatic tissue rather than the lymph fluid itself. Multiple subtypes of NHL can affect either T-cells or B-cells within white blood cells. NHL may be aggressive (fast-growing) or indolent (slower-growing).
How are Lymphomas Diagnosed?
Common symptoms that might indicate either non-Hodgkin or Hodgkin lymphoma include:
- An enlarged lymph node
- Unexplained fatigue
- Fever with no other symptoms
- Excessive sweating at night
- Unexplained weight change
- Shortness of breath
- Chest pain or cough
- Poor appetite
Common diagnostic tests for all types of lymphomas include:
- A physical exam to look at swelling and inflammation
- A biopsy of the lymph node to look at the cells
- Blood tests
- Bone marrow biopsy
- Chest X-ray to see if it’s spread to the lungs
- A CT or PET scan to see if the cancer has spread any further
What Type of Doctor Treats Lymphomas?
A hematologist, who is a blood specialist, is the type of physician who diagnoses and typically treats lymphomas of all types. In many cases, patients are already seeing a hematologist due to abnormal test results or physical symptoms that another physician identified, such as swollen lymph nodes or blood test results.
The hematologist will run diagnostic tests to determine if lymphoma is present. And if it is, the type of lymphoma will be determined.
Most hematologists, including those at Willamette Valley Cancer Institute, are also cancer specialists and will continue to work with the patient to create a customized lymphoma treatment plan.
Which Type of Lymphoma is Most Common?
The most common type of lymphoma is non-Hodgkin lymphoma, accounting for 90% of cases. NHL is more commonly diagnosed later in life, but it can develop at any age. Non-Hodgkin lymphoma is further divided into B-cell lymphomas and T-cell lymphomas. B-cell lymphomas are the most common type of NHL, accounting for about 80% of cases.
Treatment Options Vary by Type of Lymphoma
Hodgkin Lymphoma Treatments
When a patient is diagnosed with Hodgkin Lymphoma, there are several different treatment approaches to choose from. The treatment approach your doctor chooses will depend on the following factors:
- The type of Hodgkin lymphoma
- The Hodgkin lymphoma stage and where it was found
- The size of the tumor
- Your age
- Your symptoms
Common treatment approaches for Hodgkin lymphoma include:
- Radiation therapy
- Targeted therapy
If the risks of treatment outweigh the potential benefits of treatment for Hodgkin’s lymphoma, your doctor may recommend watchful waiting, in which you visit them frequently to monitor cancer for growth before moving forward with any treatment.
In some cases, cancer may return after treatment, also known as a relapse or recurrence. When Hodgkin lymphoma returns, treatment recommendations may include higher doses of chemotherapy, radiation therapy, a stem cell transplant, or any combination of the three.
Treatment Options for Non-Hodgkin Lymphoma
If your doctor detects non-Hodgkin lymphoma, their treatment approach will depend on the following factors:
- The type of non-Hodgkin lymphoma
- The stage of NHL and where the cancer was found
- Whether it is a slow (indolent) or fast-growing (aggressive) lymphoma
- Your age at diagnosis
- Your overall health and whether you have other health conditions
Indolent non-Hodgkin lymphoma is slower growing and doesn’t always require immediate treatment. If this is the type of cancer you have and you do not have any symptoms, your doctor might recommend watchful waiting. Indolent non-Hodgkin lymphoma with symptoms will usually warrant immediate treatment with chemotherapy or radiation.
Common treatment approaches for non-Hodgkin lymphoma include:
- Targeted therapy (common drugs include Rituxan and Sevalin)
- Immunotherapy drugs
- Surgical treatment
- Stem cell transplants
Clinical Research for All Types of Lymphoma
There are extensive studies underway, with more in development for the study of new and advanced therapies to treat all types of lymphomas. There have been several treatments recently introduced that are also under investigation for use with even more patients. If you’d like to learn more about the research studies available through WVCI, talk to your oncologist.
Personalized Cancer Treatment Across Willamette Valley
If you or a loved one have been newly diagnosed with lymphoma, the oncologists at Willamette Valley Cancer Institute know the value of having a treatment plan you feel comfortable with and are ready to support you. We provide patients with access to the latest cancer treatments that are catered to each patient’s unique needs. The WVCI medical oncologists and hematologists have experience dealing with many types of cancers—even those that are rare and difficult to treat. Our cancer clinics are located in Albany, Corvallis, Eugene, Florence, Lincoln City, and Newport, Oregon.