Local symptoms, systemic symptoms, and more

The most common early sign of lymphoma is lymph node swelling. However, swelling of the lymph nodes does not always mean a person has cancer.

Lymphoma is a general name for cancers that start in the lymph system. The lymph system consists of organs and tissues, such as lymph nodes, that hold infection-fighting white blood cells.

The most common early symptom of lymphoma is inflammation or swelling in at least one lymph node. Lymphoma-related lymph node swelling is more common in the armpit, groin, and side of the neck. Swollen lymphoma-related lymph nodes are often painless bumps or lumps at first.

There are two primary types of lymphoma: Hodgkin lymphoma and non-Hodgkin lymphoma.

Read on for more information about the early symptoms of lymphoma, whether an early diagnosis is possible, and when to see a doctor.

The most common early symptom of lymphoma is one or more swollen lymph nodes, often in the groin, armpit, and side of the neck.

Other symptoms may include:

• fevers, chills, and night sweats
• unexplained weight loss, 10% loss of body weight or more over 6 months
• exhaustion
• bruising or bleeding easily
• frequent or severe infections

Depending on the body region lymphoma impacts, it can cause additional symptoms. Common symptoms of specific types of lymphoma include the following.

Symptoms of lymphoma in the abdomen:

• being full after eating a small amount
• loss of appetite
• vomiting or nausea
• abdominal pain and swelling

Symptoms of lymphoma in the chest

• cough
• shortness of breath
• trouble breathing
• chest pressure or pain

Symptoms of lymphoma in the brain

• headache
• trouble thinking
• facial numbness
• weakness
• seizures
• personality changes
• double vision
• trouble speaking

Lymphomas involving the skin tend to cause:

• purple or red bumps and lumps under the skin
• itchy skin
• rashes

Symptoms of lymphoma can be local or systemic. Local symptoms impact one specific region of the body. Systemic symptoms affect the whole body.

Common local symptoms of lymphoma include:

• loss of appetite or feeling full quickly after eating
• vomiting or nausea
• abdominal pain and swelling
• cough, shortness of breath, or trouble breathing
• chest pressure or pain
• headache and trouble thinking
• weakness
• seizures
• personality changes

Common systemic symptoms of lymphoma include:

• fevers, chills, and night sweats
• exhaustion
• bruising or bleeding easily
• frequent or severe infections
• unexplained weight loss
• bluish-red swelling in the arms, upper chest, or head (in severe cases)

While it is possible to detect lymphoma early, there are currently no screening tests. If a doctor is unsure of the cause of a lump, bump, or swollen lymph node, they may take a biopsy, or a small sample of tissues or fluids, for laboratory testing.

A doctor may also use imaging tests, such as MRI, CT scans, PET scans, x-ray, bone scans, or ultrasounds to help:

• find a possible cause for the symptoms
• determine the extent of lymphoma
• determine if treatment is working
• look for signs lymphoma has returned after treatment

People with risk factors for lymphoma should undergo regular medical check-ups.

Risk factors for lymphoma include:

• having an autoimmune disease, in particular rheumatoid arthritis, Sjogren (Sjögren) disease, celiac disease, or systemic lupus erythematosus
• previous cancer treatment, especially radiation therapy and chemotherapy medications
• organ transplants
• HIV infections
• family history of lymphoma
• Epstein Barr, herpes virus 8, or human T-cell lymphotropic virus
• long-term infections with the bacterial species Helicobacter pylori, Chlamydophila psittaci, or Campylobacter jejuni
• exposure to certain ingredients in radiation, pesticides, and herbicides
• being male
• being Asian or African American
• living in the United States or Europe
• having breast implants

The overall risk of developing lymphoma increases with age, with most cases impacting people 60 years or older. The risk of developing Hodgkin lymphoma is greatest for people 15-39 years of age or 75 and older.

Many of the signs and symptoms of lymphoma are similar to those of other, often less severe, conditions.

However, A person should consider seeing a doctor as soon as possible if the following symptoms develop:

• swelling of the lymph nodes or an unexplained bump or lump, in particular around the groin, armpits, and side of the neck
• frequent or severe infections
• unexplained weight loss that amounts to a 10% loss of total body weight or more in 6 months
• unexplained chills, fever, or drenching night sweats
• unexplained exhaustion or fatigue
• bruising or bleeding easily
• bluish-red swelling in the arms, upper chest, or head
• trouble breathing or shortness of breath
• constant headache
• problems thinking or speaking
• personality changes
• facial numbness
• unexplained lumps and bumps under the skin
• unexplained abdominal pain or swelling
• nausea, vomiting, and loss of appetite
• chest pain or pressure

Lymphoma is a general term for cancers that start in the lymph system or lymphocytes (white blood cells). There is no widely accepted test to detect lymphoma.

In some cases, however, doctors may diagnose lymphoma early. A swollen lymph node or lymph nodes are often the first sign of lymphoma. People with risk factors that increase the risk of developing lymphoma should receive regular, complete medical exams.

what were your symptoms of lymphoma? – Pre-Diagnosis, Signs & Symptoms – Cancer Chat

Hi I’m not sure I should even be on here but here goes, 

I’ve had a swollen neck node since around May last year, I thought nothing of it until a few weeks ago. I started getting extremely tired so much so I’m falling asleep at dining table or having to go to bed for a nap. I like running but have found myself a little breathless and of course no energy to run like I use to. A few week ago I had a week of crazy night sweats which I put down to the menopause and my itchy skin I put down to dry skin. Got blood tests done at GP surgery and they’re all normal range, my gp isn’t concerned bout the swollen node and says tiredness is because I suffer from under active thyroid but I have this feeling something isn’t right with me, so should I push for another appointment with GP or just wait? Also what were your symptoms before diagnosis? 

Sorry if I’m not on proper thread 

lou 

• 0000000Z” data-yesvotes=”0″ data-novotes=”0″>

  Hi Lou, 

  honestly if you feel you’re not right I would get a second opinion. I’ve had a lump which I noticed on the side of my neck around 3 weeks ago now. I have been 2 doctors and have another booked on Monday as it’s getting bigger. Everyone says they’re not worried about it but I am and I know my body. I also have a cough. Until someone can rule anything nasty out and I feel I’ve had proper checks done I won’t rest and will keep going doctors. 

  I’m waiting for my bloods back from my doctor 

   

  xx

• Hi C 

  thanks for reply, like you say I just know my body and feel something isn’t right. My swelling is noticeable but hasn’t gotten any bigger since I first noticed it last year. You say you have a cough, are you constantly coughing and is it a dry type of cough? I rang my GP this morning but can’t get appointment until middle of next week as receptionist says it’s not an emergency.  

• Hey, 

  Defo, even if it’s for your peace of mind. I noticed my lump at the end of Feb and it’s got a tad bigger since. It’s more of a swelling. My cough developed around a week ago. It’s a dry cough and mainly gets going if I start talking, hopefully both are nothing serious. I’ve been so anxious and google doesn’t help at all . 

  Let me know how you get on at the doctors. I had a blood test last Thursday for blood count but I’m too anxious to call so I’m going to wait till Monday as it’s my Birthday Sunday and I just want to enjoy that and not worry as I know I will if I call and they said it was abnormal ha. Xx

   

• Hi, my first symptoms were fatigue, itchy skin on my scalp strangely enough. I was losing weight and not being able to eat much also drenching night sweats which I had to change bed at night. . After many visits to doctors who didn’t know what was wrong with me, I finally had a lump on my neck and was sent to an ENT doc. I have an auto immune problem and I think doctors just put it down to that. It was only after biopsy in neck I was told it was lymphoma, this is the only way they can diagnose lymphoma. I guess your lymph nodes swell for lots of reasons, mine did get bigger then went down a bit but never went away till I had chemo. I think my doctor could tell it was suspicious as she told me to still go to ENT even if it went down. The doctor who did my biopsy told me it was probably a thyroid problem so in my case it’s just as well they did biopsy. If it’s still there in a few weeks I’d go back. Also even if it is lymphoma and it’s indolent, most people go on watch and wait with no treatment. 

• 0000000Z” data-yesvotes=”0″ data-novotes=”0″>

  Hope you get some answers from doctor and wishing you a happy birthday for Sunday. Let me know how you get on x

  lou 

• Hi and thank you for the reply. I’ve had this node swelling since last year but only since January have I been feeling unwell. I’m going back to gp next week but I’m not holding out much hope getting my issue resolved. Are you currently undergoing treatment? And how are coping? I hope you don’t mind the questions 

• Hi, I just finished treatment in November but on one of my follow up appointments in January my doctor found another lump in my neck. She ordered xrays, biopsies etc and I’m still waiting on results. She did say as my ct scan in December was excellent and I feel well, if it has came back I will go onwatch and wait but she doesn’t think it’s in the lymph node but it is suspicious and has ordered further tests. I should be used to the wait. I coped well with the chemo, the staff in the unit were super but I’m hoping I don’t see them for a while lol. X

• A super stressful time for you, I’ll keep you in my thoughts and I really hope you don’t see the staff for a very long either x Thank you for taking time to reply to me x

• Thanks Lou. 

  I’m going to push for a scan on it as it is getting more swollen.

  Thank you I will try 🙂 xxx

• 0000000Z” data-yesvotes=”0″ data-novotes=”0″>

  Hi Llou, 

  My mum had Non Hodgkins Lymphoma. She had a swollen neck, night sweats, was losing weight etc. She went to the docs who took bloods and told her she was fine, nothing to worry about, she was most likely just menopausal etc. These symptoms continued, but because the doc had said she was ok my mum (who never liked to ‘bother’ anyone!) just accepted his word and didn’t go back. Ended up she took really ill one day, was taken into hospital, the lymphoma was diagnosed but by then it was too late for her, and she died a few months later. Now I’m absolutely not saying that there’s anything similar up with you, and chances are youll be just hunky dory, but ABSOLUTELY go back to your GP and get a second opinion. Or a third. Or a fourth. Much better erring on the side of caution. This was 16 years ago by the way, and I’m sure most doctors are probably much better clued up than my mum’s was back then. 

  Sending you lots of luck and positivity xx

Cancer of the lymph nodes – the first signs and symptoms of cancer of the lymphatic system in Moscow

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900 06 Remote consultation with an oncologist-radiologist of the Israeli clinic Hadassah Medical Meirovich Amirkhay

90 005

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Lymphoma. Treat to cure

— We often see news stories about children who have leukemia or lymphoma. It seems that adults are not susceptible to oncohematological diseases. Is it so?

— In fact, most hematological cancer patients are adults. According to the National Cancer Registry, in 2018, more than 7,000 cases of diseases of lymphoid and hematopoietic tissues were registered in Ukraine, of which less than 400 were in children. Patients under 18 years of age get sick less often, their oncohematological processes proceed more favorably, the risks increase only in adolescents 15 years of age and older. But for adult patients, oncohematological diseases are characteristic, which often have a severe course and sometimes a fatal outcome.

About 50% of all oncohematological diseases are lymphoproliferative processes, that is, lymphomas of varying degrees of malignancy, chronic lymphocytic leukemia and other diseases of a lymphoid nature that are characteristic of adults.

— At what age do the risks of “getting” oncohematological disease increase?

— Oncohematological diseases in adults have different age peaks. For example, Hodgkin’s lymphoma has two age peaks of incidence: the first is from 18 to 30 years, the second is over the age of 55 years. With regard to non-Hodgkin’s lymphomas, there are no such pronounced peaks in the incidence. Young patients are more likely to suffer from acute leukemia, while the disease has a more aggressive course, while in older people such processes are more favorable, but it depends on the variant of the disease.

I want to emphasize that today there is a very clear trend in all oncological diseases – the so-called “rejuvenation”. That is, all those oncohematological processes that were previously characteristic mainly of the elderly are now quite often seen in young patients. This also applies to lymphomas, and chronic myeloid leukemia, and even chronic lymphocytic leukemia. In addition, we note different variants of the course of diseases, we see non-standard mutations, changes in the bone marrow, in the genetic profile of the disease, which were not previously characteristic of these processes and it was not possible to detect them. On the one hand, this complicates our task. But on the other hand, every day our capabilities are expanding and more and more targeted drugs appear (that is, they purposefully affect a specific cellular system) for the treatment of these diseases.

— Is it possible to suspect oncohematological disease based on a general blood test?

— Yes, if a very high level of leukocytes is found in the patient’s blood during examination, this gives the doctor reason to suspect a pathology of the hematopoietic system and recommend further examination. In most cases, a multiple increase in the number of leukocytes indicates the development of acute or chronic leukemia.

But most often, a blood test can be normal or with slight deviations – and a person who has turned to a family doctor with complaints of feeling unwell is treated for gastritis, myocarditis, colitis, pneumonia, etc. , skipping lymphoma, myeloma disease, chronic lymphocytic leukemia. It should be remembered that one blood test alone is not enough to diagnose these diseases.

– What are the symptoms of lymphoma?

– These are enlarged, painless lymph nodes. The patient notes that he lost weight, although there were no changes in the daily routine and nutrition. There is often a prolonged fever without any symptoms of a cold. Also, patients with lymphoma often complain of increased night sweats – up to the point that in the middle of the night you have to change pajamas and bedding.

– How is lymphoma diagnosed?

— It happens that a person himself discovers enlarged lymph nodes — cervical, submandibular or axillary, that is, those that are accessible to palpation. Or they are found by a specialist when a patient goes to a family doctor, dentist, otolaryngologist. If the lymph node is enlarged for a month or more, this is a reason to do an ultrasound scan and take a biopsy. Because, unfortunately, very often such a symptom is the debut of a lymphoproliferative disease – Hodgkin’s or non-Hodgkin’s lymphoma, sometimes lymphocytic leukemia.

Do not be afraid of a lymph node biopsy – this procedure, if performed correctly, does not pose a danger to the patient’s health and at the same time helps to reliably understand what kind of disease it is. Without a histological examination, no hematologist in the world has the right to prescribe treatment. At the same time, it is very important to confirm the results obtained in one more, and preferably in two independent laboratories.

Very often, when patients from other clinics and regions come to LISOD, we understand that their histological preparations need to be clarified and rechecked. The equipment of laboratories does not always allow for a complete examination of the material, the diagnoses that are established initially do not always correspond to the modern classification, so we suggest that the patient get an alternative opinion from the reference laboratory. It can be either a Ukrainian laboratory or one located abroad, either chosen by the patient himself or recommended by us.

If the histological results confirm that the patient has lymphoma, we need to find out how advanced the disease is. The most accurate diagnostic method for patients with lymphomas is PET-CT, since with its help we see not only the lymph nodes involved, but also the bone marrow lesion, as well as the degree of activity of the pathological process. This is exactly the tool that will help us establish the stage of the disease, plan the right treatment, and further evaluate its effectiveness.

Various instrumental methods are also used. For example, since there are a number of lymphomas that occur against the background of Helicobacter-positive gastritis or are localized in the intestine, endoscopic studies (gastro-, colonoscopy, etc.) are necessary for such patients.

— Why does lymphoma occur? What provokes the development of the disease?

– Hodgkin’s lymphoma is associated with Epstein-Barr virus infection in almost 100% of cases. If a person has a high titer of antibodies to the virus in their blood or has a history of infectious mononucleosis (it is also caused by this virus), we are alarmed, because in the future such a person may get Hodgkin’s lymphoma. Maybe – does not necessarily mean sick!

A significant proportion of lymphomas are associated with the human immunodeficiency virus. Such lymphomas stand out in a separate group, require special attention, more intensive and aggressive treatment.

There are so-called MALT lymphomas associated with infection with Helicobacter pylori. Such a disease can be compared to winning the lottery. Like a Helicobacter infection, this lymphoma is treated with antibiotics—even without chemotherapy.

– Is lymphoma a curable disease? What treatments are most effective?

— Today, most oncological and oncohematological diseases can be cured. If a lymphoproliferative, myeloproliferative process is detected at an early stage, it can be cured. Lymphomas at the first, second, third and even at the fourth stage can be cured thanks to modern treatment regimens, targeted drugs, bone marrow transplantation technologies, CAR T-cell therapy, therapy with T-lymphocytes with chimeric antigen receptors. In Ukraine, not all technologies are available to patients yet, but this is a matter of time. By the way, the specialists of the Israeli clinic Ichilov (including Professor Mittelman, who oversees the direction of oncohematology at LISOD) were pioneers in the use of CAR T-cell therapy. Today it is one of the most effective methods of treating lymphomas at an advanced stage.

In case of disease progression, relapse or refractory course, even if the patient cannot be completely cured, we can prolong his life and improve its quality.

— Does LISOD treat lymphomas and other hematological malignancies?

— Yes, we have an oncohematology department with a team of excellent specialists. I have already mentioned Professor Mittelman, with whom we are constantly in touch. He is one of the best hematologists in Israel, president of the Israeli Society of Hematology and Transfusiology, who remotely accompanies the treatment of all our patients. Also Irina Dyagil – Doctor of Medical Sciences, Honored Doctor of Ukraine, a recognized authority in the field of clinical and experimental hematology. With such a team, we can do almost anything.

Our patients receive chemo-targeted therapy, chemotherapy, radiation therapy, immunotherapy in accordance with the recommendations of international protocols. So far, we do not provide high-dose chemotherapy and CAR T-cell therapy, but we are confidently moving in the direction of development, and our direct connection with the Ichilov clinic contributes to this.

We already have our own achievements in this area: several cases of successful treatment of fairly rare types of leukemia.

We accept patients with all types of lymphomas. Prior to transplantation, they can receive all types of chemotherapy at LISOD, including intensive (salvage therapy) prior to high-dose chemotherapy. We have examples of successful treatment of very advanced lymphomas. Patients turned to us as a last resort, as they were denied therapy in other medical institutions. After several courses of immunotherapy, they began to feel very well and lead a fairly active lifestyle. And this proves that advanced lymphomas need to be treated in order to prolong life for people and improve its quality.

And one more of our advantages is full transfusiological support. Our patients do not experience any difficulties in obtaining blood products – red blood cells, plasma, platelets, etc. They do not need to look for donors, we take care of the whole process.

— What is the duration of treatment?

– Depends on the disease. For example, according to the protocol for the treatment of acute leukemia, therapy lasts about one and a half years. Chronic diseases (myeloid leukemia, lymphocytic leukemia) require treatment from six months, sometimes – throughout life. In this case, the patient lives fully.

It happens that patients with chronic myeloid leukemia who have achieved remission decide to stop therapy – and this is not uncommon in fact. Professor Dyagil, who deals with the treatment of chronic myeloproliferative diseases in the European leukemia network ELNet, can confirm the information that today it is possible to withdraw from targeted drug therapy patients with chronic myelogenous leukemia, provided that deep molecular remission is achieved and maintained for at least 2 years. Over the 20 years of the existence of the era of TKIs – tyrosine kinase inhibitors – we have come to the conclusion that a whole cohort of patients has “grown up” who have achieved stable remission in the treatment of chronic myeloid leukemia and need only observation and periodic molecular monitoring.

Patients with chronic lymphocytic leukemia undergo a two-year cycle of treatment with venetoclax, obinutuzumab and are under the supervision of a hematologist.

Patients after autologous bone marrow transplantation for multiple myeloma also live for many years simply under observation – without any treatment.

— How has the COVID-19 pandemic affected the treatment of hematological cancer patients at LISOD?

— Patients in our department are as vulnerable as other oncohematology patients around the world. It is clear that the risks of infection and the complicated course of viral infections are higher for them than for ordinary people. We have a special attitude and attention to all patients undergoing treatment. When you are discharged after chemotherapy, please follow the recommendations more carefully and take better care of yourself. We insist on observing the maximum safety rules – self-isolation, mask mode. Please also keep in touch with us and call us if you experience any unusual symptoms. Sometimes signs that patients perceive as a complication of chemotherapy can be the first symptoms of COVID infection, so it is important that the patient reports this in time.