Colorectal lymphoma is a form of colon cancer that begins in the lymph nodes. People with lymphoma in their colon typically require some combination of chemotherapy, surgery, and radiation.

According to the American Cancer Society, 106,970 new cases of colon cancer are expected in 2023. One type of cancer that can impact the colon is lymphoma.

Colorectal lymphoma or lymphoma in the colon is a potentially fatal condition that is often detected only after it has already reached more advanced stages.

Whether you’ve been diagnosed with colorectal lymphoma or you’re worried that you may get it, it’s important to discuss recommendations for the next steps with your healthcare team. We’ve gathered information to help you feel prepared for these discussions.

Lymphoma in the colon is extremely serious and potentially life threatening. Diffuse large cell B lymphoma (DLBCL) is the subgroup of lymphoma most frequently seen in the colon. It’s made up of cells that rapidly multiply and are more aggressive than other type B cell lymphomas.

Additionally, colorectal cancer is the third leading cause of cancer deaths in both men and women. Although the rate of people dying from colon cancers has been decreasing thanks to improved methods of detection and treatment options, it’s still very serious.

Colorectal lymphoma is one type of colon cancer, and it begins in the lymph nodes.

Lymphoma is a general term for cancer that begins in the lymphatic system. While many types of cancers can spread to the lymph nodes, only those that begin in the lymphoid tissue are considered lymphoma.

Lymphoid tissue can be found throughout the body allowing lymphoma to form in many locations. Approximately 40% of extranodal lymphoma are found in the GI tract. However, lymphoma originating in the colon is still very rare representing only 1% or less of colon cancer.

Symptoms of colorectal lymphoma typically develop after a tumor has already formed.

After a tumor has developed, you may experience:

  • abdominal pain
  • unexplained weight loss
  • gastrointestinal bleeding or bloody stools

If there’s obstruction, you may also experience nausea and vomiting. However, one way that colorectal lymphoma differs from other types of colon cancers is that bowel obstruction and perforations are rare since the tumors are pliable and soft.

Diagnosis of colorectal lymphoma is tricky because this type of colon cancer can appear without symptoms.

Therefore, it’s important to consider cancer screening even before you have symptoms. This is particularly true between the ages of 50 and 70, when you may be most frequently impacted by colorectal lymphoma.

If you’re experiencing symptoms like abdominal pain and bloody bowels, your doctor may perform a physical exam looking for abdominal masses and enlarged organs. Your doctor may also perform a digital rectal exam to feel for any abnormal areas in the rectum.

In addition to a physical exam, your doctor will likely request additional tests like a colonoscopy or ultrasound. Computerized tomography (CT) scans or a double-contrast barium enema with X-ray are frequently used to identify colorectal lymphomas.

If a mass is discovered, your doctor will typically take a biopsy and run gene and protein tests on the tissue sample. If cancer is confirmed by the biopsy, MRI scans, X-rays, and blood tests may be requested to see how much of the body is affected.

There’s no one standard treatment for primary colonic lymphoma because many different factors like your symptoms and how far the cancer has spread need to be considered.

Treatment for lymphoma in the colon can include:

Surgery is the prime method of treatment in cases where there’s an obstruction, perforation, or bleeding. In some cases, doctors are able to diagnose before surgery and treat the lymphoma with chemotherapy combined with immunotherapy.

If there’s a tumor that needs to be removed, doctors will often remove the portion of the colon with the tumor and then reconnect the ends of the colon.

In most cases, people undergo surgery to remove the tumor followed by chemotherapy. In some cases, radiation may be advised to help prevent new tumors from forming.

Because symptoms often appear so late, half of colorectal lymphomas aren’t identified until they’re already in stage 4. By this point, it’s likely that the cancer will have already metastasized or spread to other organs. This makes it harder to successfully treat.

A review of studies has shown that when used together, surgery and chemotherapy increased median survival times from 36 to 53 months. Without chemotherapy, relapse rates after surgery were higher, too.

One study in the review found that 83% of colorectal lymphoma patients lived for 10 or more years if the lymphoma hadn’t spread or metastasized and surgery was followed by chemotherapy.

Early detection of lymphoma in your colon can improve your chance of survival. Although symptoms often don’t appear until after a tumor has formed, screening tools like colonoscopies can help to identify colon cancer sooner.

If you have a family history of colon cancer, it’s important to talk with your doctor about whether you’d benefit from screening and how you can reduce your chances of getting cancer.