Lymphoma can be challenging to diagnose in its early stages. Early symptoms may be either nonexistent or fairly mild. Symptoms of lymphoma are also non-specific. Common symptoms are easily overlooked or ignored. They include:
- night sweats
- unexplained weight loss
Fatigue and listlessness can be symptoms of lymphoma. However, fatigue can also be a sign of insufficient sleep or poor diet. Persistent fatigue is something you should have checked out by a doctor. Even if it’s not caused by lymphoma, it may be a sign of another condition needing treatment.
It’s estimated that 9 out of 10 people with cancer will experience fatigue, and it’s one of the most common symptoms of lymphoma. Depending on the individual, this fatigue can be mild or severe.
Night sweats, chills, and fever
Fever is a natural response to an infection, but it may also be a sign of advanced lymphoma. Most lymphoma-related fevers are relatively low-grade. They’re often accompanied by chills.
Night sweats may occur if you have a fever while asleep. Intense night sweats associated with lymphoma can cause you to wake up to soaking wet sheets. Excessive sweating can sometimes occur during the day as well.
You should report to your doctor any unexplained fevers that come and go for two weeks, repeatedly. They can be a sign of lymphoma.
Unexplained weight loss
Sudden, unexplained weight loss of 10 percent or more of your body weight may be a sign of lymphoma. Like other lymphoma symptoms, this may also be caused by other medical conditions.
With lymphoma, cancer cells can burn up more of your body’s energy resources while your body tries to fight these cells off. This can lead to sudden weight loss, especially since many lymphomas typically grow quickly.
You should discuss any extensive and unintentional weight loss with a doctor. It can be a sign of a serious health problem. If you lose 5 percent of your body weight in a month, or 10 percent within six months, make an appointment to see your doctor.
Rash and itching
Lymphoma can sometimes cause an itchy rash. Rashes are most commonly seen in lymphomas of the skin. They may appear as reddish or purple scaly areas. These rashes often occur in skin folds and can be easily confused with other conditions like eczema. They can spread as the lymphoma progresses. Lymphoma can also form lumps or nodules within the skin.
About one-third of people with Hodgkin’s lymphoma will experience itching, though it’s less common in those with non-Hodgkin’s lymphoma. Itching can occur without rashes. It’s believed that chemicals called cytokines, which are released to fight cancer cells, contribute to making the skin itch. Any rash that does not resolve on its own after two weeks should be seen by a doctor for further evaluation.
Chest pain or lower back pain
The thymus is a small, two-lobed organ that is located behind the sternum and between the lungs. It’s part of the immune system. Occasionally lymphoma affects the thymus gland, and this can cause chest pain.
Rarely, lymphoma affects lymph nodes located in the lower back. Swelling there may put pressure on the nerves of the spinal cord. However, there are many more likely causes of lower back pain than lymphoma. But any persistent pain anywhere on your body should be evaluated by your doctor.
Types of lymphoma
There are more than 67 different subtypes of lymphoma. They fall under two main categories: Hodgkin’s lymphoma and non-Hodgkin’s lymphoma (NHL). These two categories are separated by how the cancers develop, spread, and are treated. There are six types of Hodgkin’s lymphomas. NHL is much more common and accounts for nearly 90% of all cases of lymphoma each year in the United States.
Lymphoma directly affects the lymphatic system, which includes a number of body parts. It can affect various parts of the body that contain lymph tissue, such as the:
- lymph nodes and lymph vessels
- small intestine
- bone marrow
Where it’s found
The first visible sign of possible lymphoma is often an enlarged lymph node. Lymph nodes may be tender or even painful to the touch. However, many people have no pain. NHLs are more likely to cause painless swelling.
The lymph nodes are widely distributed throughout the body. Some are deep, while others are fairly close to the surface. Swellings in more superficial locations can be more noticeable. These include lymph nodes in the armpits, neck, and groin.
A lump at one of these sites does not necessarily indicate lymphoma. Swollen lymph nodes are more likely to be caused by infection than cancer. For example, swelling in the lymph nodes of the neck is frequently linked to throat infections. Lymphocytes, or white blood cells, flood the nodes during infection.
Swellings in the nodes of the armpits or abdomen need more immediate attention. They are less likely to be related to temporary infections.
Symptoms in children
Lymphoma may present differently in children than it does in adults, and symptoms may vary depending on where the lymphoma is in the body.
Some typical symptoms of lymphoma in adults may affect children as well. These include:
- enlarged or swollen lymph nodes, which may or may not be painful
- weight loss
- night sweats
However, children may present with other symptoms, too. Common symptoms children with lymphoma have include:
- a swollen abdomen
- abdominal pain
- feeling full after eating very little
- a cough or shortness of breath
If your child is experiencing frequent infections or any of these symptoms, see your doctor for evaluation.
While most of these signs are more likely to be the result of other diseases and conditions, it’s still important to get your child checked.
If you’re experiencing symptoms that resemble lymphoma, your doctor will run tests to determine the underlying cause. In the case of lymphoma, doctors will first diagnose the condition and then determine how advanced it is.
They might first run preliminary blood tests to look for abnormalities, including abnormal red and white blood cell counts. If you have enlarged lymph nodes, they’re also likely to take a tissue sample or biopsy from the lymph node to look for cancer cells.
If your doctor suspects that lymphoma has spread or might be present in your bone marrow, they may order a bone marrow biopsy. In this procedure, which is done under local anesthesia, bone marrow is taken from within the bone by a hollow needle.
Your doctor may also use the following tests to get an internal view of your chest, abdomen, or pelvis. These include:
These tests will help your doctor look for abnormal lymph nodes and tumors and allow them to evaluate the health of organs and tissue.
Lymphoma treatment will depend on which type of lymphoma you have, where it’s located, and how advanced it is.
Chemotherapy, immunotherapy, and radiation are commonly used to treat many types of lymphoma. These treatments all focus on killing cancer cells and reducing the size of tumors.
Sometimes, a bone marrow transplant may be used to replace the diseased bone marrow so that the body can produce the healthy blood cells it needs.
In rare cases, your doctor may recommend surgery. Surgery is more common when the lymphoma has not spread and starts in body parts such as the spleen, stomach, or thyroid.
The outlook depends heavily on what type of lymphoma you have and how advanced it is at the time of diagnosis. Other factors, such as age, contribute to outlook as well. People under 60 years old typically have better survival rates, for example. The overall 5-year survival rate for NHL is 69 percent, and the 10-year survival rate is 59 percent. But so much also depends on your overall health and your response to treatment.
Q&A: Men vs. women
Does lymphoma differ between men and women?
NHL, the most common classification of lymphoma, is more common in men, but women fare better.
The typical early symptoms such as fatigue, night sweats, and enlarged lymph nodes are similar in both men and women. Outside of the lymph system, the gastrointestinal tract, the head and neck, and the skin are the most common places for both genders. However, lymphomas involving the breast, thyroid, and respiratory system are more common in women. Lymphoma of the breast in women and lymphoma of the testes in men are extremely rare and account for only 1-2% of all cases of NHL.
When it comes to the treatment of lymphoma, women seem to have a better outcome than men. In fact, with the exception of bladder cancer, women do better in terms of both treatment and survival of all common cancers. This is especially true in women under 55 years old. The differences in outlook between women and men with cancer, including lymphoma, are not well understood. Research continues on this topic.Judith Marcin, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.