Lymphoma

Child showing the classic swollen jaw of Burkitt Lymphoma. The disease is named after the surgeon who first described it in 1958.


Lymphomas are cancers that develop in the lymphatic system -- the tissues and organs that produce, store, and carry white blood cells. The lymphatic system includes the bone marrow, spleen, thymus, lymph nodes, and a network of thin tubes that carry lymph and white blood cells into all the tissues of the body. Types of lymphoma include non-Hodgkin's, Hodgkin's, and cutaneous T-cell lymphoma.

In non-Hodgkin's lymphoma, the most common form of the disease, cells in the lymphatic system become abnormal. They divide and grow without any order or control, or old cells that should die, don't. Non-Hodgkin's lymphoma can begin or spread to almost any part of the body.

In Hodgkin's disease, cells in the lymphatic system also become abnormal, but the cancer tends to spread in a fairly orderly way from one group of lymph nodes to the next. Eventually, it can spread almost anywhere.

In cutaneous T-cell lymphoma, T-lymphocytes (infection-fighting white blood cells) become cancerous, causing skin problems.

Signs and Symptoms:

Lymphoma is accompanied by the following signs and symptoms, by type:

Non-Hodgkin's and Hodgkin's:
Painless swelling in lymph nodes in neck, underarm, or groin
Unexplained fever
Drenching night sweats
Tiredness
Unexplained weight loss
Itchy skin

Cutaneous T-Cell:
Itchiness
Dark patches on skin
Tumors on skin (mycosis fungoides)
Skin infections.

Who's Most At Risk?:

People with the following conditions or characteristics are at risk for developing lymphoma, by type:

Non-Hodgkin's:
Congenital immunodeficiency
Infections: Epstein-Barr virus (EBV), Helicobacter pylori, Kaposi's sarcoma herpes virus (HIV-related lymphoma), human T-cell leukemia virus type 1
Immunosuppressive therapy following organ transplant
Autoimmune diseases
Prior chemotherapy or radiation exposure or therapy
Exposure to certain chemicals or solvents

Hodgkin's:
Viruses: EBV, mononucleosis, HIV
Tonsillectomy
Genetic predisposition
Caucasians more likely than African-Americans
Men more likely than women
Same-sex siblings: 10 times greater risk

Cutaneous T-Cell:
Human T-cell leukemia virus type 1
Exposure to certain chemicals or solvents.

What to Expect at Your Provider's Office:

If you are experiencing symptoms of lymphoma, you should see your health care provider. Your health care provider will carefully check for swelling or lumps in the neck, underarms, and groin. If the lymph nodes don't feel normal, a biopsy will be performed. The doctor will remove a small piece of the lymph node -- or, in the case of cutaneous T-cell lymphoma, a growth from the skin -- and a pathologist will examine the tissue under a microscope to check for cancer cells.

If you have cancer, your doctor will do more tests to find out if the cancer has spread to other parts of the body (staging). This may involve blood and bone marrow tests, CT scans, and, possibly, a laparotomy, in which the doctor cuts into the abdomen and checks the organs for cancer.

Treatment Options:
Treatment Plan

A treatment plan will be based on the diagnosis, the stage of the disease, the size of the tumor, and your general health and age.
Drug Therapies

Your health care provider may prescribe the following drug therapies:

Hodgkin's and Non-Hodgkin's:
Radiation therapy
Chemotherapy, possibly with alpha interferon

Cutaneous T-Cell:
Emollients, moisturizers, topical steroids
Chemotherapy
Electron beam therapy
Retinoids and interferon.

Surgical and Other Procedures:

Bone marrow transplantation and peripheral blood stem cell transplantation are sometimes performed. Radioimmunotherapy, which is treatment with a radioactive substance that is linked to an antibody that will attach to the tumor when injected into the body, is being tested in clinical trials. Surgical removal of the tumor may also be performed.

Complementary and Alternative Therapies:

A comprehensive treatment plan for lymphoma may include a range of complementary and alternative therapies. Be sure to ask your team of health care providers about the best ways to incorporate these therapies into your overall treatment plan. Always tell your health care providers of the supplements you are taking.

Improved relaxation and decreased stress, through such activities as guided imagery, tai chi, yoga, and meditation are helpful in promoting a sense of well-being. Intimacy and support from others helps promote a positive and empowering attitude.

Nutrition and Supplements:

These nutritional tips may help reduce symptoms:
Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, soy, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as kale, spinach, and peppers).
Avoid refined foods, such as white breads, pastas, and sugar.
Eat cruciferous vegetables (such as broccoli, cabbage, and cauliflower).
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
Use healthy oils in foods, such as olive oil or vegetable oil.
Reduce or eliminate trans fatty acids, found in such commercially baked goods as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.
Exercise lightly, if possible, 5 days a week.

You may address nutritional deficiencies with the following supplements:
A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins and trace minerals such as magnesium, calcium, zinc, and selenium.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. Some probiotic supplements may need refrigeration - check the label carefully.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tbsp. oil two to three times daily, to help decrease inflammation. Fish oils may increase bleeding in sensitive individuals, such as those taking blood thinning mediations (including aspirin).
Vitamin C, 500 - 1,000 mg two to three times daily, as an antioxidant.
L-theanine, 200 mg one to three times daily, for nervous system support.
Melatonin, 2 - 5 mg before bed, when needed for sleep. Some alternative health care providers will use higher dosages.

Herbs:

Herbs are generally available as standardized, dried extracts (pills, capsules, or tablets), teas, or tinctures/liquid extracts (alcohol extraction, unless otherwise noted). Mix liquid extracts with favorite beverage. Dose for teas is 1 - 2 heaping teaspoonfuls/cup water steeped for 10 - 15 minutes (roots need longer).
Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anticancer and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Reishi mushroom (Ganoderma lucidum) standardized extract, 150 - 300 mg two to three times daily, for anticancer and immune effects. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
Olive leaf (Olea europaea) standardized extract, 250 - 500 mg one to three times daily, for anticancer and immune effects.
Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support.
Fermented wheat germ extract, one packet dissolved in favorite beverage once or twice daily, for anticancer and immune effects.

Homeopathy:

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of gastritis symptoms (such as nausea and vomiting) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for you individually.

Homeopathy may help reduce symptoms and strengthen overall constitution and may help decrease the side effects of chemotherapy.
Radium bromatum is specific for radiation poisoning, especially followed by arthritic complaints. Acute dose is three to five pellets of 12X to 30C every 1 - 4 hours until symptoms are relieved.

Physical Medicine:

Contrast hydrotherapy may help enhance immune function and facilitate the transport of nutrients and waste products. End hot showers with 1 - 2 minutes of cold-water spray. Since hydrotherapy stimulates lymphatic flow, talk to your physician first before beginning and hydrotherapy regimen.

Acupuncture:

Acupuncture may help strengthen immunity and detoxification. It may also reduce the side effects of chemotherapy. For many patients and physicians, acupuncture has become one of the most widely used alternative interventions in cancer treatment. Unlike botanicals and nutrients, acupuncture works without ingesting substances so possible interactions with cancer treatments is unlikely.

Prognosis/Possible Complications:

Prognosis varies depending on the type and stage of lymphoma. Survival rates for Stage I and II non-Hodgkin's lymphoma and Hodgkin's lymphoma are very high.

Potential complications include the following:
Hodgkin's sometimes develops into non-Hodgkin's lymphoma
Radiation and chemotherapy can cause secondary cancers
Infections and pulmonary fibrosis (thickening and scarring of the air sacs of the lungs) may occur.

Following Up:

Once you are in remission, it is essential that you be checked for signs of relapse on a regular basis.