Lymphoma is a diverse and potentially life-threatening cancer that originates in the lymphocytes, a type of white blood cell crucial for the immune system. With various subtypes and manifestations, lymphoma poses a significant medical challenge, affecting people of all ages and backgrounds worldwide.

World Lymphoma Awareness Day (WLAD) is a global initiative aimed at raising awareness about lymphoma, a group of blood cancers that affect the lymphatic system. Celebrated annually on September 15th, WLAD serves as a poignant reminder of the need for understanding, early detection, and support for individuals battling this complex disease.

What is lymphoma?

Lymphoma is not one disease, but it is a general term for a group of cancers that originate in what is called the lymphatic system. The lymphatic system comprises of the tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. Lymphoma occurs when white blood cells grow abnormally, and it can affect children and adults.

These white cells are called lymphocytes, and they travel around the body in the lymphatic system, carrying a fluid called lymph. The lymph fluid passes through glands called lymph nodes, which are spread throughout the body. Therefore, lymphoma might also be referred to as a cancer of the immune system.

There are two main kinds of lymphoma, Hodgkin’s and Non-Hodgkin’s. The difference between Hodgkin's lymphoma and non-Hodgkin's lymphoma can be seen by looking at the cancer cells under a microscope. If a specific type of cell called a Reed-Sternberg cell is seen, the lymphoma is classified as Hodgkin's. If the Reed-Sternberg cell is not present, the lymphoma is classified as non-Hodgkin's.

What is the cause?

Lymphoma is due to a genetic mutation in lymphocytes, causing them to continue multiplying beyond normal. However, the cause of this is mainly unknown. Some types of lymphoma are more common in young adults, while others are most often diagnosed in people over 55.

The mutation also allows the abnormal cells to go on living when other normal cells would die. This causes too many circulating diseased and ineffective lymphocytes, and causes the lymph nodes, the spleen, and the liver to swell. There are several risk factors that can increase the risk of lymphoma, and these include:

• Age - there is an increased risk for non-Hodgkin lymphoma for those 60 and above, and a risk for Hodgkin lymphoma in younger people.
• Being male - males are slightly more likely to develop lymphoma than females, although certain subtypes may be more common in females.
• Impaired immune system - lymphoma is more common in people with immune system diseases such HIV/AIDS, post organ transplantation, in people born with an immune disease, or in people who take drugs that suppress their immune system.
• Some infections - these include the Epstein-Barr virus, hepatitis C, or human T-cell leukemia/lymphoma (HTLV-1)
• Immune system diseases such as rheumatoid arthritis, Sjögren's syndrome, lupus, or celiac disease.
• Previous treatment for cancer with radiation.
• Previous treatment for Hodgkin or non-Hodgkin lymphoma.

What are the symptoms?'

Symptoms of both Hodgkin and non-Hodgkin lymphoma include swollen lymph nodes or glands, especially in the part of the body where the lymphoma starts to grow. Other symptoms include fever, night sweats, fatigue, and unexplained weight loss. Otherwise, some specific symptoms will depend on the part of the body that is affected, like seizures in the case of brain tumors.

How is it diagnosed?

Several investigations will be performed when lymphoma is suspected, and these will include some or all of the following:

• Physical examination
• Blood tests
• Bone marrow aspiration or biopsy -this is the removal of fluid or tissue from the bone marrow, which is the spongy part inside bone where blood cells are made.
• Chest x-ray
• Ultrasound
• CT and/or MRI
• PET scan

How is lymphoma treated?

Treatment will depend on the specific type or subtype of lymphoma one has, and the stage of the disease. These treatment options include or a combination of:

• Chemotherapy
• Radiation therapy
• Immunotherapy
• If these treatments don't work a stem cell transplant might be considered

What is the prognosis?

Prognosis depends on the individual and the type of lymphoma one has, the treatment options available in the area, preexisting medical conditions, and one’s general level of fitness. On average many people survive lymphoma for prolonged periods, but this does not predict what will happen to an individual person.

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