Lymphoma: What are the warning signs?

A recent Yahoo article revealed that a reporter only discovered she had a cancerous growth on her neck after a viewer that spotted her on TV advised her to get it checked. But how common is lymphoma cancer in Singapore and are there other warning signs besides swelling of the lymph nodes in the neck?

Lymphoma in Singapore

According to the Singapore Cancer Registry, lymphoma ranks the fifth most common cancer among men and sixth most common cancer among women.

Lymphoma cancer: How it happens

Lymphoma cancer is a type of cancer affecting certain types of immune system cells, specifically the white blood cells called lymphocytes B or lymphocytes T.

Lymphocytes travel throughout the body in a clear fluid called lymph. Using a network of vessels that make up the lymphatic system, the lymph passes through small, bean-shaped organs called lymph nodes, which trap harmful substances. Larger clusters of lymph nodes can be found in the neck, armpits and groin.

In lymphoma, lymphocytes B or T multiply uncontrollably and fail to die like normal cells eventually would. Patients with lymphoma often notice a swelling of their lymph nodes caused by the formation of painless lumps or tumours. Lymphoma can also occur in other organs as small amounts of lymph and lymph tissue pass through virtually all organs in the body.

“Although the exact causes of lymphoma still remain unknown, it might be related to viruses and infections,” says Prof Lim Soon Thye, Deputy Medical Director (Clinical) and Senior Consultant of the Division of Medical Oncology at National Cancer Centre Singapore (NCCS), a member of the SingHealth group.

Patients with human immunodeficiency (HIV) infections or on long-term immunosuppressive drugs also have a higher risk of developing lymphoma.

Symptoms of lymphoma

Painless swelling of the lymph nodes in the neck, underarm or groin. This is the most common symptom
Persistent fever
Drenching night sweats
Unexplained weight loss
Patchy red skin and itching
Lack of energy, tiredness or fatigue

Lymphoma cancer can be broadly divided into two categories:

Hodgkin’s lymphoma vs non-Hodgkin’s lymphoma

Lymphoma cancer can be broadly divided into two categories:

1. Hodgkin’s lymphoma

Patients diagnosed with Hodgkin’s lymphoma (also called Hodgkin’s disease) often have large abnormal cells called Reed-Sternberg cells in their lymph nodes. This disease is highly curable and accounts for about 10 per cent of all lymphoma cases.

Although lymphoma cancer can occur at any age, Hodgkin’s disease is most prevalent in two particular age groups:

People between 15 and 40 years of age.
People aged 55 years and above.

2. Non-Hodgkin’s lymphoma (more common)

There are mainly two types of non-Hodgkin’s lymphoma:

Aggressive (high grade): Tends to grow and spread quickly and cause severe symptoms. If left untreated, it can be fatal within a few months or sooner
Slow-growing (low-grade): Tends to grow and spread slowly and cause few symptoms. It is harder to treat and carries a higher risk of relapse

The risk of developing non-Hodgkin’s lymphoma increases with age, with most patients being diagnosed in their 60s.

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