September has been declared National Blood Cancer Awareness Month, and for good reason: it's estimated that a person in the US is diagnosed with a blood cancer every three minutes. When people say "blood cancer," the general illness that springs to mind is leukemia, but there are two other main types of blood cancer: myeloma, a cancer of the blood marrow, and lymphoma, a cancer of the lymph nodes. Lymphoma is divided into two types, Hodgkin's and non-Hodgkin's: Hodgkin's only makes up about 10 percent of all cases, with non-Hodgkin's comprising the other 90 or so. (The categories are named after the 19th century British physician Thomas Hodgkin, who discovered Hodgkin's lymphoma in 1832, but was completely ignored until another doctor rediscovered it 33 years later.)
Essentially, a lymphoma diagnosis means that your lymphocytes — a kind of white blood cell designated as part of your immune system's arsenal against infection — are reproducing abnormally and collecting in your lymph nodes and other parts of the body's lymphatic system, like the spleen. The good news is that survival rates of lymphoma in general are pretty high, though there are more severe forms of the cancer in both Hodgkin's and non-Hodgkin's categories. And, crucially, one of the big problems is diagnosis. Lymphoma can often masquerade as other, far less serious conditions — meaning that people don't go get checked out by doctors until things have progressed a bit. Early diagnosis is a definite help when it comes to treatment, particularly for aggressive, fast-growing lymphomas, so let's get into the symptoms that might mean you need to get checked out.
1. Swollen Lymph Nodes
On their own, swollen lymph nodes are rarely anything to worry about. They indicate that the body is fighting off an infection of some kind; lymphatic fluid is gathering in the body's lymph nodes, which lie under the neck, at the base of the skull, in the armpit, in the groin, and elsewhere, preparing to fight a grand immune system battle. "Although enlarged lymph nodes are a common symptom of lymphoma, they are much more often caused by infections," the American Cancer Society notes.
Pain also won't help you pick out a dangerous lymph node; usually, lymphoma-swollen lymph nodes are painless, and only cause pain when they're big enough to press down on nerves or other organs and create havoc.
So how do you tell whether a collection of swollen lymph nodes (or just one) is a concern? Time. If they don't seem to be going down after the normal time period in which an infection should have abated, or seem to be recurring with high frequency without any infection-like symptoms accompanying them, you need to get yourself to the doctor.
2. Night Sweats
The medical explanation behind this one remains a blank (though Cancer Research UK suggests that it might be "due to the body fighting the cancer"), but lymphoma appears to cause massive night sweats, also referred to as "drenching" because of the sheer amount of sweat that pours from the person's body. It's also been suggested that they might be a bodily response to the hormones produced by lymphoma cells, or that they're a consequence of another common lymphoma symptom: a fever.
It's also important to note that, just because they're called night sweats, they may not actually be restricted to the night. You may find yourself sweating inexplicably through your clothes in a business meeting at 10am.
3. Unexplained Weight Loss
Along with night sweats and fever, an unexpected weight loss is defined as a B-symptom of lymphoma: physicians will look for primary signs (the lymph nodes being the most obvious), but the presence of B-symptoms, which usually occur as a trio, may indicate that lymphoma is a possibility. What sort of measure are we talking here? Well, the common definition is more than 10 percent of your body weight, lost in around six months or less. This isn't a few pounds lost through careful dieting or an accidentally hectic week; it's an extensive and progressive loss of body weight that isn't connected to anything you may actually be doing, and may in fact be the opposite of what you intend.
4. Swollen, Firm Abdomen
One of the interesting things about the lymphatic system is that it's not just focused around the nodes, even though they're often the most visible parts to observers. It also uses lymphatic tissue, which lives in various parts of the body involved with the immune system: the spleen, the adenoids, bone marrow and other areas that transport lymph throughout the body. While the lymph nodes are meant to filter the fluid, it goes basically everywhere. The abdomen is a prime place for lymphatic tissue to show that something's gone a bit awry.
The American Cancer Society lays out several reasons that swollen, firm or painful abdomens can be linked to lymphoma, alongside other symptoms. There are nodes in the abdomen itself that may have enlarged, and they could have pushed against other organs; the spleen itself also could have suffered from a swelling of the lymphatic tissue, and end up causing pain by itself. If lymphoma cells have gotten into other abdominal organs, they can cause pain and firmness, too. For lymphoma to be a possibility, though, this needs to be a regular issue over a long period of time, not just the occasional stomachache after hitting the lunch buffet too hard.
5. Pruritus, Or Itching
This is most common in Hodgkin's lymphoma, and rarer in non-Hodgkin's types, but it's still a concern there. In some sufferers, pruritus — which the Lymphoma Coalition defines as a "persistent itch all over the body without an apparent cause or rash" — is one of the dermatological signs of lymphoma. Medscape goes further, describing it as often "intolerable, continuous, and severe," and noted that it may be localized to the areas affected by the disease, like specific lymph nodes.
They also point out, horrifyingly, that pruritus may actually turn up five years before an effective diagnosis for lymphoma. If you're having a persistent itching problem and no dermatological cure prescribed by experts appears to have worked, it may be time to ask about the possibility of lymphoma, even if your lymph nodes appear fine; while uncommon, the Lymphoma Research Foundation points out that some lymphoma patients never seem to experience swollen lymph nodes at all.
Most importantly, don't panic! Here's what to do with this information: if you have swollen lymph nodes, monitor them before making a doctor's appointment, along with any signs that you may just have a perfectly normal infection. If the lymph node swelling doesn't go away, particularly if you also have B-symptoms, go to your GP and ask about lymphoma as a possibility. And if you're healthy, sign up to be a bone marrow donor, if you haven't already; lymphoma sufferers are among the patients who need them.
Images: Ed Uthman/Wikimedia Commons, Giphy