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Most Common Early Symptom Of Lymphoma
The first noticeable symptom of lymphoma is often an enlarged lymph node in your neck, underarms, or groin. Most early lymphoma symptoms can mimic those of more common conditions like the flu.
Lymphomas are divided into two main categories: Hodgkin's and non-Hodgkin's lymphoma. Non-Hodgkin's lymphoma is more common but tends to have a better outlook.
The early symptoms of lymphoma tend to be general. Along with a swollen lymph node, they may include:
Your initial symptoms can depend on factors such as:
Read on to learn more about the most common early symptoms of lymphoma.
What is lymphoma?Lymphoma is a group of cancers that start in lymphocytes in your lymphatic system. Lymphocytes are three types of white blood cells:
Lymphoma can start almost anywhere in your body, but the main locations it develops in include your:
Learn more about lymphoma.
The most common initial symptom of lymphoma is a swollen lymph node in your:
For people with slow-growing lymphoma, swollen lymph nodes may grow and shrink for years. Aggressive lymphoma might cause rapid enlargement of a lymph node.
Lymphoma can develop in different parts of your body. The area where swollen lymph nodes develop depends on where the cancer starts. The lump is often painless, but some people may find that it aches.
Initial symptoms of advanced lymphoma
About 43.5% of Hodgkin's lymphomas diagnosed in the United States from 2012 to 2021 had reached distant body parts when they were diagnosed. About 50.2% of non-Hodgkin lymphomas diagnosed during this period had also reached distant body parts.
Advanced lymphomas might present with symptoms collectively known as B symptoms. They include:
Initial symptoms of gastrointestinal lymphoma
Along with swollen lymph nodes, other potential signs and symptoms of lymphoma include:
Other symptoms may develop depending on where lymphoma starts. Some examples include the following.
Hodgkin's lymphoma occurs in about 8,570 people in the United States each year and leads to about 910 deaths. Non-Hodgkin's lymphoma is more common, occurring in about 80,620 people and leading to about 20,140 deaths each year.
Symptoms of lymphoma are often general, which can lead to a delay in diagnosis. Your doctor will likely initially perform a:
If they find a suspicious lymph node, they may order a lymph node biopsy. During this test, part or all of your lymph node is removed for testing.
You may receive other tests as well, such as:
The most common early symptom of lymphoma is a swollen lymph node. This swollen lymph node often occurs in areas such as your groin, underarms, or neck.
Other potential early symptoms of lymphoma often mimic symptoms of the flu or other common illnesses. They may include fever, unintentional weight loss, and fatigue.
Follicular Lymphoma: What To Consider When You Plan Your Treatment
Treatment for follicular lymphoma is not one-size-fits-all. Many treatments are available for this form of non-Hodgkin's lymphoma. While it may be overwhelming to face so many choices, a wide range of options is a good thing. It increases the odds that one will work for you. Also, if one treatment works for a while and then stops working, you can move on to another treatment.
Many factors will go into your doctor's recommendation for how to treat your follicular lymphoma. Your doctor will weigh your symptoms, the severity of the tumor, your age, and your overall health. Here's what you and your doctor will consider when choosing your treatment for follicular lymphoma.
Your Symptoms and Aggressiveness of the TumorsFollicular lymphoma can progress very slowly – so slowly that at first you may not need treatment. This is especially true if you have fewer or smaller tumors ("low tumor burden") and you don't have any symptoms.
If your cancer is slow growing and you don't have symptoms, your doctor might suggest you "watch and wait." People who take this approach will have regular physical exams, imaging tests, and bloodwork to keep tabs on the progress of the cancer.
Some people have a high tumor burden that comes along with symptoms. Tumor burden and symptoms are key factors that doctors consider when it comes to when to start treatment and what therapies to use.
Signs that suggest it's time to start treatment include the following:
When it is time to start treatment, the specific strategy will depend a lot on the stage of the cancer. Here's a look at different treatments based on lymphoma stage.
Stage I - Early Stage II. When follicular lymphoma is only in one lymph node area or two areas next to each other, doctors may treat it with radiation alone.
In this treatment, a radiation oncologist will direct high-energy beams of radiation right at the affected area to help slow or stop the growth of the cancer. About half of people who get this treatment at this stage are cured.
You'll get this treatment in small doses spread out across several weeks. This helps minimize the side effects, which can include the following:
Stage II to IV. Most people within these stages, once they start treatment, get chemoimmunotherapy. That's chemotherapy plus monoclonal antibodies (antibodies made in a lab).
You usually get chemotherapy for follicular lymphoma through an IV, a pill, or an injection into your spine. You'll get chemo a couple of days a week for several weeks to a few months.
Chemotherapy kills cancer cells but can kill normal cells, too. That's why it can cause many side effects, such as:
The monoclonal antibodies given for follicular lymphoma belong to a class of drugs called anti-CD20 antibodies. They take aim at a specific protein, called CD20, on the surface of follicular lymphoma cells. The anti-CD20 antibodies most commonly used to treat follicular lymphoma are obinutuzumab (Gazyva) and rituximab (Rituxan). But if your follicular lymphoma is resistant to treatment or comes back, your team may consider mosunetuzumab (Lunsumio) as a combination CD20-antibody and CD3 T-cell treatment. Others include epicortamab-bysp (Epkinly). Like chemotherapy, these are also IV drugs that you will get at an infusion center.
Because monoclonal antibodies target cancer cells and don't hurt normal cells, they may have fewer side effects than chemotherapy. But you could still have:
These are usually mild and short-lived. Before your infusion, you will take medicine to help prevent some of the following more serious reactions like:
If chemoimmunotherapy shrinks your tumors, you might continue on monoclonal antibodies as maintenance therapy to help further delay progression of the disease.
Your Overall HealthBecause chemotherapy is made up of very strong drugs and can cause lots of side effects, you have to be strong enough to tolerate it. If you are an older adult, have other health conditions, or are otherwise too sick for chemotherapy, you may receive anti-CD20 antibodies alone without chemotherapy.
If you have very large lymph nodes and you can't tolerate chemotherapy, you may receive radiation in addition to anti-CD20 medicine to help shrink the lymph nodes and relieve symptoms.
Past treatments
Follicular lymphoma is hard to cure. Treatment keeps symptoms under control and can keep the cancer at bay for years at a time. But many people eventually relapse, and it can happen more than once. If your disease progresses after one type of treatment, your doctor will recommend that you move onto another.
These are some of the treatments that might be available to you after your first treatment:
Other chemotherapy. Your doctor might try you on a chemotherapy drug or combination of drugs that you haven't had yet.
Targeted drugs. These are drugs that block a specific process in cancer cells that is helping them grow or survive. There are several different types of targeted drugs that may work in people who have follicular lymphoma.
CAR T-cell therapy. In this treatment, doctors remove immune-system cells from your body, reengineer them to recognize and fight cancer cells, and then put them back in your body.
Stem cell (bone marrow) transplant. This treatment allows doctors to give you a higher dose of chemotherapy. Usually, doctors have to limit the chemotherapy dose because it can damage your bone marrow, where your body makes new blood cells. But doctors can give very high doses of chemotherapy when the treatment is followed by a stem cell transplant, which will regenerate the bone marrow.
Novel agents. These are newer drugs that are not traditional chemotherapy. Doctors may try these after patients progress or relapse. Some options include lenalidomide (Revlimid), PI3K inhibitors, and tazemetostat.
Radioimmunotherapy. This treatment uses a radioactive drug to carry radiation directly to cancer cells. That helps keep radiation away from healthy tissue, which can prevent certain consequences down the road. That said, this type of treatment is hard to administer and it can come with some serious short- and long-term side effects. So doctors may not prescribe this therapy as often as other approaches.
Clinical trials. You might have access to a new drug before it hits the market by participating in a clinical trial. Clinical trial participants try experimental treatments under close medical supervision. If you are interested in a clinical trial, ask your doctor how you might find one that would be right for you.
Leukemia & Lymphoma Resource Center
Visual Guide to Non-Hodgkin's LymphomaWith more than 30 different types, non-Hodgkin's lymphoma can even confuse doctors. This WebMD slideshow can help you learn more about what it is, the difference between B-cell and T-cell lymphomas, the symptoms you may have, tests for diagnosis, treatment options, and more.
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