Lymphoma

Lymphoma is broadly divided into:

• Hodgkin Lymphoma - identified by Reed-Sternberg cells under a microscope; often seen in younger adults
• Non-Hodgkin Lymphoma (NHL) - a larger, more varied group

Non-Hodgkin lymphoma is further classified into:

• Low-grade (indolent) - slow growing, may not need immediate treatment
• High-grade (aggressive) - fast growing, requires prompt therapy

Treatment planning depends heavily on this classification, not just the size of the swelling.

• Painless swelling in the neck, armpit, or groin
• Gradual increase in size over weeks
• Nodes that feel firm, sometimes rubbery, and mobile initially
• Occasionally, a feeling of fullness in the abdomen (if deeper nodes are involved)

A key point to note is that pain is usually absent in early stages, which is why patients delay consultation. Do not delay seeking care; contact lymphoma treatment doctors in Navi Mumbai for further evaluation.

• Recurrent fever, often above 38°C without any infection
• Drenching night sweats
• Unexplained weight loss (>5-6 kg over a few months)
• Persistent fatigue not improving with rest
• Itching without visible rash

Some of the signs are often ignored by patients as part of lifestyle stress.

• Swelling persisting beyond 2-3 weeks
• Increasing size or multiple nodes appearing
• No clear infection or not responding to antibiotics
• Nodes in unusual locations (like above the collarbone)
• Associated systemic symptoms (fever, weight loss, night sweats)

In medical practice, persistence is often a more important red flag than size alone.

Here are the most common ways in which lymphoma is diagnosed:

• Excisional biopsy - removal of entire lymph node (preferred for accuracy)
• Histopathology - to identify abnormal lymphocytes
• Immunohistochemistry (IHC) - helps classify subtype
• PET-CT scan - assesses spread across the body
• Blood tests - baseline health and organ function
• Bone marrow biopsy - in selected cases

A needle biopsy alone may sometimes miss the full picture, especially in lymphoma.

Staging and Grading of Lymphoma

The stage of lymphoma determines how much it has spread in the body. This is important for determining the further treatment plan.

• Stage I:
  The disease is limited to either a single lymph node region (for example, just one group of nodes along the right side of the neck) or a single organ outside the lymphatic system
• Stage II:
  More than one lymph node region is involved, but all are on the same side of the diaphragm, either entirely in the chest or entirely in the abdomen
• Stage III:
  Lymph node involvement is seen on both sides of the diaphragm, say, nodes in the neck as well as in the abdomen
• Stage IV
  The disease has spread beyond lymph nodes to organs such as the liver, lungs, or bone marrow

Grading, particularly in non-Hodgkin lymphoma, refers to how fast the disease is likely to grow. Some lymphomas remain indolent for years, while others progress rapidly over weeks. This distinction is equally important as staging when deciding treatment.

Treatment Options Explained

Treatment depends on type, stage, and patient fitness. Broadly:

• Observation (Watchful waiting) - For some low-grade lymphomas without symptoms
• Chemotherapy - Given in cycles, usually every 21 days. It is also combined with immunotherapy
• Immunotherapy / Targeted therapy - Specifically targeted to lymphoma cells
• Radiation therapy - Used for localized or bulky disease
• Stem cell transplant - Considered in relapsed or high-risk cases

Most treatments today are protocol-driven, but always tailored to the individual.

The majority of patients receive chemotherapy in a daycare setting:

• Each session may last a few hours; admission is not always required
• Recovery typically occurs before the next cycle

Side effects do occur, which include hair loss, mouth ulcers, and nausea, but they are usually temporary and manageable. Blood counts tend to dip around day 7-10 of the cycle, so precautions against infection become important during that window.

Managing lymphoma is rarely about a single treatment decision; it's a stepwise, coordinated process. In most cases, patients and families come in with understandable anxiety, often expecting immediate treatment to begin. But the first step is always clarity.

Our approach involves:

• Reviewing biopsy findings and imaging in detail
• Discussing the exact type and stage of lymphoma
• Explaining the treatment options in detail
• Coordinating care between oncologists, hematologists, radiologists, and supportive care teams

When detected early, lymphomas can have positive treatment outcomes. Even in more advanced stages, treatment often achieves good disease control, and maintaining quality of life becomes a central focus throughout care. Consult cancer specialists at UMC Hospitals for the best and advanced blood cancer treatment in Navi Mumbai.