onkommon.com
Blood cancers · free patient guide
Lymphoma
Hodgkin and non-Hodgkin lymphoma
Haemato-oncology clinic
What it is
Lymphoma is cancer of the lymphatic system. It presents most often as a painless swollen node, and its subtypes range from very slow-growing disease that may be watched, to fast-growing disease treated with urgency.
The subtype is everything. It cannot be determined from a needle aspiration alone, an adequate tissue biopsy is usually needed, and that is worth insisting on.
Lymphoma is frequently mistaken for tuberculosis in India, and vice versa, both cause enlarged nodes, fever, night sweats and weight loss. Getting the tissue diagnosis right, rather than treating empirically, matters enormously here.
Warning signs worth acting on
- A painless swollen node in the neck, armpit or groin lasting more than a few weeks
- Drenching night sweats
- Unexplained fever without infection
- Unexplained weight loss
- Persistent itching all over the body
- A node being treated as tuberculosis that is not responding as expected
How it is diagnosed
- Excision or core biopsy of an affected node, a fine-needle aspiration is frequently not enough
- Immunohistochemistry to determine the subtype
- PET-CT for staging
- Bone marrow examination in defined situations
- Independent pathology review, which changes the subtype more often in this disease than most
Immunophenotyping and molecular markers define the subtype and inform treatment. Some subtypes have specific targeted or cellular options.
Is it inherited?
Largely not inherited. Immune conditions and some infections are relevant risk factors and are worth mentioning to your doctor.
Genetic counselling & family risk →
Prevention & early detection
No established screening. A painless node that persists beyond a few weeks should be examined rather than watched indefinitely.
Treatment options
What may form part of a plan
Which of these apply to you depends on your stage, your pathology, your other health and what you want from treatment. That decision belongs at a tumour board, not on a website.
Chemotherapy
Drug treatment that acts on rapidly dividing cells throughout the body.
Immunotherapy
Treatment that works on the immune system rather than directly on the tumour.
Targeted therapy
Medicines matched to a specific alteration found in your tumour.
Radiotherapy
Targeted radiation to a defined area, planned in millimetres.
CAR-T cell therapy
Your own immune cells, collected, re-engineered and returned.
Stem cell & bone marrow transplant
High-dose treatment followed by restoration of the blood-forming system.
Conservative management & active surveillance
Sometimes the right decision is to watch carefully and treat nothing yet.
Clinical trials
Most Indian patients never learn a trial exists, because nobody is looking.
At KPCIRC
The pathway for this disease
- Insistence on adequate tissue, this is the diagnosis most often made on an inadequate sample
- Independent pathology review before treatment starts
- Fertility discussion before treatment, particularly in young patients
- Infection and neutropenia protocol
- Long survivorship follow-up, because many patients are young and late effects matter for decades
Support that matters most here
Take this with you
Questions to ask your own doctor
These work wherever you are treated. Print the page or take a photograph of this list.
- What exact subtype is this, and was the sample adequate to be sure?
- Has the pathology been reviewed independently?
- Should I bank sperm or eggs before we start?
- What are the long-term effects I should know about now?
This page is not an emergency service. Severe breathlessness, chest pain, uncontrolled bleeding, a high fever during chemotherapy, or a sudden change in alertness means going to your nearest emergency department now, not reading further.