Lymphoma - Diagnosis & Treatment

How is lymphoma diagnosed?

Your doctor may recommend the following tests and procedures to diagnose Hodgkin's lymphoma:

Physical examination

Your neck, groin and underarm will be checked for any swollen lymph nodes. Your doctor will also look for signs of a swollen spleen or liver.

Blood tests

These are necessary to look for irregularities in your blood that suggest the possibility of cancer. Aside from a complete blood count, there will also be tests for different types of white blood cells, as well as liver and kidney function tests.

Computerised tomography (CT scan)

A CT scan is a diagnostic test that makes use of a series of X-rays to create a three-dimensional picture of the body. Your doctor will require you to undergo a CT scan to look for signs of lymphoma in other areas of your body.

Magnetic resonance imaging (MRI)

This imaging tool makes use of strong magnetic field and radio waves to create a more detailed picture of the body. Your doctor may recommend MRI to look for more signs of lymphoma in other areas of the body.

Lymph node biopsy

During a lymph node biopsy, all or part of a lymph node will be removed and sent to the laboratory for thorough examination. The lymph node will be checked for abnormal cells (Reed-Sternberg cells).

Bone marrow biopsy

In this procedure, a sample of bone marrow is removed to search for Hodgkin lymphoma cells. It takes about 10 minutes and involves making a small incision on the skin wherein the needle can easily pass through.

How is lymphoma treated?

Treatment for lymphoma is dependent on the type of lymphoma diagnosed and its severity. Very often, it involves a combination of two or more treatments. These options include:

Chemotherapy

In chemotherapy, strong medicines are used to destroy cancerous cells and prevent them from reproducing and growing. However, these drugs can also damage the normal cells of the body.

Immunotherapy

Immunotherapy is considered as a second line of treatment. It uses the patient’s own immune system, or medications made from components of the immune system, to fight the disease. They include monoclonal antibodies and injections known as checkpoint inhibitors. An example of immunotherapy is chimeric antigen receptor (CAR) T-cell therapy, which genetically engineers a patient’s immune cells to identify and destroy cancer cells.

Stem cell transplantation

A patient with recurrent lymphoma may receive stem cell transplantation as a second line of treatment. This is a transplant of blood-forming stem cells and will allow the patient to receive chemotherapy, radiation therapy, or both. Through transplanted stem cells, new blood cells develop. These stem cells may come from the patient or from a healthy donor.

Radiation therapy

Radiation therapy uses high-energy rays to kill the lymphoma cells. It will shrink the tumours and help control the pain. Radiation is sometimes used as the first-line therapy in patients who have very large lymph node masses.

Targeted therapy

In targeted therapy, drugs are used to target the genes and proteins that contribute to the growth, progression and spread of the cancer cells. Targeted therapy reduces the effect of treatment on healthy cells. However, this may not be a permanent solution as the cancer may evolve and become immune to the drug, so this is where immunotherapy may come in.