Non-Hodgkin Lymphoma

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Sneaky Lymphoma Symptoms Often Lead to a Late Diagnosis

Dr. Elise Chong Penn Medicine

Lymphoma Symptoms Can Be Hard to Spot

  • Often people aren’t diagnosed with lymphoma until the late stages because they didn’t notice the symptoms
  • Swollen lymph nodes, weight loss, fever, and night sweats are common early symptoms
  • Even when lymphoma is diagnosed at a late stage, it can have a good outcome

Lymphoma is a cancer that often creeps in silently, without symptoms. And even when people do have symptoms, they don’t necessarily point directly to cancer. For example, swollen glands are much more likely to be from an upper respiratory infection than lymphoma.

The sneaky nature of symptoms, coupled with a lack of screening for lymphoma, leads many people to be diagnosed at an advanced stage — III or IV. By that point, the cancer may have already spread throughout their body. Yet even at a late stage, the outlook isn’t as dire as many people might assume.

Related: 6 Symptoms of Lymphoma & How to Spot Them

“The one thing that I always reassure people about when they are diagnosed with advanced stage lymphoma is that, unlike other cancers, where advanced stage is a death sentence, that’s certainly not the case for lymphoma,” Dr. Elise Chong, medical oncologist at Penn Medicine, tells SurvivorNet.

For example, the 5-year relative survival rate for early-stage follicular lymphoma is 96%. Once the disease has spread, the 5-year survival rate is 85% — still good odds.

“We have many treatments with which people can either be cured with advanced stage lymphoma or have very good remissions,” Dr. Chong adds. “So it doesn’t change how treatable someone is, even when they do have advanced stage lymphoma.”

Spotting the Symptoms

The first lymphoma symptoms can be so subtle that you might not even notice them. It may not be until you visit your doctor for a check-up that you discover there could be a problem.

“People say, ‘But I feel completely fine,’ and that’s very normal,” Dr. Chong says. If a lump is found, often “it’s only because either someone palpated a lymph node and felt some swelling in their neck or in their groin or under their arm.”

If you are at risk for this cancer because you had cancer or an organ transplant in the past, you have an autoimmune disease, or you have an infection such as HIV or Epstein-Barr, it may be worth watching out for symptoms like these:

  • Swollen lymph nodes in your neck, armpits, or groin
  • Weight loss
  • Tiredness
  • Fevers
  • Swollen belly

But keep in mind that these are more likely to be symptoms of something far less serious, such as a run-of-the-mill infection.

There are also a group of symptoms doctors refer to as “B symptoms.” Those include a fever, night sweats, or weight loss. “If people are having any of these symptoms, it’s really important that they tell their physician early so that the proper testing can be done,” Dr. Chong says.

Finding Lymphoma With Imaging Tests

Sometimes the first sign of lymphoma appears not as a symptom, but as a clue on an imaging test that’s done for another reason. “I have patients who’ve gotten into car accidents and said, ‘I had a scan of my body and they saw these lymph nodes,’ and that’s how initially the lymphoma was found,” says Dr. Chong.

If your symptoms appear first, your doctor might send you for an imaging test. An x-ray or computed tomography (CT) scan can identify the cause.

The only way to confirm whether you have lymphoma is with a biopsy. Your doctor will remove a piece of tissue from a lymph node, or the entire node. Then, a specially trained doctor called a pathologist examines the sample in a laboratory to see whether it contains lymphoma cells, and if so, which type of lymphoma they are.

A biopsy can either put your mind at ease by letting you know that you don’t have cancer, or give you a sense of direction by giving your doctor a launching-off point to plan your treatment. If you do have lymphoma, you can get at least some comfort from knowing that there are a number of good treatments to help manage it, even if you’re diagnosed at an advanced stage.

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Dr. Elise Chong is a medical oncologist at Penn Medicine, and an assistant professor of medicine at the Hospital of the University of Pennsylvania. She is board certified in medical oncology and internal medicine. Read More

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  • Doctors categorize the cancers based on whether they grow out of B cells or T cells
  • What type of non-Hodgkin lymphoma a person is diagnosed with will determine treatment
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