Detection and Treatment

Lymphoma: Detection & Treatment Options

The common tests for lymphoma are described in this chapter. You may not have all the tests. When the tests are done, your doctor or doctors will tell you what they have learned about your cancer, and suggest the best treatment for you.

Your doctor will begin by examining your body, especially the areas where there are lymph nodes. Your doctor will also discuss your medical history and ask about symptoms.

Tissue Biopsy

If you have swollen lymph nodes that your doctor thinks may be cancerous, they will take some tissue from a swollen lymph node. This is called a tissue biopsy. The whole node may be removed or only a part of the node. This tissue will be sent to a pathology laboratory to be examined in detail to see if it has cancer cells in it.

You could have either a general or a local anaesthetic when you have your biopsy. This will depend on where the lymph node is that the doctor wishes to biopsy. If the biopsy shows that you have lymphoma, other tests will be done to find out whether the cancer has spread, and if so, to where. This is called ‘staging’ the cancer.

Blood Tests

Your doctor may take some blood from your arm using a needle and syringe. This will be sent to a pathology laboratory to be examined. These tests will also tell the doctors how well your other organs such as liver and kidneys are working.

Bone Marrow Biopsy

Lymphoma cells can spread to bone marrow. In a bone marrow biopsy, a sample from your bone marrow is taken with a needle. The bone marrow is usually taken from the back of your hipbone. You will have a local anaesthetic and possibly some sedative so you do not feel pain during the biopsy. The sample will be looked at under a microscope to see if the lymphoma has spread to the bone marrow.

Computerised tomography (CT) scan

A CT scan is a special type of x-ray that gives a three dimensional (3­D) picture of the organs and other structures in your body. It usually takes about 30 to 40 minutes to complete this painless test. You will be asked to lie on a table while the CT scanner, which is large and round like a doughnut, moves around you. Before the scan, you may have an injection of a dye that shows up body tissues more clearly. You will be asked not to eat or drink for a while before you have your scan. Most people are able to go home as soon as their scan is over.

A child with a non-Hodgkin lymphoma will also have an ultrasound scan of their abdomen.

Gallium scan

In this test your whole body is checked. You will have an injection of radioactive gallium, a sort of metal. After a few days, when it has had time to circulate around your body, you will return to the hospital to have pictures of your body taken with a special camera (a gamma camera). If gallium is seen outside body areas that normally would take it up, a cancer may be present at that site.

Positron emission tomography (PET) scan

A PET scan builds up clear and detailed pictures of the body. You will have an injection of a glucose solution containing a very small amount of a radioactive substance. The scanner can ‘see’ this substance, which shows where the glucose is being used in the body. Cancer cells show up as areas where glucose is being used by actively growing cells.

Biologic Therapy

This treatment increases your body’s natural ability to fight cancer. It does this by giving a boost to your immune system.There are several kinds of biologic therapy:

  • Monoclonal Antibodies: These are drugs like Rituxan®, which directly target lymphoma cells and do not harm normal cells.These drugs are sometimes called “smart drugs” or “guided missiles” because they know exactly where to go in your body.
  • Radioimmunotherapy: These are therapies like Rituxan®, which have a radioisotope attached to them.These “guided missiles” are able to destroy cancer cells because they attach to the lymphoma and deliver small doses of medicine to the cells.
  • Interleukin 2: This is a medicine that activates the immune system so that it can kill cancer cells.
  • Vaccines: These are treatments that help the body protect itself against the lymphoma.

Chemotherapy

This treatment uses drugs to kill cancer cells and reduce the size of cancer tumors. Chemotherapy drugs may also affect healthy cells and cause side effects like hair loss or mouth sores.There are many types of chemotherapy drugs. Many drugs are often used together for chemotherapy.

Radiation Therapy

This treatment uses radiation (high energy X-­rays) to kill cancer cells.The treatment often only takes place in the part of your body where the lymphoma is located.

Transplants

Sometimes high doses of chemotherapy destroy the lymphoma cells and your bone marrow, which is the “factory” for blood cells. To help your bone marrow make new healthy blood cells, some stem cells (immature cells that will grow up into red blood cells, white blood cells, and platelets) may be taken with a special machine before chemotherapy is given.

These cells are then transplanted (put back) into the body. These transplanted cells will then find their way to the bone marrow and restore it, so that it can build healthy new blood cells.

There are two types of transplants:

  1. Autologous transplants­ this uses your own bone marrow or stem cells.
  2. Allogeneic transplants­ this uses bone marrow or stem cells from a donor (someone else, often a brother or sister).

Use these links to find out more about lymphoma: