Dr. Hon Siong Leng, Clinical Haematologist and Transplant Physician
Lymphoma is a cancer that begins in the lymphocytes, the white blood cells responsible for defending the body against infections. It occurs when a genetic mutation transforms these immune system ‘soldiers’ into abnormal, cancerous cells. Categorised into two main types, Non-Hodgkin Lymphoma (NHL) and Hodgkin Lymphoma (HL), this disease is a significant global concern. We spoke with Dr. Hon Siong Leng, Clinical Haematologist and Transplant Physician, who shares vital insights on the risk factors, early warning signs, and the cutting-edge therapies that have made lymphoma remarkably curable.
According to Globocan 2022, the NHL ranked 10th globally among cancer sites, accounting for 553,389 cases and 250,679 deaths in that year alone(i). In Malaysia, lymphoma is the 4th most common cancer(ii) and the 7th leading cause of cancer-related deaths(iii).
Classification of Non-Hodgkin Lymphoma (NHL) and Hodgkin Lymphoma (HL)
The difference between Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) lies in the presence of Reed-Sternberg cells found in HL but not in NHLiv. HL is typically diagnosed in younger adults, while NHL is more common in older adults and has many subtypes, including B-cell and T-cell lymphomasv.
“Unlike normal lymphocytes, the abnormal cells replicate rapidly and have an extended lifespan. These cancerous cells spread through the blood and lymphatic systems, eventually growing in various body parts, including the lymph nodes, spleen, bone marrow, and other organs. As a result, patients with lymphoma will usually present with painless enlargement of lymph nodes or abnormal blood counts,” Dr Hon explains.
While NHL is more prevalent than HL, men are at a higher risk of developing both types. Dr Hon shares that individuals with lymphoma may experience a range of symptoms, such as prolonged fever for unknown reason, with temperature above 39.5 degrees, unexpected weight loss, skin rash or itching, and unusual drenching sweating at night. It is crucial to recognise these symptoms early, as timely diagnosis and early intervention can significantly improve treatment outcomes.
Stay vigilant: Be on the lookout for the signs of lymphoma
While lymphoma can affect individuals of all ages, certain factors can increase the risk of developing the disease. The likelihood of developing lymphoma rises with age, particularly NHL, rises with age, with the median age of diagnosis being 67 years(vi) In Malaysia, NHL is the 6th most common cancer among males and the 8th most common cancer among females(iii).
However, age is just one of the many risk factors. People with weakened immune systems are more susceptible to lymphoma. This includes those who have undergone organ transplants in the past, and are on immunosuppressive medications, as well as individuals infected with viruses such as HIV, AIDS or Epstein-Barr virus (EBV)(vii).
Dr Hon also emphasises that a family history of lymphoma and environmental factors also play a role in elevating the risk of lymphoma. Exposure to chemicals such as benzene, pesticides and herbicides such as glyphosate has been linked to an increased risk of developing the diseaseviii. Additionally, individuals who have previously undergone cancer treatment like chemotherapy or radiotherapy may face a higher likelihood of lymphoma later in life.
Living with lymphoma: Survival Rates and Treatment Options
The good news is that lymphoma is one of the highly curable forms of cancer. Dr Hon notes that the overall cure rate for lymphoma can be as high as 80% with even stage 4 showing a cure rate of up to 70%. However, Dr Hon also mentioned that the treatment options vary depending on the type and staging of lymphoma as well as the aggressiveness of the cancer. Common treatments include immunochemotherapy, radiation therapy, targeted therapy, autologous stem cell or bone marrow transplantation and Chimeric Antigenic Receptor-T (CAR-T) Cell Therapy. Hence, it is important to consult with the specialist to tailor the treatment plan.
“A diagnosis of lymphoma can impact patients both mentally and physically. The side effects of treatment, coupled with the emotional toll of battling cancer, can affect a patient’s quality of life. However, people with lymphoma can manage these challenges by maintaining a balanced diet that includes lean proteins, whole grains and full-fat dairy products, consuming well-cooked food during treatment and avoiding traditional medicine to prevent potential drug intervention. When it comes to daily activities, meditation or relaxation exercises like deep breathing exercises may reduce the stress and fatigue of the patients and further increase the quality of lifeix. A supporting group may also increase the treatment outcomes by managing symptoms and side effects and providing emotional and spiritual support,” Dr Hon added.
Lymphoma is a formidable adversary, but with early detection, the right treatment, and strong support, it is a battle that can be won.
