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What to know about lymphoma

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Lymphoma is a cancer of the lymphatic system. It develops in lymphocytes, which are a type of white blood cell. These cells help fight disease in the body and play an essential role in the body’s immune defenses.

As this type of cancer is present in the lymph system, it can quickly metastasize, or spread, to different tissues and organs throughout the body. Lymphoma most often spreads to the liver, bone marrow, or lungs.

People of any age can develop lymphoma, but it is among the most common causes of cancer in children and young adults aged 15–24 years. It is often treatable.

In this article, we look at the symptoms of lymphoma, how to treat it, and the risk factors for the different types.

Types

There are two main types of lymphoma: Hodgkin and non-Hodgkin lymphoma. Within these, there are many subtypes.

Non-Hodgkin lymphoma

a woman describing the symptoms of her lymphoma to a doctor.
Swollen glands that do not go away can be a sign of lymphoma.

Non-Hodgkin lymphoma, which is the most common type, typically develops from B and T lymphocytes (cells) in the lymph nodes or tissues throughout the body. Tumor growth in non-Hodgkin lymphoma may not affect every lymph node, often skipping some and growing on others.

It accounts for 95% of lymphoma cases.

According to the National Cancer Institute (NCI), non-Hodgkin lymphoma accounts for 4.2%Trusted Source of all cancers in the United States, and a person’s lifetime risk of developing it is about 2.2%.

Hodgkin lymphoma

Hodgkin lymphoma is a cancer of the immune system, and doctors can identify it by the presence of Reed-Sternberg cells, which are abnormally large B lymphocytes. In people with Hodgkin lymphoma, the cancer usually moves from one lymph node to an adjacent one.

The NCI estimate that Hodgkin lymphoma accounts for 0.5%Trusted Source of all cancers and approximately 0.2% of people in the U.S. will receive a diagnosis in their lifetime.

Symptoms

The symptoms of lymphoma are similar to those of some viral diseases, such as the common cold. However, they typically continue for a more extended period.

Some people will not experience any symptoms. Others may notice a swelling of the lymph nodes. There are lymph nodes all around the body. Swelling often occurs in the neck, groin, abdomen, or armpits.

The swellings are often painless. They may become painful if the enlarged glands press on organs, bones, and other structures. Some people confuse lymphoma with back pain.

Lymph nodes can also swell during common infections, such as a cold. In lymphoma, the swelling does not resolve. Pain is also more likely to accompany the swelling if it has occurred due to an infection.

The overlap of symptoms can lead to misdiagnosis. Anyone who has persistently swollen glands should see their doctor for a consultation.

Other symptoms of both types of lymphoma may include:

  • ongoing fever without infection
  • night sweats, fever, and chills
  • weight loss and reduced appetite
  • unusual itching
  • persistent fatigue or a lack of energy
  • pain in lymph nodes after drinking alcohol

Some additional symptoms of non-Hodgkin lymphoma include:

  • persistent coughing
  • shortness of breath
  • pain or swelling in the abdomen

Pain, weakness, paralysis, or altered sensation may occur if an enlarged lymph node presses against spinal nerves or the spinal cord.

Lymphoma can spread rapidly from the lymph nodes to other parts of the body through the lymphatic system. As cancerous lymphocytes spread into other tissues, the immune system cannot defend against infections as effectively.

Treatment

senior mans hand in chair as he receives chemotherapy
Chemotherapy is one of the possible treatments that doctors may use to treat lymphoma.

The course of treatment depends on the type of lymphoma a person has and the stage it has reached.

Indolent, or slow growing lymphoma may not need treatment.

Watchful waiting may be enough to make sure the cancer does not spread.

If treatment is necessary, it may involve the following:

  • Biologic therapy: This is a drug treatment that stimulates the immune system to attack the cancer. The drug achieves this by introducing living microorganisms into the body.
  • Antibody therapy: A medical professional inserts synthetic antibodies into the bloodstream. These respond to the cancer’s toxins.
  • Chemotherapy: A healthcare team administers aggressive drug treatment to target and kill cancer cells.
  • Radioimmunotherapy: This delivers high powered radioactive doses directly into cancerous B cells and T-cells to destroy them.
  • Radiation therapy: A doctor may recommend this type of therapy to target and destroy small areas of cancer. Radiation therapy uses concentrated doses of radiation to kill cancerous cells.
  • Stem cell transplantation: This can help restore damaged bone marrow following high dose chemotherapy or radiation therapy.
  • Steroids: A doctor may inject steroids to treat lymphoma.
  • Surgery: A surgeon may remove the spleen or other organs after the lymphoma has spread. However, a cancer specialist, or oncologist, will more commonly request surgery to obtain a biopsy.

Read more about the most severe stage of lymphoma.

Risk factors

Different risk factors can increase the risk of both types of lymphoma.

Non-Hodgkin lymphoma

Risk factors for non-Hodgkin lymphoma include:

  • Age: Most lymphomas occur in people aged 60 years and older. However, some types are more likely to develop in children and young adults.
  • Sex: Some types are more likely in women. Men have a higher risk of other types.
  • Ethnicity and location: In the U.S., African American and Asian American people have a lower risk for non-Hodgkin lymphoma than white people. Non-Hodgkin Lymphoma is more common in developed nations.
  • Chemicals and radiation: Nuclear radiation and certain agricultural chemicals have links to non-Hodgkin lymphoma.
  • Immunodeficiency: A person with a less active immune system has a higher risk. This may be due to anti-rejection medications following an organ transplant or HIV.
  • Autoimmune diseases: This type of disease occurs when the immune system attacks the body’s own cells. Examples include rheumatoid arthritis and celiac disease.
  • Infection: Certain viral and bacterial infections that transform lymphocytes, such as the Epstein-Barr virus (EBV), increase the risk. This virus causes glandular fever.
  • Breast implants: These can lead to anaplastic large cell lymphoma in the breast tissue.
  • Body weight and diet: The American Cancer Society (ACS) has suggested that overweight and obesity may have some involvement in the development of lymphoma. However, more research is necessary to confirm the link.

Hodgkin lymphoma

Risk factors for Hodgkin lymphoma include:

  • Infectious mononucleosis: The Epstein-Barr virus (EBV) can cause mononucleosis. This disease increases the risk of lymphoma.
  • Age: People aged 20–30 years and those 55 years of age have a higher risk of lymphoma.
  • Sex: Hodgkin lymphoma is slightly more common in males than females.
  • Family history: If a sibling has Hodgkin lymphoma, the risk is slightly higher. If the sibling is an identical twin, this risk increases significantly.
  • HIV infection: This can weaken the immune system and increase the risk of lymphoma.

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Diagnosis

patient in mri scan
A doctor may request imaging scans to help diagnose lymphoma.

There are no routine screenings for lymphoma. If a person has persistent viral symptoms, they should seek medical consultation.

The doctor will ask about the person’s individual and family medical history and try to rule out other conditions.

They will also carry out a physical examination, including an inspection of the abdomen and chin, neck, groin, and armpits, where swellings may occur.

The doctor will look for signs of infection near lymph nodes since this can account for most cases of swelling.

Tests for lymphoma

Tests will confirm whether lymphoma is present.

Blood tests and biopsies: These can detect the presence of lymphoma and help a doctor distinguish between different types.

A biopsy involves a surgeon taking a sample of lymph tissue. The doctor will then send it for examination in a laboratory. The surgeon may remove a small section or all of a lymph node. In some cases, they might use a needle to take a tissue sample.

It might be necessary to carry out a bone marrow biopsy. This may require a local anesthetic, a sedative, or a general anesthetic.

Biopsies and other tests can confirm the stage of the cancer to see whether it has spread to other parts of the body.

Imaging tests: A doctor may request imaging scans, such as:

A spinal tap: In this procedure, a surgeon uses a long, thin needle to remove and test spinal fluid under local anesthetic.

Staging of the cancer depends on the type, growth rate, and cellular characteristics. In stage 0 or 1, the cancer stays in a confined area. By stage 4, it has spread to more distant organs, and doctors find it more challenging to treat.

Outlook

With treatment, more than 72%Trusted Source of people with a diagnosis of non-Hodgkin lymphoma will survive for at least 5 years.

With Hodgkin lymphoma, 86.6%Trusted Source of people who receive treatment will survive for at least 5 years.

The chances of a good outcome decrease as lymphoma progresses. It is essential to seek medical attention for any symptoms of cold or infection that continue for an extended period. Early diagnosis can improve a person’s chances of successful treatment.

Q:

Where does lymphoma spread to?

A:

When someone has stage 3-4 lymphoma, it means that the cancer has spread to other areas of the body beyond the lymphoma nodes. Lymphoma most often spreads to the liver, bone marrow, or lungs.

Last medically reviewed on August 22, 2019

FEEDBACK:

Medically reviewed by Christina Chun, MPH — Written by Adam Felman on August 22, 2019

Latest news

What causes dizziness after a workout?

Feeling dizzy after a workout is a common occurrence. Often, it is the result of something minor, such as mild dehydration.

In other instances, however, it can indicate an underlying condition that requires treatment.

In this article, we list seven potential causes of dizziness after exercise, and we discuss treatments and methods of prevention.

Causes

Possible reasons for feeling dizzy after a workout include:

1. Overexertion

a woman jogger feeling dizzy after a workout.
Overexertion may cause a person to feel dizzy after a workout.

Overexertion occurs when people push themselves too hard during physical activity. Signs of overexertion include:

  • dizziness
  • feeling faint
  • lightheadedness
  • nausea
  • shortness of breath
  • thirst
  • vomiting

According to 2015 researchTrusted Source, injuries related to overexertion account for 36.2% of all injuries occurring at fitness facilities.

Overexertion does not just happen in gyms or exercise classes, however. It can happen during any activity.

2. Use of continual motion machines

The type of exercise a person does may influence whether they feel dizzy. For example, using an elliptical machine or a treadmill, which both involve continuous movement, is more likely to cause dizziness.

Some people experience lightheadedness or dizziness when they step off the machine. They may feel like they are still moving when they are not.

This experience is called vertigo. Others experience dizziness as a symptom of motion sickness.

3. Dehydration

Dehydration occurs when the body loses more water than it takes in. Although dehydration is most common in children and older adults, it can affect people of any age.

Healthy adults are most likely to experience dehydration from a minor illness or intense physical activity, especially during hot weather.

Symptoms of dehydration include:

  • dizziness
  • dry mouth
  • extreme thirst
  • feeling faint or lightheaded
  • less frequent urination
  • tiredness
  • weakness

Even mild dehydration, which is a loss of just 1–2% of body weight, can cause these symptoms. Many people think that thirst is one of the first signs of dehydration, but by the time someone feels thirsty, they are already experiencing dehydration.

4. Lack of oxygen

Improper breathing during exercise means that some people do not take in enough oxygen to meet the needs of their muscles.

During exercise, muscles use more oxygen than usual. This is why heart rate and breathing become faster to facilitate a higher intake of oxygen.

People who do not breathe often enough or deeply enough can experience a lower-than-optimal level of oxygen in the brain. Dizziness is a sign that the brain requires more oxygen.

5. Low blood pressure

Blood pressure is the force of the blood that pushes against the artery walls. In most people, healthy blood pressure is less than 120/80 millimeters of mercury (mm Hg). People who have low blood pressure, or hypotension, will have a reading of less than 90/60 mm HgTrusted Source.

Blood pressure is typically at its lowest within an hour of exercise. Some people may notice a more sudden drop, however.

In addition to dizziness, symptoms of hypotension include:

  • blurred vision
  • fainting
  • fatigue
  • loss of concentration
  • nausea

Vigorous activities most often cause low blood pressure, although any activity can trigger it. Some people with hypotension feel symptoms simply if they stand up too quickly.

Hypotension can be a cause of exercise-induced dizziness during pregnancy. It also results from dehydration, heart problems, and the use of certain medications.

6. Low blood sugar

Hypoglycemia, or low blood sugar, occurs when the level of glucose (sugar) in the blood is very low.

Sugar is the body’s primary energy source. During exercise, the muscles use more glucose than usual. As a result, some people experience low blood sugar during or after physical exertion.

Symptoms of hypoglycemia include:

  • dizziness
  • anxiety
  • clumsiness
  • fatigue
  • hunger
  • irritability
  • shaking
  • sweating

People may be more likely to experience hypoglycemia if they have not eaten much before exercising. This can be a common problem for those who exercise first thing in the morning.

7. Heart arrhythmia

A heart arrhythmia is an abnormal heartbeat. Arrhythmias may cause the heart to beat too quickly, too slowly, or irregularly. Many conditions can cause arrhythmias, including heart conditions and emotional stress.

Exercise can also trigger or worsenTrusted Source a heart arrhythmia, particularly in people who have heart disease.

Not all arrhythmias cause symptoms, but when symptoms do occur, they include:

  • dizziness
  • change in heartbeat
  • fainting
  • lightheadedness
  • shortness of breath
  • sweating

Even when symptoms occur, it does not necessarily mean that a person has a serious problem. However, it is always important to see a doctor for persistent arrhythmias.

Treatment

The treatment for feeling dizzy after a workout depends on the underlying cause of the problem.

In some cases, treatment is simple and straightforward. In others, it may be necessary to see a doctor for further investigation and medical attention.

Rest and breathe

a man and woman resting after a workout.
Resting for a few minutes may help resolve dizziness.

When dizziness occurs as a result of overexertion, improper breathing, or low blood pressure, people can try the following:

  • Cool down and rest for a few minutes.
  • Sit down and place the head between the knees, which increases blood flow to the brain.
  • Practice deep breathing for several minutes, making sure to inhale and exhale slowly.
  • When exercising, consciously practice breathing in and out in a regular rhythm.

When dizziness occurs while using a treadmill or other machine that uses continual motion, people should hold tightly to the rails and slow down their pace until it is safe to stop. These actions may prevent dangerous falls.

Avoid walking around or driving until dizziness subsides.

Hydrate

The only treatment for dehydration is to replace fluids and electrolytes. For most people, drinking water or a sports drink will resolve symptoms.

Some people may need an over-the-counter oral rehydration solution, which contains water and electrolytes.

People should drink enough fluid during the day so that their urine is pale yellow. If exercising during very hot or humid weather, try to drink chilled fluids to help cool down. The body absorbs cool fluids better than warmer ones.

To avoid dehydration in the future, people should sip fluids all day before, during, and after exercise. Drinking small amounts frequently is typically better than drinking large amounts less often.

Severe dehydration requires medical attention.

Eat something

People can boost low blood sugar levels by having something to eat. Healthful carbohydrates are best for treating low blood sugar, so people may wish to keep a banana or some dates on hand.

Drinking a glass of fruit juice may provide faster relief from the symptoms of hypoglycemia.

However, it is a good idea to follow this up with a meal or a snack containing whole grains and proteins to avoid another blood sugar crash.

Medical attention

If symptoms persist or recur despite taking steps to stop feeling dizzy after exercise, it may be necessary to speak to a doctor.

A doctor can check for an underlying reason for the dizziness, such as:

  • diabetes
  • heart problems, including arrhythmia
  • pregnancy
  • severe dehydration
  • severe hypoglycemia

They may prescribe medications or medical treatments for diabetes and heart problems. In cases of severe dehydration or severe hypoglycemia, it may be necessary to receive urgent treatment with intravenous fluids or intravenous glucose.

Prevention

The following tips may reduce the risk of experiencing dizziness after a workout:

  • increasing the intensity of workouts gradually
  • avoiding pushing the body too hard
  • practicing regular breathing during exercises
  • considering doing Pilates or yoga, as these activities can teach people how to regulate their breathing
  • drinking plenty of fluids before, during, and after workouts
  • having a snack of complex carbohydrates and lean proteins an hour or so before a workout
  • quitting smoking

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Dig deeper into the health topics you care about most. Subscribe to our facts-first newsletter today.Enter your emailSIGN UP NOW

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When to see a doctor

female patient with doctor discussing triple negative breast cancer recurrence and survival rates in office
A person can speak to their doctor if dizziness is persistent.

If the dizziness persists, people must see their doctor. A doctor can investigate the problem and check for underlying health conditions.

Individuals should seek urgent medical care if they suddenly or frequently experience the symptoms of a heart arrhythmia.

It is also necessary to seek urgent care for severe symptoms of other conditions, such as:

  • confusion and disorientation
  • extreme fatigue
  • inability to keep down fluids
  • loss of consciousness

Summary

Often, feeling dizzy after a workout is not a serious cause for concern. It usually indicates that someone is overexerting themselves or has not had enough to eat or drink before exercising.

If dizziness only occurs when using a treadmill or similar machine, it can suggest vertigo.

Occasionally, feeling dizzy after a workout may mean that a person has low blood pressure, especially if they are pregnant. Less commonly, dizziness after exercise indicates a heart problem or diabetes.

Individuals who experience frequent or severe dizziness should see a doctor.

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