Lymphoma

Also called Hodgkin lymphoma, Non-Hodgkin lymphoma, Blood cancer

Cancer of the lymphatic system. The fifth commonest cancer in the UK, and the symptoms mimic ordinary illness for months.

What it is

Lymphoma is cancer of the lymphatic system, the network of vessels and nodes that carries immune cells. Around 20,000 people are diagnosed in the UK each year, making it the fifth commonest cancer and the commonest cancer in young adults.

There are two broad groups. Hodgkin lymphoma, more common in young people, has high cure rates. Non-Hodgkin lymphoma covers many different diseases, ranging from very slow-growing types that may need no treatment for years to aggressive ones needing urgent chemotherapy.

The diagnostic problem is that it looks like ordinary illness. Swollen glands, tiredness, night sweats and a bit of weight loss are all things people put down to a virus or to being run down, and the average delay before diagnosis is long.

The B symptoms, so called, are the ones that should prompt investigation: drenching night sweats, unexplained fever, and weight loss over 10% in six months.

Signs you might notice

Swollen, painless lymph nodes in the neck, armpit or groin, lasting more than a few weeks.

Drenching night sweats, the kind that soak nightclothes and sheets.

Unexplained fevers that come and go.

Unexplained weight loss.

Persistent fatigue, itching without a rash, and breathlessness.

A swollen gland after a cold that does not settle within six weeks needs assessment.

How it can affect day-to-day life

The delay comes from how normal each symptom seems on its own. It is the combination and the persistence that matters, and keeping a simple note of when things started helps a GP enormously.

For slow-growing lymphomas, watch and wait is standard and is psychologically hard: living with an untreated cancer, with scans and no treatment, needs support that is often not offered.

Treatment effects are long: fatigue, fertility, and for some regimens, late cardiac and second-cancer risks that need lifelong follow-up.

Supporting someone well

Get a lump that has not settled in six weeks checked, and say how long it has been there.

Report night sweats and weight loss specifically. Those words change the urgency of an appointment.

Ask about fertility preservation before treatment starts.

On watch and wait, ask for psychological support; it is a legitimate need, not an overreaction.

Attend long-term follow-up, which exists because of late effects.

Fever during chemotherapy is neutropenic sepsis until proved otherwise: that is an emergency, and any temperature over 38 needs the chemotherapy hotline immediately.

Where to get help

See a GP for a persistent lump or B symptoms, and ask about urgent referral.

Lymphoma Action run a helpline on 0808 808 5555 and Blood Cancer UK on 0808 2080 888.

Fever on chemotherapy: ring the 24-hour chemotherapy hotline, do not wait.