Lymphoma

Lymphoma is a cancer of lymphocytes, the white cells of the immune system. It usually begins in lymph nodes but can arise in the spleen, bone marrow, stomach, skin or almost any organ.

There are two families, Hodgkin lymphoma and non-Hodgkin lymphoma, and more than 60 subtypes that behave very differently. Some grow over weeks and need immediate treatment; others grow so slowly that careful observation is the right first step. The exact subtype, established on a biopsy, decides everything.

Symptoms

• A painless, rubbery lump in the neck, armpit or groin that persists beyond a few weeks
• Drenching night sweats
• Unexplained fever
• Loss of more than a tenth of body weight over 6 months
• Persistent tiredness
• Generalised itching without a rash
• Cough, breathlessness or chest pressure from nodes in the chest
• Fullness or discomfort under the left ribs from an enlarged spleen

Causes and risk factors

In most people no cause is found. Known risk factors include a weakened immune system (HIV, immunosuppressant medicines after a transplant), some autoimmune diseases, and certain infections: Epstein-Barr virus, Helicobacter pylori in stomach lymphoma, hepatitis C and HTLV-1. Risk rises with age for most non-Hodgkin types, while Hodgkin lymphoma has one peak in young adults and another later in life. It is not contagious and is rarely inherited.

How it is diagnosed

• Excision or core biopsy: A whole node or a generous core is needed. Fine needle samples are not enough to classify lymphoma.
• Immunohistochemistry and molecular tests: Identify the precise subtype and markers that guide targeted drugs.
• PET-CT: Maps all active disease for staging and is repeated to judge response.
• Blood tests: Blood count, LDH, liver and kidney function, and hepatitis B, hepatitis C and HIV screening before treatment.
• Bone marrow biopsy: Needed in some subtypes when PET-CT does not answer the question.
• Heart and fertility assessment: An echocardiogram before certain chemotherapy drugs, and a discussion about sperm or egg storage.

Treatment options

• Active monitoring: For slow growing lymphomas without symptoms. Starting early has not been shown to lengthen life in these types.
• Chemo-immunotherapy: Combinations such as ABVD for Hodgkin lymphoma or R-CHOP for diffuse large B-cell lymphoma, given in cycles every 2 to 3 weeks over several months.
• Radiotherapy: For localised disease or a bulky area after chemotherapy.
• Targeted and immune drugs: BTK inhibitors, brentuximab vedotin, checkpoint inhibitors and bispecific antibodies, chosen by subtype.
• Autologous stem cell transplant: High dose treatment supported by your own stem cells for relapsed disease that still responds to chemotherapy.
• CAR-T cell therapy: For selected relapsed B-cell lymphomas. Availability varies by country and centre, so confirm before planning around it.

When it is urgent

Go to a local emergency department for a fever of 38 degrees or higher during chemotherapy, for increasing breathlessness, swelling of the face and neck, new back pain with leg weakness or loss of bladder control, or confusion. These cannot wait for travel.

Travelling to Türkiye for treatment

Treatment usually lasts 4 to 6 months with visits every 2 to 3 weeks and a real risk of infection in between, so having all of it far from home is hard and often unwise. Useful reasons to travel are narrower: a second pathology review of your biopsy, PET-CT staging with a written treatment plan your local team can deliver, or a defined block such as radiotherapy or an autologous transplant if you can stay for the whole period with a companion. Bring the biopsy blocks and all scan discs.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions