What are the symptoms of lymphoma?
Basically, the two main forms of lymph node cancer – Hodgkin’s lymphoma (Hodgkin’s disease) and non-Hodgkin’s lymphoma (NHL) – are characterized by very similar symptoms. However, the type and extent of symptoms vary depending on the stage of the disease. In the early stages, the signs of lymph node cancer are usually only discretely pronounced and rather nonspecific. In the further course of lymph node cancer, further symptoms are added depending on the organ or tissue involvement.
Overview of lymph node cancer symptoms
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Early stage |
Persistent, usually painless swelling of lymph nodes |
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General symptoms such as weakness, fatigue, loss of performance as well as the so-called B-symptomatics (= fever, night sweats and weight loss) |
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Advanced stage |
Infestation of the bone marrow with resulting anemia (recognizable, for example, by pallor of the skin), tendency to infection and bleeding |
What are the first signs of lymph node cancer?
Swelling of the lymph nodes
A very common first sign of lymph node cancer is persistently enlarged lymph nodes that usually do not hurt. Typically, the swelling lasts for a long time (several weeks) and is often the only symptom in the early stages. For example, the lymph nodes on the neck, in the neck, in the armpit and/or groin are affected.
Swelling of lymph nodes that is not visible or palpable from the outside is also possible. For example, in some lymphoma sufferers, the lymph nodes behind the breastbone are swollen. When pressure is applied to the trachea, this sometimes results in an irritating cough and shortness of breath.
Swollen lymph nodes are not a specific sign of lymphoma, but also occur in many infectious diseases. However, they are then usually sensitive to pressure and regress as the infection subsides.
General symptoms
As another nonspecific sign of lymphoma, some patients experience itching on the body.
B-symptomatics
Many people affected with lymph node cancer exhibit what is known as B-symptomatology:
- fever (> 38.5° C without signs of infection)
- severe night sweats
- @ Unwanted and unexplained weight loss of more than ten percent of body weight
B-symptomatology is a classic combination of symptoms that occurs in severe consumptive diseases – diseases that lead to weight loss in a short period of time due to the breakdown of fat and muscle tissue. In addition to lymphoma, these include, for example, other cancers, tuberculosis, and HIV infection or AIDS.
Alcohol pain
Alcohol pain is very rare: It occurs only in Hodgkin’s lymphoma and only in less than one percent of patients. However, this symptom is very characteristic for Hodgkin’s disease!
Infestation of other lymphatic tissues
Other lymphatic tissues, such as the adenoids, are also more frequently affected by cancer. They are also painlessly enlarged – either in addition to the lymph nodes or instead of them. This is particularly the case with some non-Hodgkin’s lymphomas: there are forms that originate primarily from internal organs (such as the lymphatic tissue of the gastric mucosa in MALT lymphoma) or from the skin (cutaneous T-cell lymphomas). Cutaneous T-cell lymphoma (CTCL), for example, is recognized by a persistent and itchy skin rash, but also shows symptoms typical of lymphoma, such as fever, weight loss, and night sweats.
However, the starting point of non-Hodgkin’s lymphoma and also Hodgkin’s lymphoma are the lymph nodes.
Lymph node cancer shows few symptoms at the beginning. Therefore, it is usually difficult to recognize the disease in its early stages and to distinguish it from other diseases. However, if you have one or more lymph nodes that are persistently swollen (over several weeks), you should consult a doctor as a precaution – especially if you also have “B symptoms”.
However, remember that the symptoms described above are not exclusive to this malignant disease, but many other, more or less harmless, causes are possible. For a reliable diagnosis, it is necessary to remove potentially affected tissue (such as lymph nodes) and examine it in the laboratory.
For more information on the examinations, read the article Lymph node cancer.
Does lymph node cancer also affect other organs or tissues?
Infestation of the liver and/or spleen
When cancer cells attack the liver or spleen, the organ in question often enlarges. This usually disturbs digestion and triggers, for example, a feeling of fullness and nausea.
An enlargement of the liver (hepato-megaly) is palpable under the right costal arch in many affected individuals. A massive infestation can impair liver function to such an extent that it can no longer perform its numerous metabolic tasks properly.
Enlargement of the spleen (splenomegaly) can be palpated under the left costal arch. The swelling of the organ often leads to pain in the upper abdomen.
Involvement of the lung
Lung metastases from lymph node cancer usually remain asymptomatic for a long time. In the advanced stage, symptoms occur depending on the affected region. Sufferers often complain of a persistent cough that does not go away despite treatment. Some sufferers also experience pain and shortness of breath (dyspnea).
Infestation of the nervous system
Infestation of the bones
Bone damage is also a symptom of lymphoma, occurring mainly in advanced stages. The bone dissolves at the sites affected by cancer cells (osteolysis) and thus loses stability. The risk of bone fractures increases and then occurs spontaneously. The calcium released from the bone during osteolysis enters the blood, causing the calcium concentration there to rise.
A typical feature of multiple myeloma (plasmocytoma) – a form of non-Hodgkin’s lymphoma – is the so-called “shotgun skull”. In this case, the cancer causes many small holes in the skull bone, which looks in the X-ray image as if the patient had been shot with a shotgun.
Other lymph node cancer symptoms
Anemia, tendency to infection and bleeding.
The bone marrow plays a central role in blood formation. If lymph node cancer cells spread uncontrollably here, they displace the healthy blood cells and various functional disorders threaten:
- Anemia – caused by a lack of red blood cells (erythrocytes). These blood cells are responsible for oxygen transport in the blood. If their number is too low, anemia develops with symptoms such as pallor, fatigue and weakness.
- Susceptibility to infections – caused by a deficiency of white blood cells (leukocytes). These blood cells are an important part of the immune system. If not enough healthy leukocytes are produced as a result of lymphoma, the body becomes susceptible to infections (such as those caused by fungi, bacteria or viruses).