Lymphoma, a Type of Blood Cancer
Understanding Lymphoma in South Africa
Lymphoma can affect people of all ages. In South Africa, delayed diagnosis is common, often because symptoms are mistaken for infections like flu, TB, or HIV. Raising awareness is key to earlier detection and better outcomes.
How Lymphoma Affects the Body
Lymphocytes are meant to protect the body from infections. When they become cancerous, they multiply uncontrollably and don't die when they should. This causes swollen lymph nodes, weakens the immune system, and can affect nearby organs like the liver, spleen, or bone marrow. Lymph nodes are small, bean-shaped glands found throughout the body; in the neck, underarms, chest, abdomen, and groin. They act as filters and are a key part of the immune system.
Lymphoma can be localised or spread throughout the body, depending on the type and stage.
There are two main categories of lymphoma:
- Hodgkin Lymphoma (HL): Characterised by the presence of Reed-Sternberg cells. It is less common but usually more treatable with early intervention.
- Non-Hodgkin Lymphoma (NHL): A diverse group of blood cancers that includes slow-growing (indolent) and fast-growing (aggressive) types. Some examples are follicular lymphoma, diffuse large B-cell lymphoma, and Burkitt lymphoma.
For a full overview of subtypes, visit our page on Types of Lymphoma.
What Causes Lymphoma?
While the exact cause is not always known, several risk factors have been linked to lymphoma:
- Exposure to chemicals like pesticides, benzene, and herbicides
- HIV and other viral infections such as Epstein-Barr virus (EBV)
- A weakened immune system, including from autoimmune diseases or organ transplants
- Prior cancer treatment with chemotherapy or radiation
- A family history of lymphoma
Some people with lymphoma have no clear risk factors at all.
Signs and Symptoms
The most common early sign of lymphoma is painless swelling in the lymph nodes, especially in the neck, underarms, or groin. Other symptoms may develop as the cancer spreads.
Common symptoms include:
- Persistent fatigue
- Night sweats
- Fever that comes and goes
- Unexplained weight loss
- Itchy skin
- Shortness of breath or chest pain
- Abdominal pain or bloating
- Enlarged spleen or liver
- Frequent infections
- Bruising or bleeding easily
In some cases of Hodgkin lymphoma, patients may experience pain in the lymph nodes after drinking alcohol.
Diagnosis and Staging
Diagnosis begins with a physical exam and blood tests. If lymphoma is suspected, a biopsy is done by removing part or all of an affected lymph node. This tissue is examined under a microscope to determine the exact type of lymphoma.
Further tests, like CT scans, PET scans, or bone marrow biopsies, help determine the stage of the disease. Lymphoma is staged using the Ann Arbor system:
- Stage I: One lymph node region or area affected
- Stage II: Two or more lymph node regions on the same side of the diaphragm
- Stage III: Lymph nodes on both sides of the diaphragm involved
- Stage IV: Spread to distant organs like the liver or bone marrow
The stage helps determine the most effective treatment plan.
Treatment Options
Treatment depends on the type of lymphoma, how advanced it is, and your overall health.
Common treatments include:
- Chemotherapy: Drugs to kill cancer cells
- Radiation therapy: High-energy waves to destroy cancer cells
- Targeted therapy: Medicine that attacks specific cancer cells
- Immunotherapy: Treatment that helps your immune system find and fight cancer cells
- Stem cell transplant: Replaces damaged bone marrow with healthy stem cells
Hodgkin lymphoma often responds well to chemotherapy and radiation. Some non-Hodgkin lymphomas grow slowly and may not need immediate treatment. Others are aggressive and need urgent intervention.
Your doctor will recommend a treatment plan tailored to your specific type and stage of lymphoma.
Lymphoma in South Africa
In South Africa, many people are diagnosed late due to lack of awareness or misdiagnosis. Patients with HIV or compromised immunity are at higher risk, and lymphoma may be more aggressive in these cases.
Public hospitals and oncology units in provinces like Gauteng, the Western Cape, and KwaZulu-Natal provide diagnosis and treatment. However, access to PET scans, advanced immunotherapy, and donor registries may be limited outside of major centres.
This is why education, early detection, and increasing donor registrations are so important.
You Can Help Save Lives
Some lymphoma patients need a stem cell transplant to survive. While 30 percent may find a match within their family, most rely on a stranger. You could be that match.
Registering as a donor is simple and free. All it takes is a cheek swab. If you are matched with a patient, you could be their only chance at survival.
