Lymphoma and lymphedema: What you need to know

Reviewed by Dr. Mary James, ND

What’s the difference between lymphoma and lymphedema? Lymphedema is when lymph fluid blocks the flow of lymph fluid and causes swelling. Lymphoma is a group of cancers that affect white blood cells that help fight infection. The two basic forms of lymphoma are Non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma. The majority of people (90%) who are diagnosed with lymphoma have some type of NHL.

Unfortunately, since lymphedema and lymphoma have such similar-sounding names, hearing there’s a problem with your lymphatic system can be confusing — and scary. Here’s more about what lymphoma and lymphedema are and what the difference is between the two, starting with lymphedema.

What is lymphedema?

Lymphedema happens when lymph fluid collects in the lymph nodes or other parts of the lymphatic system and causes swelling. While lymphedema causes discomfort, it’s not dangerous in and of itself. But it still is important that you find out why the blockage is occurring, since sometimes it’s associated with a malignancy such as breast cancer that can be dangerous if left untreated.

There are two types of lymphedema:

• Primary lymphedema, which is often due to congenital (genetic) syndromes.
• Secondary lymphedema is commonly associated with cancer treatment regardless of whether surgery, radiation or chemotherapy is used. It can happen even with a simple blood draw in a location where you’ve had cellulitis (an infection and inflammation of the subsurface skin cells). If you have been treated for cancer (recently or not), you will have been given information about lymphedema. Remember to contact your healthcare provider if it occurs.

How is lymphedema treated?

Lymphedema is treated by trying to relieve the blockage and restore proper flow of lymph. There are several ways to do this — but we urge you to consult your healthcare provider before you undertake treatment.

• Compression garments (socks or stockings if in the leg; other elastic, snug-fitting garments for other limbs or body parts). These should fit snugly but not so tightly that they cut off circulation. The goal is to increase pressure so lymph moves more forcefully through its channels. Avoid so much pressure that it stops movement, which is counterproductive.
• Manual lymphatic drainage, which is a massage of the affected area to promote movement of lymph through the channels. It is usually used in conjunction with compression garments.
• Pneumatic compression therapy uses a device to create pressure adjacent to the affected area, effectively pushing the lymph out of the area of swelling. It is usually is done on an outpatient basis, but is not used in patients with deep venous thrombosis, congestive heart failure or active infections, as it can worsen those conditions.
• Surgery to remove areas of scar tissue or to improve lymph drainage. It is usually reserved for patients whose lymphedema is recurrent or chronic, for whom other kinds of therapy do not work, or in whom the swelling is so serious as to prevent them from normal activities.

You can find out more about your lymphatic system and how to keep it health, with our article The lymphatic system and your health.

How can you prevent lymphedema?

One of the best ways to avoid lymphedema altogether is simply moving your body. If you’ve just undergone cancer treatment, this might be easier said than done — but exercise doesn’t have to be intense. Simply walking or swimming or engaging in gentle stretching or yoga is sufficient. Deep breathing exercises can also be helpful, as it expands and contracts muscles that compress abdominal and thoracic lymph nodes.

What is lymphoma?

Lymphoma is cancer that affects white blood cells called lymphocytes that help fight infection, which are carried by the lymph channels as well as in the blood. There are two different kinds of lymphocyte — B and T lymphocytes — and either or both can be affected.

When lymphocytes transform into cancerous cells, they often collect in lymph nodes to create a mass, or tumor, that you may be able to feel as a lump. A lump in your armpit or neck (where the most obvious lymph nodes are located) that doesn’t seem to be related to an illness and that doesn’t go away or that increases in size is something you should check out, regardless of whether it is painful.

Common signs and symptoms of lymphoma

• Lump in your armpit or neck
• Night sweats
• Fever or chills
• Unexplained weight loss
• Loss of appetite
• Shortness of breath
• Itching (25% of patients)
• Headache or pain in the back or bones

Most of these symptoms can be mistaken for the flu or other viral infection, but where a virus would eventually get better, lymphoma symptoms will persist. If you experience such vague, flu-like symptoms for a particularly long time, it’s best to see your healthcare provider.

Risk factors for lymphoma

There are numerous risk factors for lymphoma, many of which you can reduce:

• Autoimmune diseases that affect your B- or T-lymphocytes
• Family history of similar cancer
• Certain acquired or inherited immune deficiencies
• Smoking
• Alcohol use
• Obesity
• Exposure to certain pesticides and herbicides

How is lymphoma treated?

When it comes to lymphoma, that scary word, “cancer,” may not mean what you fear it does. There are many different types of lymphoma, and some are so slow-moving that they need no treatment at all for several years. So much of what having lymphoma might mean for you depends what type of lymphoma it is.

If you have symptoms that suggest lymphoma, your practitioner will arrange for you to have a biopsy to collect cells to be examined for the presence of cancer. Imaging scans may be done before or after the biopsy to pinpoint locations where cancerous cells might be found. A pathologist will look at the cells, identify any that appear malignant and further classify the cancer cells to narrow down the type of lymphoma present.

Treatment options tend to be very specific to different types of lymphoma. Other factors for the type of treatment include how strong your immune system is, how far the cancer has progressed, where it’s located, and whether it’s slow-moving (also called indolent) or aggressive (fast-moving).

An indolent lymphoma may need no treatment at all for months or even years. A “watch and wait” approach may be taken to see if the disease shows signs of progressing, and treatment is only started if it does.

When treatment is necessary, it usually consists of chemotherapy or immunotherapy — drugs specifically targeting the type of lymphoma you have. Radiation therapy may or may not be recommended as well. Specialized treatments include stem cell transplants and bone marrow transplants. These tend to be reserved for particularly aggressive lymphomas that do not respond to standard drug therapies.

If you want to learn more about the types of lymphoma, treatment methods, visit the Leukemia and Lymphoma Society or the American Cancer Society. The site also includes good information for support resources you may find helpful.