* An Overview of Lymphoma, or Lymphatic Cancer - types, symptoms, causes and alternative treatments

Patient-friendly overview of Lymphoma, a group of blood cancers which develop from lymphocytes; the main types being Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma (NHL); they are not lifestyle-driven but largely develop due to environmental toxins and infection and are treated in very different ways.

LYMPHOMA, or LYMPHATIC CANCER - symptoms, causes, types and treatment alternatives

This comprehensive review on Lymphoma, or Lymphatic cancer, will give you a huge start towards helping you increase your personal odds of beating lymphatic cancer - the symptoms, the diagnosis and all the latest options on cancer treatments and cancer therapies from immunotherapy to proton beam therapy and from chemotherapy to natural compounds. We will also cover the causes.

This article has been compiled by Chris Woollams from worldwide research and expert sources.

Lymphoma overview

It’s all too easy to think of lymphoma as some sort of rare and minor cancer. Sadly, this is far from the case. The total number of cases diagnosed was approximately 12,000 for Non-Hodgkin Lymphoma and 1,700 for Hodgkin Lymphoma in the UK in 2016. This cancer has been growing in our modern world, and according to Dr. Alasdair Rankin of Bloodies, this cancer risk is not reduced by making better lifestyle choices. Its causes include chemical pollutants from formaldehyde to benzene and herbicides and pesticides. In 2018 an American jury decided that, on evidence presented to them, Monsanto’s RoundUp was responsible for causing Lymphoma in several plaintiffs.

Treatment may simply involve ’active surveillance’, or chemotherapy, immunotherapy, radiotherapy, proton beam therapy and/or bone marrow transplantation.

Also Lymphoma is not a single cancer, rather it is a group of 30-40 different but related cancers.

Types of Lymphoma

Lymphoma or lymphatic cancer is thus the term given to the group of cancers in the lymphatic system - your germ-fighting system - occurring when some of the white immune cells, called lymphocytes, become abnormal and malignant.

Lymphoma is usually divided into two subgroups:

• Non-Hodgkin lymphoma, or NHL 

This is called Hodgkin’s Disease or Hodgkin’s Lymphoma in the USA.

• Hodgkin lymphoma 

This is called Hodgkin’s Lymphoma in the USA.

Non-Hodgkin’s Lymphoma (NHL) accounts for about 80 per cent of cases.

American Websites will also include further subgroups such as 

      * Cutaneous B-cell lymphoma, 

      * Cutaneous T-cell lymphoma and 

      * Waldenstrom macroglobulinemia.

Lymphoma and the Lymphatic System

Lymph is a colourless liquid which bathes the cells of your body, passing through the walls of the capillaries into the lymph system, then to at least one lymph node before passing into the blood stream. You have twice as much lymph as blood in your body and the lymph serves to take some nutrients to your cells while taking toxins and bacteria away from your cells. Lymph also carries triglycerides from fat digested in the intestine. 

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Lymph is a part of your immune system. The lymphatic system is made up of a series of vessels and glands, or lymph nodes, spread throughout your body. The biggest volume of lymph is in your thoracic duct which lies across your chest. Even your tonsils are part of the lymph system.

There is no heart to pump your lymph. At night when you sleep, your lymph flow slows. Gravity can move lymph, but the prime driver of lymph flow is your own action (or lack of it). Obviously actions that get the chest moving will create movement in the lymph. These include arm movements, stretching, laughter, press ups, swimming Tai Chi and so on.

The lymph contains infection-fighting white blood cells, Some are called lymphocytes. There are several forms, notably B-lymphocytes and T-lymphocytes. They develop in the bone marrow and some mature in the thymus.

In lymphoma, the lymphocytes start to multiply abnormally and collect in certain parts of the lymphatic system, such as the lymph nodes. You also become more vulnerable to infection as the lymphocytes become damaged.

Lymphoma Symptoms

The most common symptom of lymphoma is a painless swelling in a lymph node, usually in the armpit, groin or neck. This is caused by the damaged lymphocytes collecting in that node. The swelling may also ache. 

The converse is not necessarily true just because you have a swollen lymph node it doesn’t mean you have lymphatic cancer; lymph nodes can swell in response to any infection. 

Once the cancer starts to spread you may find you have symptoms of tiredness or fatigue, night sweats, fever, unexplained weight loss, a persistent cough or feeling of breathlessness and trouble getting rid of infections. Some people experience a persistent itching of the skin all over the body and even a sensitivity to alcohol! 

If the lymphoma is in your abdomen, you may even experience bloating or indigestion.

With Hodgkin’s lymphoma symptoms may also include nose bleeds, or blood spots under the skin.

Hodgkin Lymphoma, Hodgkin’s disease or Hodgkin’s Lymphoma

Named after the Doctor, Thomas Hodgkin, who first identified the disease in 1832, Hodgkin's lymphoma is one of the most common cancers among younger people, although still relatively rare. It affects young adults aged between 15 and 35, and adults over the age of 55. More men than women are affected. The disease, although aggressive, can be successfully treated in about 80 per cent of cases. 

It is defined by the presence of a large, abnormal B-lymphocyte cell. (This is called a Reed-Sternberg cell.) B-lymphocytes are produced in the body in response to invasion by a foreign body. This could typically be a virus or bacterium, but could include a toxin or a chemical.

Subtypes of Hodgkin’s Lymphoma

* Nodular Sclerosing Hodgkin’s Lymphoma: The affected lymph nodes have mixed areas of normal cells, Reed-Stemberg cells and prominent scar tissue. This is the most common type, making up 60% to 80% of all cases.
* Lymphocyte-Rich Classical Hodgkin’s Lymphoma: A newly identified subtype and behaves like mixed cellular Hodgkin’s lymphoma.
* Mixed Cellular Hodgkin’s Lymphoma: The affected lymph nodes contain many Reed-Stemberg cells in addition to several other cell types. Mixed cellular primarily affects older adults.
* Lymphocyte Depletion Hodgkin’s Lymphoma: There are large numbers of Reed-Stemberg cells, but very few other cell types are found in the lymph nodes. It is the least common form of Hodgkin’s lymphoma and found in less than 5% of the cases. It is seen more often in elderly or in patients with AIDS.
* Nodular Lymphocyte Predominance Hodgkin’s Lymphoma: This is not considered a classic Hodgkin’s lymphoma, because it lacks some of the features that identify Hodgkin’s lymphoma and also Non-Hodgkin’s lymphoma. Most of the lymphocytes found in the lymph nodes are normal. Abnormal cells, known as "popcorn cells" are a special type of B-cell found in the nodular variety. NLPHL accounts for about 5% or 6% of the cases of Hodgkin’s lymphoma. It affects more men than women. The average age of patients is in their mid-30s. This type of Hodgkin’s lymphoma is usually diagnosed at an early stage and the prognosis is excellent.

Non-Hodgkin’s lymphoma

Non-Hodgkin’s lymphoma is then any type of lymphoma without the Reed-Sternberg cell. It is the most common form of lymphoma and is broadly categorised in two groups:

            * high-grade, or aggressive non-Hodgkin lymphoma, where the cancer develops quickly and aggressively.

          * low-grade, or indolent non-Hodgkin lymphoma, where the cancer develops slowly and you may not have any symptoms for many years.

This cancer is associated with aging and the average age at diagnosis is around 65. 

High-grade non-Hodgkin’s lymphoma advances rapidly but can be quickly diagnosed and treated. About 60 per cent of cases achieve 5-year survival.

The low-grade disease is much harder to diagnose and may not cause symptoms until quite advanced. This makes it more difficult to cure although the symptoms can be successfully held at bay.

Mantle Cell Lymphoma (MCL)

Mantle Cell Lymphoma (MCL) is a type of NHL and is about 6% of all cases. Most patients (70%) have an aggressive grade 4 disease on diagnosis and although there are treatments, recurrence is expected withing 5 years.

Typically on diagnosis patients also have night fever and sweats, gut disturbances, loss of weight, loss of appetite and even nausea.

10-15% of patients are however diagnosed with stage I or Stage II disease which can be indolent. It is usual to measure the Sox11 marker to assess presence and aggression.

Causes of Lymphoma

There is convincing evidence that this is a cancer of the modern world. One major study (by the University of Massachusetts, Lowell) detailed specific cancers and their environmental causes. Lymphoma was one of these cancers.

Research has indicated that causes include:

Chemical Pollution: Chemical solvents such as acetone, benzene, toluene, xylene, turpentine, and various alcohols, not just ethyl alcohol have been linked to lymphoma. For example, the Yale School of Public Health has produced a report on organic solvents and their links to non-Hodgkin lymphoma. UC Berkeley School of Public Health conducted a meta-study using data from 22 research studies and concluded that, "The finding of elevated relative risks in studies of both benzene exposure and refinery work provides further evidence that benzene exposure causes NHL". Benzene exposure, linked to both leukemia and lymphoma is the subject of both increasing American research, and lawsuits! 

Tricyclic Anti-depressants: People who take tricyclic antidepressants are at increased risk for a rare group of blood cancers known as non-Hodgkin lymphoma, according to study conducted by researchers from the Institute of Cancer Epidemiology at the Danish Cancer Society, and published in the journal, Epidemiology.

"Our results indicate an increased risk of non-Hodgkin lymphoma specifically among long-term users of tricyclic antidepressant medications," the researchers wrote. "Given the high prevalence of antidepressant use, this finding warrants additional studies."

Dark Hair Dyes have been linked to lymphoma. A 2008 American study in the Journal of Epidemiology commented on this.

Formaldehyde has also been linked to Lymphoma, as was reported a few years ago in CANCERactive’s Cancer Watch.

Pesticides: Chemicals linked to herbicides, defoliation (agent Orange included) and pesticides have been linked to Lymphoma. Agricultural workers have higher risks of these cancers, and risks extend to communities drinking water originating in field run-offs.

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In 2018 a San Francisco judge ordered Monsanto to pay a terminally ill groundsman, Dewayne Johnson, $289 million after jurors decided that based on evidence presented, Mr. Johnson’s lymphoma had been caused by the herbicide RoundUp. Many more cases may now follow.

Interestingly several studies have shown a reduced risk of NHL in people who consume organic foods. A 2014 study in the UK concluded that it was the only cancer where organic food really made a difference. And in a 2018 study across a four year period in France, people who consumed good levels of organic food regularly had a lowered risk of several cancers including lymphoma and especially NHL.

Aspartame - One study by the Ramazzini Foundation, which was accused of flaws and so was repeated super-accurately showed that consuming a daily can of diet drink containing aspartame could double your risk of blood and lymph cancers.

Heavy metals and even EMFs have also been the subject of concern but nothing is proven as yet.

Infection - The Epstein-Barr virus has been associated with lymphoma. And people with HIV seem to be at a higher risk, as are people with the stomach bacterium Helicobacter pylori. Research has also indicated a link with Borrelia Borgdorferi RNA (the Lyme Disease bacterium). 

Memorial Sloan-Kettering are looking at possible genetic factors in families. And people who have a compromised immune system or who are on immune suppressing drugs are at higher risk.

The fact is that the number of new cases of non-Hodgkin’s lymphoma in our modern world has been slowly but steadily rising by more than 4 per cent a year. This growth rate would make it almost the largest cancer in the UK by 2030.

Treatments for Lymphoma

There are many, many treatments available, possibly due to the fear that this cancer is on its way to being one of the biggest cancers in the Western World; and because there are so many slightly different types of this disease. So your treatment will be personalised and very individual to you.

Treatment of Non-Hodgkin’s Lymphoma

You may just be put on to ’Active Surveillance’ as your cancer is slow growing.

1. Radiotherapy may be used in confined areas like the neck or lymph nodes or over larger areas such as the chest or upper abdomen. It may be used in conjunction with chemotherapy, or on its own.

Radio-immunotherapy may use radio-labeled monoclonal antibodies for some types of Lymphoma.

Research with Proton Beam Therapy and NHL shows it to be very effective. Maryland Medical School say that Lymphoma is a highly treatable and curable cancer, and so it pays not to damage healthy tissues like heart and lungs with the beam of Radiotherapy. They advocate Proton Beam Therapy. 

2. Common chemotherapy options include the drugs:

   * ABVD: This refers to a combination of the drugs Adriamycin, Bleomycin, Vinblastine, and Dacarbazine (DTIC). These are administered as injections and are usually repeated every 2 weeks.

   * CHOP: one of the most common chemotherapy regimens for treating Non-Hodgkin’s lymphoma. It employs 4 drugs in the regimen. Cyclophosphamide (brand names Cytoxan, Neosar); Adriamycin (doxorubicin, or hydroxydoxorubicin); Vincristine (Oncovin). Note that this treatment may well cause fertility problems, and side-effects such as tingling in the hands and feet, nausea and hair loss. According to the American NCI, patients on this treatment are at a higher risk of developing secondary cancers in the brain, liver, kidney, bladder, skin and lung. The treatment usually involves 6 cycles each of 4 weeks.

   * R-CHOP: adds the monoclonal antibody Rituximab (Rituxan); clinical trials are currently looking at whether it should be prescribed every 14 or 21 days for non-Hodgkin's lymphoma.Antibodies attack your cancer cells and are thus one form of immunotherapy. O_CHOP is the new alternative.

You can improve the performance of your drugs as they try to eliminate all your white cells, while reduce your risks of side-effects:

Go to: Ten ways to improve your chemotherapy while reducing your side-effects

   * Immunotherapy: Other monoclonal antibodies include the drugs Brentuximab, Obinutuzumab, Ofatumumab, Ibritumomab and Alemtuzumab.

The immunotherapy Pembrolizumab (Keytruda) is also showing promise and so are CAR-T immunotherapy drugs.

Lymphoma and Stem Cell Transplants

Stem cell transplants enable treatment with higher levels of chemotherapy and radiation therapy to kill all the cancer cells before reintroducing stem cells into the body and thus rebuilding non-cancerous lymphocytes. Stem cells are taking from the blood, not from the bone marrow.

Be clear, you will undertake a ’conditioning program’ before the Stem Cell Transplant, involving very high doses of one or both of the two main chemotherapy drugs. The aim is to destroy as many lymphoma cells as possible and ideally, all.

There are two types of Stem Cell Transplants - Allogenic - which uses donated stem cells; and Autologous - which uses the patient’s own cells taken prior to chemo.

Following the Stem Cell Transplant, you will have no immune system, so you will also be given about 6 drugs to prevent attack from viruses, yeasts, bacteria and so on.These may even be given earlier, during the drug phase.

Although this can seem almost a ridiculous cocktail of drugs, we have known patients not given the cocktail to get infections and fall very ill for up to twelve months. Equally, some doctors develop an extreme fear of infection and don’t even want the patient to eat organic vegetables or take probiotics for fear of them ’being attacked’. It’s nonsense as you will see from this review.

In fact, there is research showing outcomes are better in lymphoma patients where their microbiome is monitored for pathogens and bacteria, so that they are less likely to fall ill. Not surprisingly, the view was that those people who kept their microbiomes the strongest had less infection. One patient we had at CANCERactive was treated by the Karolinska and they monitored him for possible yeast or fungal infection weekly throughout his treatment.

There is American Research showing that people who recover fastest have samples of their original microbiome re-administered to them only 10 days to 2 weeks after the Stem Cell Transplant. You should read this study on autologous fecal transplants, ideally before you have any drugs.

Lymphoma Diagnosis

Lymphoma may be diagnosed and confirmed in a number of ways:

Lymphangiogram: A dye, injected into the lymphatic vessels, enables the  lymph nodes and lymphatic vessels to be seen more clearly using X-rays.

Gallium (Radioisotope) Scan: Radioactive gallium is injected into a blood vessel and it circulates throughout the body and may collect in a tumour. The body is then scanned from several different angles and this test can be very useful with Hodgkin’s lymphoma.

Blood Tests: Can determine abnormal levels of red and white cells.

Bone Marrow Aspiration and Biopsy: Bone marrow is obtained inserting a long, thin needle into a large bone (for example, the hip) and collecting a small sample of marrow. The skin, tissue and surface of the bone are numbed with a local anesthetic first.

X-Ray: Taking pictures of the infected areas inside the body.

Biopsy: Taking a piece of tissue from an area of suspected cancer to examine the white cells under a microscope.

Computerised Tomography (CT) Scan:  A 3D X-ray picture is taken from different angles around the body. The pictures are then combined using a computer. There is concern that too many CT scans can actually cause cancer.

Magnetic Resonance Imaging (MRI): An MRI is similar to a CT scan but uses magnets and radio frequency waves instead of X-rays. Less used in Hodgkin’s lymphoma than CT scans, but useful in evaluation of the bones and brain.

Positron Emission Tomography (PET) Scan: PET images provide information about how tissues function.

Staging of Lymphoma

The stage describes the extent to which the tumor has spread in the body. It helps predict outcome and prognosis and can determine the treatment approach.

Stage I (early stage): One lymph node region is involved.
Stage II (locally advanced disease): The cancer is found in two or more lymph regions on one side of the diaphragm or the cancer is found in one lymph node region plus a nearby area or organ.
Stage III (advanced disease): The disease involves lymph nodes both above and below the diaphragm or one node area and one organ on opposite sides of the diaphragm.
Stage IV (widespread disease): The lymphoma is outside the lymph nodes and spleen and has spread to one or more organs such as bone, bone marrow, skin and even other organs.

Alternative Lymphoma Therapies

Several research studies from Cancer Watch and elsewhere may interest readers:

Vaccines - Perhaps the biggest development was the recent use of a two stage vaccine to beat Lymphoma by Scientists at Stamford Medical School.

Go to: New cancer vaccine wipes out Lymphoma completely

Then there are natural compounds that definitely have an effect:

1. Fucoidan is a natural compound found in various forms of seaweed like kombu, limu, wakame andmozuku plus animals like the sea cucumber. Researchers from the Hashemite University in Jordan at the AACR Dead Sea International Conference on Advances in Cancer Research working on previous studies that the extract from common brown seaweed causes cancer cell death (apoptosis) and shrinks tumours, have found that fucoidan suppressed cancer cell growth and caused a significant increase in apoptosis, or cellular death, in lymphoma cancer cells while leaving healthy cells intact.

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Some forms of B-cell lymphoma are especially resistant to standard treatment and thus new therapies are needed, said Professor Mohammad Irhimeh adding, "in this study, we looked at a new treatment strategy using novel active compounds derived from a natural source seaweed". Clinical Trials are planned.

2. Vitamin D: Lymphoma patients with a vitamin D deficiency are twice as likely to die from their cancer as patients with normal blood levels say scientists at the Mayo Clinic (American Society of Haematology Conference).

50 per cent of patients in the study (all diagnosed in the years from 2002 to 2008) had a blood vitamin D deficiency. Over the following three years this group were 50 per cent more likely to become worse and twice as likely to die as those having normal blood vitamin D levels.

At CANCERactive we have covered many research studies that show people with low levels of plasma vitamin D are more likely to develop cancer; and those with cancer and low vitamin D have lowered survival. Your target should be 80-100 ng/ml in the blood; Boston Medical School have 25 years of research behind them and recommend cancer patients take 5,000IUs a day; and chemotherapy drugs halve your plasma levels so a double dose while on chemo might be wise.

3. Dandelion Root Extract: Researchers from Windsor Medical School in Canada have looked at this weed’s action against several cancers in the laboratory and occasionally in animals. One report was that it killed 98% of cancer cells in 48 hours. Dandelion flower does have strong antioxidant properties according to Maryland Medical School. Clinical trials are underway.

4. Curcumin: Markers for Cancer Stem Cells were decreased in Burkitt’s lymphoma when cells were treated with curcumin, an ingredient in turmeric. Curcumin is known to target the Nuclear Factor Kappa B pathway (NFKB) and it has been shown to inhibit Hodgkin’s Lymphoma cells and make them more sensitive to the drug Cisplatin.

Go to: Curcumin and cancer

5. Green Tea: The Mayo clinic went as far as saying that 5 cups of Green Tea (with its active ingredient of EGCG) per day stopped lymphoma in its tracks. Less euphoric, but none-the-less relevant was research from the Tohoku School of Medicine. A 9-year study followed the consumption of green tea by 42,000 people. Looking at blood cancers and cancer in lymph nodes in particular, the researchers found there was a 40 per cent reduction for the former, and 50 per cent for the latter, in those people consuming 5 cups per day (American Journal of Epidemiology). Another study went further - it stated that curcumin and EGCG induced complete remission in B-cell Non-Hodgkin’s Lymphoma!

6. Honokiol: This extract from the magnolia plant has an increasing amount of research on it. The FDA agrees it has anti-tumour and anti-angiogenisis effects but it is not water soluble. Research showed that liposomal delivery of honokiol stopped the growth of lymphoma in mice, The effect was dose-dependant. Liposomal honokiol more than doubled survival times (Blood Journal, 2009). Honokiol has been shown to inhibit NHL cells; it has significant anti-cancer activity on lymphoid malignant cells; and Honokiol improves the performance of Gemcitabine against Burkitt’s lymphoma.

7. Aspirin: Known to reduce the risk of Lymphoma cancer, aspirin and other NSAIDs like Indomethacin can block not just NFKB but Interleukin-6, which is found in elevated levels in lymphoma. Research shows aspirin seems to be able to reduce mortality rates. 

8. Detoxification: 

        * Goldenseal and bismuth: (Gastro-bismol or Pepto-bismol) are known to kill off Helicobacter pylori, as will Para Free Plus.

        * Artemisinin is know to deal with Borrelia Burgdorferi and other pathogens.

      * Selenium (which has some ability to displace some heavy metals from cells), Indole 3 Carbinol which has been shown to displace and/or denature some chemical pollutants from the body, Chlorella which has research behind it showing it can help clean certain tissues and prevent DNA damage.

        * Beneficial bacteria (probiotics), which have been shown in clinical research to help eliminate chemical pollutants and heavy metals from the body in conjunction with fibres like lignans, may also have a role to play in prevention or as part of an integrative programme.

Heal Your Gut

There seems to be little doubt that toxins produced by infection and infective agents can play a big part in Lymphoma, whether this is from infection like Epstein-Barr or Helicobacter pylori, or Borrelia, or a parasite or pathogen or even a chronic yeast infection, even caused by the treatment when your defences are poor.

Scientists at UCLA have shown that certain gut bacteria have a role to play in B-cell Lymphoma and concluded the gut microbiome could cause or prevent the disease and its progression. For a guide on what you can do to kill parasites, pathogens and yeasts, and how to add commensal (good) bacteria back into your microbiome go here -

Go to: Heal your Gut - Heal your Body

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Summary of Lymphoma

It is clear that Lymphoma is almost a disease in its own right. Growing rapidly, caused by the pollution in the modern world, with up to 40 variations and many individual treatments. Great attention needs to be paid to this disease. It belies the usual blah from cancer and health bodies that getting cancer is your own fault. In this case, it most probably isn’t. And by 2030 it could be the Western World’s largest cancer! 

What is clear is that you can empower yourself if you have lymphoma to deal with the environmental toxins and/or microbiome infection, to boost your Vitamin D levels, and to improve the performance of your drugs whilst minimising your side-effects, and with supplements like curcumin, fucoidan, dandelion, green tea and honokiol which have benefits against the disease.

IMPORTANT INFORMATION