Early Detection: 10 Warning Signs of Non-Hodgkin Lymphoma

Lymph node enlargement is the most common symptom of non-Hodgkin lymphoma. When lymphocytes start to reproduce rapidly inside the lymph node, it increases in size. A person may notice this enlargement as a lump under the skin.  Enlarged lymph nodes due to non-Hodgkin lymphoma differ from those that develop normally when we have an infection in that they are not usually sore.

Lymph nodes are present all over the body. It's easier to notice enlargement at sites where they are closer to the surface of the skin, such as in the neck and armpits. They can also be seen in the groin and abdomen. Like most tumors, this increase in size generally is not painful.

If the non-Hodgkin lymphoma starts in the spleen or the liver, this organ may become enlarged. As the size of the tumor increases, fluid may also start building up, and the abdomen may become swollen and tender.

The more the tumor grows, the more pressure is put on the surrounding structures, such as the stomach. This can cause abdominal pain, nausea, decreased appetite, and early satiety or feeling full or heavy after eating only a small meal. Increasing the pressure on the intestines may lead to decreased bowel movements, nausea, vomiting, and abdominal pain. Sometimes, this pressure causes the intestine to tear.

Fever is a common symptom of non-Hodgkin lymphoma. The fever doesn't have a particular pattern, but some people experience increases throughout one week, decreases throughout the following week, and so on.

The cause of this cyclic pattern is not well understood, but some experts speculate it has to do with the inflammatory chemicals and proteins inside the body called cytokines.

Around 40 percent of cancer patients experience unexplained weight loss. If they lose up to one-tenth of their total weight over six months or less, this could be the first symptom that something is wrong.

There is no precise cause for this drastic weight loss, but it usually starts with loss of appetite. Other contributing factors include nausea, vomiting, pain, and depression. In advanced cases, the weight loss progresses to cachexia, a combination of weight loss and muscle wasting.

Another symptom of non-Hodgkin lymphoma is drenching night sweats accompanied by shivering. People with the disease may wake up to find their clothes soaked and the sheets of their bed thoroughly wet, even if the room is cool.

Increased sweating can also happen during the day. The presence of fever, weight loss, and night sweats indicates a more advanced stage of the disease. These are "B symptoms" and suggest that the illness is starting to affect the constitution of the body and not just causing local issues such as swollen lymph nodes.

Non-Hodgkin lymphoma can leave people feeling exhausted and weak. This feeling can come on during or after physical activity, but it can also be unrelated. Patients may feel unable to carry out regular daily tasks, and their energy often is not restored after resting or sleeping.

This symptom may be due to the presence of the lymphoma, which drains the body's energy sources or releases harmful proteins or cytokines the body must fight. It can also be due to stress, anxiety, lack of sleep, or anemia. Fatigue caused by cancer can last for years and may persist even after treatment.

Non-Hodgkin lymphoma sometimes causes red or purple lumps and itchy skin. When the tumor starts in the skin, the manifestations tend to differ according to the type of malignant lymphocyte involved; it can either be a T-cell lymphocyte or a B-cell lymphocyte.

T-cell lymphoma skin lesions include flat red patches, thick, raised plaques, and sometimes the skin of the palms and soles becomes thickened. B-cell lymphoma skin lesions present as a reddish rash or nodules with a raised smooth surface. These lesions can become infected or develop ulcers.

If lymphoma starts in the chest, it can develop in the thymus, an organ between the sternum and the heart. As the cancer grows, it starts compressing the windpipe, which can lead to a cough, chest pain, and difficulty breathing.

Lymphoma arising in the chest may also compress the nearby superior vena cava, the vein responsible for delivering the blood going from the head and arms back to the heart. This compression might lead to a cough, chest pain, difficulty in swallowing, enlargement of the veins in the head and neck, and bluish discoloration in the head and arm.

It's rare for lymphoma to start in the brain, except in patients with very low immunity, such as those with AIDS.

Lymphoma in the brain can lead to many neurological symptoms, including headaches, seizures, personality changes, double vision, vertigo, speaking difficulties, vision impairment, facial numbness, weakness, progressive dementia that causes many cognitive abnormalities, and a decreased ability to think and remember.

In some people, lymphoma affects the bone marrow, which is the tissue responsible for producing blood cells. Cancer in this area can lead to decreased counts of different blood cells.

Low numbers of white and red blood cells can cause

• increased risk of infection as the lack of blood cells reduces the body's ability to fight them
• anemia, which causes fatigue, weakness, and shortness of breath due to low red blood cells
• nasal bleeding, bleeding gums, long or heavy periods, and bruising due to low platelets.