Follicular Lymphoma: Symptoms, Causes, Treatment

What are the symptoms of follicular lymphoma?

Follicular lymphoma is a type of non-Hodgkin lymphoma that affects the lymphatic system, which is part of the body’s immune system. The symptoms of follicular lymphoma can vary depending on the stage of the disease and other factors, but common symptoms may include:

Enlarged lymph nodes: The most common symptom of follicular lymphoma is painless swelling of lymph nodes, usually in the neck, armpits, or groin.
Fatigue: Feeling tired or weak is a common symptom of lymphoma, including follicular lymphoma, due to the body’s immune response to the cancer.
Night sweats: Experiencing drenching sweats during the night, which may require changing clothes or bedding, is a common symptom of lymphoma.
Unintended weight loss: Losing weight without trying, often defined as losing more than 10% of body weight over 6 months to a year, can be a symptom of lymphoma.
Fever: Some people with lymphoma may experience persistent or recurrent fevers without an obvious cause.
Loss of appetite: A decreased appetite or feeling full after eating small amounts can be a symptom of lymphoma.
Itching: Some people with lymphoma may experience itching, often without a rash, which is thought to be related to the release of certain chemicals by the immune system in response to the cancer.
Other symptoms: Less common symptoms of follicular lymphoma may include chest pain, coughing, difficulty breathing, abdominal pain or swelling, and neurological symptoms if the lymphoma affects the central nervous system.

It’s important to note that these symptoms can also be caused by other conditions, so a healthcare provider should be consulted for proper diagnosis and treatment if you experience any persistent or concerning symptoms.

What are the causes of follicular lymphoma?

The exact cause of follicular lymphoma is not known, but several factors may contribute to its development. These factors include:

Genetic mutations: Changes in the DNA of lymphocytes (a type of white blood cell) can lead to uncontrolled cell growth and the development of lymphoma. Some genetic mutations associated with follicular lymphoma include alterations in the BCL2 gene.
Immune system dysfunction: Problems with the immune system, which normally helps to protect the body against infections and diseases, may play a role in the development of lymphoma. This could include conditions that weaken the immune system, such as HIV/AIDS or certain autoimmune diseases.
Chronic inflammation: Prolonged inflammation in the body, often due to infections or autoimmune diseases, may contribute to the development of lymphoma.
Environmental factors: Exposure to certain chemicals, such as pesticides, solvents, or benzene, may increase the risk of developing lymphoma.
Age: Follicular lymphoma is more common in older adults, with the risk increasing with age.
Gender: Follicular lymphoma is slightly more common in women than in men.
Family history: Having a close relative, such as a parent or sibling, with lymphoma or another type of cancer may increase the risk of developing follicular lymphoma.

It’s important to note that while these factors may increase the risk of developing follicular lymphoma, most people with these risk factors do not develop the disease. The exact cause of follicular lymphoma is likely to be complex and involve a combination of genetic, environmental, and other factors.

How is the diagnosis of follicular lymphoma made?

The diagnosis of follicular lymphoma usually involves a combination of medical history, physical examination, imaging tests, and a biopsy of the affected lymph node or other involved tissue. Here are the key steps involved in diagnosing follicular lymphoma:

Medical history and physical examination: Your healthcare provider will ask about your symptoms, medical history, and any risk factors you may have for lymphoma. They will also perform a physical examination to check for swollen lymph nodes or other signs of disease.
Imaging tests: Imaging tests, such as CT scans, PET scans, or MRIs, may be done to help determine the extent of the disease and identify the locations of enlarged lymph nodes or other affected areas.
Blood tests: Blood tests may be done to check for abnormalities in blood cell counts or other markers that may suggest lymphoma.
Biopsy: A biopsy is the definitive test for diagnosing lymphoma. During a biopsy, a small sample of tissue is taken from an affected lymph node or other affected area and examined under a microscope to look for cancer cells. The biopsy may be done using a needle (fine needle aspiration or core needle biopsy) or through a surgical procedure (excisional biopsy).
Bone marrow biopsy: In some cases, a bone marrow biopsy may be done to see if the lymphoma has spread to the bone marrow.
Lymph node biopsy: If lymph nodes are enlarged and accessible, a biopsy of a lymph node may be performed to confirm the diagnosis and determine the subtype of lymphoma.
Flow cytometry: This test is often done on the biopsy sample to analyze the types of cells present and their characteristics, helping to confirm the diagnosis and determine the subtype of lymphoma.
Other tests: Depending on the individual case, additional tests may be done to help determine the extent of the disease and plan treatment, such as a lumbar puncture (spinal tap) to check for lymphoma cells in the cerebrospinal fluid or a bone scan to check for bone involvement.

Once a diagnosis of follicular lymphoma is confirmed, further tests may be done to determine the stage of the disease and plan appropriate treatment. It’s important to consult with a healthcare provider who specializes in the diagnosis and treatment of lymphoma for an accurate diagnosis and personalized treatment plan.

What is the treatment for follicular lymphoma?

The treatment for follicular lymphoma depends on several factors, including the stage of the disease, the extent of the lymphoma, the person’s age and overall health, and their symptoms. Treatment options may include:

Watchful waiting: For some people with early-stage follicular lymphoma that is not causing symptoms, a “watchful waiting” approach may be recommended. This involves closely monitoring the lymphoma without starting treatment until it progresses and causes symptoms.
Radiation therapy: Radiation therapy uses high-energy beams to target and destroy cancer cells. It may be used alone or in combination with other treatments, particularly for early-stage follicular lymphoma.
Chemotherapy: Chemotherapy uses drugs to kill cancer cells. It may be used alone or in combination with other treatments, such as immunotherapy or targeted therapy, depending on the stage and aggressiveness of the lymphoma.
Immunotherapy: Immunotherapy drugs, such as rituximab, work by helping the immune system recognize and attack cancer cells. They may be used alone or in combination with other treatments for follicular lymphoma.
Targeted therapy: Targeted therapy drugs, such as lenalidomide or idelalisib, are designed to target specific abnormalities in cancer cells. They may be used alone or in combination with other treatments for follicular lymphoma.
Stem cell transplant: For some people with advanced follicular lymphoma that has not responded to other treatments, a stem cell transplant may be considered. This involves high-dose chemotherapy to destroy cancer cells, followed by a transplant of stem cells to help restore the bone marrow’s ability to produce blood cells.
Clinical trials: Clinical trials are research studies that test new treatments or treatment combinations. They may offer options for people with follicular lymphoma who have not responded to standard treatments.

The choice of treatment depends on several factors, and a healthcare provider who specializes in treating lymphoma can help determine the most appropriate treatment plan. It’s important to discuss the potential benefits and risks of each treatment option with your healthcare team to make an informed decision about your care.

What is the survival rate of follicular lymphoma?

The survival rate for follicular lymphoma (FL) depends on several factors, including the stage of the disease at diagnosis, the patient’s age, and the response to treatment.

According to the American Cancer Society, the overall 5-year survival rate for patients with follicular lymphoma is about 70-80%. This means that about 70-80% of people diagnosed with follicular lymphoma are likely to survive for at least 5 years after diagnosis.

Here are some more specific survival rates for follicular lymphoma:

Stage I: The 5-year survival rate is around 85-90%.
Stage II: The 5-year survival rate is around 75-80%.
Stage III: The 5-year survival rate is around 60-65%.
Stage IV: The 5-year survival rate is around 40-50%.

It’s important to note that these survival rates are based on data from large studies and may vary depending on individual circumstances. Additionally, many people with follicular lymphoma experience long-term remission or even cure with treatment.

The type of treatment received also plays a significant role in determining survival rates. For example:

Patients who receive rituximab-based chemotherapy have a better overall survival rate compared to those who do not receive rituximab.
Patients who undergo autologous stem cell transplantation (ASCT) may have a better overall survival rate compared to those who do not undergo ASCT.
Patients who have a complete response to initial therapy may have a better overall survival rate compared to those who do not achieve a complete response.

It’s essential to consult with a healthcare provider for personalized information on prognosis and treatment options for follicular lymphoma.