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What are the Signs and Symptoms of Follicular Lymphoma

Leena Palande
Follicular lymphoma, a slow growing cancer, is a type of non-Hodgkin's lymphoma. Follicular lymphoma symptoms are likely to go unnoticed because they are mild and minor. Symptoms and some important facts of the disease are described in this story. Read ahead...
Follicular lymphoma is known as 'indolent' non-Hodgkin's lymphoma; because it is a slow growing lymphoma. Its 'low-grade' nature can be seen through a microscope. It never behaves aggressively. The symptoms of follicular lymphoma are minor, and in most cases they usually go unnoticed. It is therefore difficult to detect it at a very early stage.

What is Follicular Lymphoma

A cancer of the lymphatic system is referred to as 'non-Hodgkin's lymphoma'. The function of the lymphatic system is to help the immune system in fighting infections. Bone marrow, thymus, spleen, lymph nodes (also called lymph glands), and the lymphatic vessels that carry the lymph fluid and connect the lymph nodes, together form the lymphatic system. 
The lymph fluid contains lymphocytes, a type of white blood cells, (WBCs), which are produced in the bone marrow.
B-cells and T-cells are the two types of lymphocytes, and follicular lymphoma is a cancer of the B-cells. Cancers of both T-cells or B-cells are known as lymphomas, and about 33% lymphomas are follicular lymphomas. This type of lymphoma is more common in older adults.
The average age of diagnosis is about 55. Both men and women are equally susceptible to this condition, though it is not an infectious disease. The causes of this disease are not yet known. What are the signs and symptoms of follicular lymphoma? Here follows the answer.

Signs and Symptoms

During the early stages, follicular lymphoma exhibits little or no signs. The person may experience simple flu-like symptoms.
He might suffer from mild to high fever, cough and cold. The symptoms usually include fever and excessive sweating, especially during the nights. The patient may feel extremely tired. Along with fatigue, the patient may complain about loss of appetite. Unexplained weight loss is one of the main and common symptoms of follicular lymphoma.
Apart from these symptoms, the patient may have swollen lymph nodes in the neck, armpit or groin. The condition can be painless. Due to excessive tiredness, the patient might feel sleepy throughout the day. The type of symptoms and the severity of the symptoms may vary from person to person.
Initially, the symptoms may go away after taking medicines. But the symptoms will return after some period. Recurrence of lymphoma symptoms in adults indicates an underlying medical condition that needs prompt medical attention. The patient should undergo the tests suggested by the doctor.

Staging and Grouping

When only one group of lymph nodes or one section of an organ tissue is affected by the cancer, it is called 'first stage of this cancer'. Gradually, the disease usually spreads to two lymph groups on the same side of the diaphragm. It is also possible that it is present in one lymph group, and it attacks the nearby organs.
This is described as stage II follicular lymphoma. When the lymph nodes on both sides of the diaphragm are invaded by the cancer, it is known as stage III. During the fourth stage, the cancer invades various internal organs. It often spreads into the liver, bone marrow, and blood.
The three grades of follicular lymphoma are determined after checking out the ratio of large to small B-cells that are affected. When the cancer involves only small cells, it is termed as grade 1 follicular lymphoma.
If both large and small cells are affected by the cancer, then it is referred to as grade 2 cancer. When most of the large cells are affected by the cancer, it is known as grade 3 cancer, and it can be then described as 'aggressive cancer'.

Diagnosis and Treatment

Before drawing any conclusions, a biopsy will be performed on an affected lymph node. Various other tests like chest X-ray, CT or PET scan, blood tests, and bone marrow test, help diagnose the stage of the disease. These tests help determine the prognosis and course of the treatment.
The treatment may vary from person to person, depending upon the overall health of the person, and the stage and grade of the cancer. Mostly, the disease is detected in the third or fourth stage. But this type of cancer grows very slowly, and hence, about 70% of the people diagnosed with later stages of the disease, survive for 10 years or more.
They may experience recurrence of the symptoms, for several years. They may experience the symptoms sporadically too.
Taking into consideration the age of the person, and the signs and symptoms (the number of nodes involved), the doctor may decide to 'wait and watch'. People diagnosed with this disease, who do not exhibit any of the follicular lymphoma symptoms, are often suggested to 'wait and watch'.
Life expectancy of these patients and life expectancy of the patients who are treated as they exhibit the symptoms, is almost equal. Chemotherapy and radiation treatment is also recommended depending upon the stage and grade of the cancer.