Let's Talk About the Causes of Lymphoma
This type of cancer can be notoriously tricky to predict or even to determine who is at risk. Here’s what experts say may play a role in causing the disease.
There’s nothing easy about cancer, and when it comes to the blood and lymph cancer known as lymphoma, there’s nothing easy about figuring out who will get it, either. Sure, scientists can point to a few risk factors, but most people who develop the disease don’t even have a family history. That said, there are certain things that boost your chances of developing lymphoma—and understanding what they are can help you take action if you ever notice symptoms.
Our Pro Panel
We went to some of the nation’s top experts in lymphoma to bring you the most up-to-date information possible.
Faisal Saghir, M.D.
Hematologist and Medical Oncologist
Northwestern Medicine Kishwaukee Hospital
Dhimant Patel, M.D.
Hematologist and Oncologist
Aurora BayCare Medical Center
Green Bay, WI
Myo Htut, M.D.
Associate Clinical Professor of Hematology
City of Hope Comprehensive Cancer Center
Lymphoma is a cancer of the lymphatic system. Sometimes called a blood cancer, it happens when white blood cells known as lymphocytes mutate and start growing out of control. There are two main types of lymphoma: Hodgkin’s lymphoma and non-Hodgkin lymphoma.
Not in the traditional way, but genes play a role. Genes in your DNA known as “oncogenes” trigger cell growth, while “tumor suppressor genes” slow it down—mistakes and mutations can turn these genes on or off, potentially leading to lymphoma.
Some types and cases of lymphoma are curable! It depends on the type and stage, and how aggressive the cancer is. In fact, Hodgkin’s lymphoma is considered one of the most curable types of cancer.
Yes. Hodgkin’s disease is a type of lymphoma named after Thomas Hodgkin, the doctor who first described it in 1832. The other main type of the disease is known as non-Hodgkin lymphoma.
What Is Lymphoma, Again?
Lymphoma is a cancer of the blood and the lymphatic system—part of your body’s germ-fighting setup that includes lymph nodes (like the ones in your neck that get swollen when you have a bad cold), the spleen, bone marrow, and an immune gland in the chest called the thymus. Lymphoma starts when infection-fighting white blood cells called lymphocytes mutate and start to grow out of control.
There are two main categories of the disease. The first is known as Hodgkin’s lymphoma—also sometimes called “Hodgkin’s disease” and named after Thomas Hodgkin, the doctor who first described it in 1832. An estimated 8,000 Americans are diagnosed with Hodgkin’s lymphoma each year. The second type is called non-Hodgkin lymphoma. It is significantly more common than Hodgkin’s, and affects about 74,000 people each year.
Under those two umbrellas, there are more than 70 different “subtypes” of lymphoma.
Like any cancer, lymphoma is a serious condition, and if you have it, it’s understandable that you feel worried. Here’s what you need to know: Your odds of beating this disease are high—higher than many other forms of cancer. The average five-year survival rate (defined as the percentage of people who live at least five years after diagnosis) for people with Hodgkin’s lymphoma is 87%. The average five-year survival rate for people with non-Hodgkin lymphoma is 71%.
If you’re diagnosed at the earliest stages, you have an even better outlook—a whopping 92% of people with Hodgkin’s lymphoma and 82% with NHL are living their best life five years and beyond after diagnosis.
So, What Causes Lymphoma?
All cancers begin the same way: A rogue cell in your body begins to morph and multiply in ways it’s not supposed to. In lymphoma, it happens with white blood cells known as lymphocytes that grow out of control.
Exactly what triggers these cells to turn cancerous isn’t well understood, but doctors have pinpointed interesting likely genetic causes—plus some other factors that slightly increase risk.
Is Lymphoma Genetic?
In some types of cancer, the genetic component is clear: In breast cancer, for example, we know that a parent can pass down several different gene mutations—like the BRCA1 and BRCA 2 mutations you may have heard of—that greatly increase a child’s chances of getting the disease. With lymphoma, researchers are still trying to get a clear picture of whether or not your parents could play a role.
So far, scientists have not found any clear inheritable gene mutations related directly to lymphoma. That said, one large study done by a coalition of European cancer experts in 2017 pinned down six separate mutations (on genes related to the immune system and auto-immune disorders) that also seem to be linked to Hodgkin’s lymphoma.
There is another way that lymphoma is genetic though—it can cause changes in your DNA’s existing genes that raise your cancer risk. Here’s the deal:
The genes contained in your DNA tell all the cells in your body how to behave.
Genes called “oncogenes” trigger cell growth, while “tumor suppressor genes” slow it down or make cells die off when they are old or damaged.
If there are mistakes and mutations in a person’s DNA, it can turn these genes on or off.
In turn, this can trigger the process of copying damaged cells, increasing the odds of cancer.
Is Family History a Risk Factor?
Family history may be a factor for some people. Even though we don’t know of a specific “lymphoma gene” or mutation that you can inherit from your parents, it does seem to run in some families.
So if you have a parent, sibling, or child with lymphoma, you are at a slightly higher risk for it than someone without close relatives with the disease.
Is Lymphoma Caused by a Virus?
It’s possible, yes. Just like some types of the sexually transmitted humapapillomavirus (HPV) can cause cervical, anal, and throat cancer, the Epstein-Barr virus (EBV) can cause lymphoma in some people.
Epstein-Barr is the virus that causes mononucleosis (also known as “mono”). Nearly everyone in the United States is exposed to it by their late teens, but not everyone gets symptoms. For a very small number of people, EBV will go on to cause lymphoma. Most EBV-related cancers happen in Southeast Asia and Africa, for reasons that are not clear.
Beyond EBV, the hepatitis C virus and HIV (the virus that causes AIDS) are known to increase a person’s risk of getting certain types of the blood cancer, although neither one directly causes lymphoma.
Bacteria and Lymphoma Risk
Helicobacter pylori, the same bacteria that causes stomach ulcers, is linked to a rare type of non-Hodgkin lymphoma known as gastric MALT lymphoma. (MALT stands for mucosa-associated lymphoid tissue). The lining of the stomach usually doesn’t contain any lymphoid tissues, but if someone gets an H. pylori infection, it can grown there as part of the body’s immune system response.
Do Autoimmune Disorders Raise Risk?
Autoimmune conditions are disorders of the immune system in which a person’s body attacks its own tissues the way it would an invading virus or bacteria, causing widespread inflammation and other symptoms.
People with severe cases of certain autoimmune disorders also have a higher risk of lymphoma, including:
Lymphoma and Breast Implants
Textured (or “rough”) breast implant, as opposed to the kind with smooth outer shells, are linked to a very rare type of lymphoma called breast-implant-associated anaplastic large cell lymphoma (BIA-ALCL).
This type of lymphoma grows in the scar tissue around the implant and may spread to nearby lymph nodes. In 2019, the Food and Drug Administration asked a major manufacturer of textured implants to take them off the market. Although the FDA didn’t recommend that women who already have the implants get them removed, it is smart to keep an eye out for symptoms.
The main signs of BIA-ALCL are breast swelling that doesn’t go away, pain in and around the implant, and/or a lump near the implant.
Do Age and Gender Play a Role?
In some cancers—colon and breast cancer, for example—age matters a lot: Both cancers are extremely rare in children and become much more common after age 50. Lymphoma doesn’t work like that.
The odds of getting lymphoma seem to rise at multiple times through a person’s life. Risks for Hodgkin’s lymphoma appear to be highest when you’re in your 20s and then rise again after the age of 55. More than half of people with non-Hodgkin lymphoma are over the age of 65.
Men are slightly more likely to get both Hodgkin’s and non-Hodgkin lymphoma than women. (Doctors aren’t sure why.)
But even though lymphoma is more common in adults than in children, hundreds of kids do develop the disease each year. In fact, non-Hodgkin lymphoma is one of the most common cancers in kids, with about 500 cases diagnosed in children under age 15 annually.
Meanwhile, Hodgkin’s lymphoma is rare in very young children, but it’s the most common cancer in teens. Researchers are still exploring the reasons that these two different types of lymphoma affect kids at different ages, but the important thing to know is that the outlook for kids who get lymphoma is good. The percentage of children who are alive five years after diagnosis is 98% for Hodgkin’s lymphoma and 91% for NHL.
Does Smoking Cause Lymphoma?
Smoking is known to cause 13 different types of cancer, including a blood and bone marrow cancer called acute myeloid leukemia. Studies don’t prove that cigarette smoke causes lymphoma, but results do suggest that smokers have a slightly higher risk of some types of lymphoma than nonsmokers.
Could Pesticides Cause Lymphoma?
Although evidence is still pretty limited, some research suggests that certain pesticides and old-fashioned hair dyes (from the 1970s and earlier) may slightly increase a person’s risk of developing lymphoma.
When you’re diagnosed with something as serious as lymphoma, it’s logical that your first question is, why me? So it’s frustrating to realize how little experts still know about the causes of the disease. And of what we do know, a lot of things like family history or if you have an autoimmune condition are totally out of your control. Deep breath. Through all of the fear and uncertainty, keep your eye on this ball: Lymphoma is a highly treatable (occasionally curable) disease. It’s time to stay calm and get your treatment on.
Hodgkin’s vs. Non-Hodgkin Lymphoma: Moffitt Cancer Center. (n.d.) “Differences Between Hodgkin & Non-Hodgkin Lymphoma.” moffitt.org/cancers/lymphomas-hodgkin-and-non-hodgkin/faqs/hodgkin-lymphoma-vs-non-hodgkin-lymphoma/
Hodgkin’s Survival and Prevalence: American Society of Clinical Oncology. (2019). “Lymphoma - Hodgkin: Statistics.” cancer.net/cancer-types/lymphoma-hodgkin/statistics
Non-Hodgkin Survival and Prevalence: American Society of Clinical Oncology. (2019). “Lymphoma - Non-Hodgkin: Statistics.” cancer.net/cancer-types/lymphoma-non-hodgkin/statistics
Lymphoma Causes: Lymphoma Action. (n.d.) “Causes of Lymphoma.” lymphoma-action.org.uk/about-lymphoma-what-lymphoma/causes-lymphoma
Lymphoma and Genetics: Nature Communications. (2017). “Genome-Wide Association Study of Classical Hodgkin Lymphoma Identifies Key Regulators of Disease Susceptibility.” nature.com/articles/s41467-017-00320-1#Abs1
Age and Hodgkin’s Lymphoma: American Cancer Society. (2018). “Key Statistics for Hodgkin Lymphoma.” cancer.org/cancer/hodgkin-lymphoma/about/key-statistics.html
Age and Non-Hodgkin Lymphoma: American Cancer Society. (2020). “Key Statistics for Non-Hodgkin Lymphoma.” cancer.org/cancer/non-hodgkin-lymphoma/about/key-statistics.html
Kids and Non-Hodgkin Lymphoma: American Society of Clinical Oncology. (2018). “Lymphoma: Non-Hodgkin Childhood Statistics.” cancer.net/cancer-types/lymphoma-non-hodgkin-childhood/statistics
Kids and Hodgkin’s Lymphoma: American Society of Clinical Oncology. (2010). “Lymphoma: Hodgkin Childhood Statistics.” cancer.net/cancer-types/lymphoma-hodgkin-childhood/statistics
Breast Implants and Lymphoma: Cleveland Clinic. (2019). “Breast Implant-Associated Anaplastic Large Cell Lymphoma.” my.clevelandclinic.org/health/diseases/21078-breast-implant-associated-anaplastic-large-cell-lymphoma
FDA Breast Implant Recall: U.S. Food and Drug Administration. (2019). “Questions and Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).” fda.gov/medical-devices/breast-implants/questions-and-answers-about-breast-implant-associated-anaplastic-large-cell-lymphoma-bia-alcl
H. Pylori and Lymphoma: National Cancer Institute. (2013). “Helicobacter pylori and Cancer.” cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/h-pylori-fact-sheet#what-is-gastric-mucosa-associated-lymphoid-tissue-malt-lymphoma-and-what-is-the-evidence-that-it-can-be-caused-by-h-pylori-infection