How to Spot Lymphoma Symptoms in Women

"Lymphoma" is a general term used to describe diseases of the lymphatic system. The lymphatic system is part of the body's immune system and helps fight infection. There are two categories of lymphoma: Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL).

Lymphoma symptoms in women can mimic other gynecologic health conditions and hormonal changes. Although women are slightly less likely to get lymphoma than men, their symptoms may be overlooked. This can delay diagnosis and treatment.

This article will describe the signs of lymphoma and discuss how lymphoma symptoms in women differ from men.

General Symptoms of Lymphoma

Enlarged lymph nodes, called lymphadenopathy, are a common lymphoma symptom that brings people to a healthcare provider. Other side effects of lymphoma include:

• Fever
• Fatigue
• Night sweats
• Weight loss

Some of these symptoms are called B symptoms. Oncologists (cancer doctors) use B symptoms to determine the stage and prognosis of certain lymphomas. B symptoms resolve with lymphoma treatment. B symptoms include:

• Fever without an infection, which comes and goes over several weeks
• Drenching night sweats
• Unintentional weight loss of at least 10% of your body weight over a six month period

Swollen Lymph Nodes

Noticing a new lump on the neck, collar bone, armpit, or groin area is common in people who have lymphoma. These lumps are usually enlarged lymph nodes. The overproduction of cancerous cells and lymphocytes, a type of white blood cell (WBC), collects in the lymph nodes forming a firm and painless lump.

Some enlarged lymph nodes may be deep in the body, unable to be felt with your fingers. However, if they are large enough, they can push on organs like the stomach or lungs. This can make it difficult to eat or breathe.

You should report any new lumps or bumps to your healthcare provider.

Fever

Having a fever is often a sign of infection. In lymphoma patients, however, fever is considered a B symptom. The exact reason for fevers in people with lymphoma is unknown. One study describes B symptoms like fever as inflammatory responses to cancer cells. Lymphoma fevers not related to infection are known to come and go, are low grade, and cause night sweats.

Keep in mind that although there is an overproduction of WBCs in lymphoma, the cells do not function properly and can result in a weakened immune system. Therefore, an infection should always be treated in those with cancer to prevent sepsis (severe blood infection).

Fatigue

Fatigue is a common side effect of lymphoma. It can be subtle, or it can be extreme. Fatigue happens because cancerous cells and lymphocytes divide rapidly, leaving little room in the bloodstream and organs for healthy cells to reproduce. A few abnormalities leading to fatigue in lymphoma include:

• Anemia (low red blood cells)
• Thrombocytopenia (low platelets)
• Neutropenia (lack of healthy WBCs)
• Hypercalcemia (too much calcium in the blood)
• Sepsis

Let your healthcare provider know should you have worsening fatigue, especially combined with enlarged lymph nodes, fever, and existing fatigue.

Night Sweats

Night sweats are a B symptom that can indicate the severity of some lymphomas. These night sweats are drenching and can be accompanied by fever and chills. Most people must change their bedding and clothes due to the intensity of lymphoma night sweats. Profuse sweating can also happen during the day.

Having night sweats does not mean you have lymphoma. Always have new and unusual symptoms evaluated.

Weight Loss

Although weight loss usually is welcomed, unexpected weight loss in conjunction with other B symptoms can be a sign of lymphoma. A weight loss of at least 10% over a six month period qualifies as a lymphoma B symptom. Following are reasons lymphoma causes weight loss:

• Loss of appetite, or feeling full
• Pain or discomfort from enlarged internal lymph nodes
• Enlarged lymph nodes compressing the esophagus or stomach and making it difficult to swallow or get food down
• Being fatigued and lacking energy to make meals and eat
  

Symptoms Specific to Women

Women and men share most common lymphoma symptoms. However, some side effects experienced by women are subtle and may be excused as being regular female life changes. Pelvic pressure, unusual bleeding, and painful sex are mistaken for hormonal fluctuations or can be signs of other gynecological cancers such as cervical or ovarian cancer.

Pelvic Pressure

Lymphoma affects many organs, including the female genital tract. Women with lymphoma of the female genital tract can be free of symptoms initially, but pelvic pressure is a common complaint as the cancer grows. Since lymphoma of the genital tract is rare, most women with pelvic pressure are usually treated by a gynecologist, who may attribute this symptom to something other than lymphoma.

Uterine Bleeding

Gynecologic lymphomas can result in vaginal bleeding and irregular menstruation. One study found that without B symptoms, women with gynecologic lymphomas were initially thought to have other gynecologic cancers, making diagnosis difficult and time-consuming.

Having regular visits with your gynecologist can help determine what is normal for your body and what may be concerning.

Pain During Sex

One or more pelvic masses, especially if increasing in size, can lead to painful intercourse. Women may also experience abdominal distension (pressure) and bloating with gynecologic lymphomas. These changes may occur over time with slower-growing lymphomas but may happen overnight with aggressive types like diffuse large B-cell lymphoma.

Why Is Lymphoma Difficult to Diagnose in Women?

Naturally occurring hormonal changes such as puberty, pregnancy, and menopause can make identifying lymphoma symptoms in women difficult. Enlarged lymph nodes may go unnoticed or unreported. Fatigue is an everyday occurrence for many women and is often considered normal.

Lymphoma night sweats can be misinterpreted as hot flashes. Weight loss can be intended and desired. Pelvic pain, bleeding, and painful sex can be attributed to normal fluctuations in hormone levels based on age.

In addition, the lack of routine follow-up care by many women makes it challenging to establish normal vs. abnormal changes in the body.

When to See a Healthcare Provider

It's essential for women to participate in yearly preventive health screenings. This practice can build a trusting relationship between women and their healthcare providers. Having blood work, imaging, and documented physical exams to compare from visit to visit is valuable, as well. Establishing routine care assists your healthcare provider in identifying and diagnosing new symptoms quicker.

Report any enlarged lymph nodes, B symptoms, or new pain immediately to your healthcare provider.

Diagnosis

Since lymphoma has many subtypes, an accurate diagnosis is crucial to receiving proper treatment. Women and men will undergo the same diagnostic testing. Some steps to diagnose lymphoma include:

• Lymph node biopsy: Once an enlarged lymph node has been identified, a radiologist or a surgeon will perform either a needle biopsy (removing a piece of the lymph node) or an excisional biopsy (removal of the entire lymph node). The lymph node tissue will be sent to a pathologist for review and diagnosis.
• Pathology tests: The lymph node tissue will undergo many tests to find what type of lymphoma you have, what genetic mutations might be making the cancer grow, and what treatment is best for that type of lymphoma. This evaluation can take seven to 14 days.
• Bone marrow biopsy: This test helps identify where cancer has spread and is important for staging. These bone marrow samples are also sent to the pathologist for evaluation.
• Imaging: Although the lymph node biopsy determines what type of lymphoma you have, special imaging tests help verify where the lymphoma is in your body and how big the tumors are. Standard imaging for lymphoma may include a chest X-ray, computed tomography (CT) scan, positron-emission tomography–computed tomography (PET-CT) scan, magnetic resonance imaging (MRI), and ultrasound.
• Lumbar puncture (LP) or spinal tap: Some lymphomas can travel to your spinal fluid and affect your brain, which is important to know when deciding a treatment plan.
• Blood tests: Certain blood tests can help determine how advanced or serious the lymphoma is.

It may feel frustrating and scary waiting for the test results, but it's essential to understand your lymphoma before starting treatment.

Treatment

Treatment for lymphoma in women and men are based on several factors, including:

• Type of lymphoma
• Cancer genetics
• Stage of the lymphoma
• Medical history
• Overall health
• Quality of life considerations

Although the medications used to treat lymphoma vary based on the above factors, the usual regimen may contain a combination of chemotherapy, immunotherapy (helps your own immune system fight cancer), steroids, radiation, and surgery.

Women with gynecologic lymphomas may need a hysterectomy (removal of the uterus), bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes), and removal of tumors from the pelvic area. A surgeon who specializes in gynecology and oncology performs this surgery.

Some people with lymphoma may be matched with a clinical trial in hopes of receiving new and cutting-edge medications. After treatment, some people may need a bone marrow transplant or CAR-T therapy (exchanging a patient’s T cells, a type of immune system cell, with manufactured T cells to fight cancer cells) if lymphoma comes back.

Not everyone with lymphoma needs treatment. For example, slow-growing lymphomas causing minimal symptoms may only need to be monitored with blood work, imaging, and physical exams.

Summary

Lymphoma is a general term describing diseases of the lymphatic system. Although men are slightly more likely to get lymphoma, women can have subtle symptoms that make diagnosis more difficult. Gynecologic lymphomas can mimic hormonal changes seen with puberty, pregnancy, and menopause.

Although treatment of lymphoma is similar for both genders, women may need gynecologic surgeries in addition to systemic cancer treatment. Establishing routine follow-up visits and participating in preventive health screenings can assist healthcare providers in identifying early lymphoma symptoms in women.

A Word From Verywell

Knowing intuitively that something in your body is amiss but not reporting it due to shame, guilt, or worry are common barriers to diagnosing curable illnesses like lymphoma. Finding a healthcare provider you can trust is essential to your health and well-being. Asking friends and family for referrals, looking at online reviews, and speaking with your insurance company representative are ways you can find a trustworthy healthcare provider.