What is the most common early symptom of lymphoma?

The most common sign of lymphoma is a lump or lumps, usually in the neck, armpit or groin. These lumps are swollen lymph nodes, sometimes known as 'glands'. Usually, they're painless. Fatigue is different to normal tiredness.

lymphoma-action.org.uk - Symptoms of lymphoma

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Common symptoms of lymphoma

We outline the common symptoms of lymphoma below. However, it’s important to note that these can have other causes. Having one or more doesn’t necessarily mean that you have lymphoma.

Swollen lymph nodes

The most common sign of lymphoma is a lump or lumps, usually in the neck, armpit or groin. These lumps are swollen lymph nodes, sometimes known as ‘glands’. Usually, they’re painless.

Fatigue

Fatigue is different to normal tiredness. It means feeling exhausted for no obvious reason or feeling washed out after doing very little.

Unexplained weight loss

Losing a lot of weight quite quickly without trying to can be a symptom of lymphoma.

Infections

Getting infections more easily and having difficulty getting rid of them can be a symptom of lymphoma.

Sweats

Sweats can happen at any time of the day with lymphoma, but they are most common at night. They are often described as ‘drenching’ and can make your nightclothes or bed sheets soaking wet.

Itching

Itching (‘pruritus’) without a rash can be a symptom of lymphoma. It can be very uncomfortable, particularly when you get hot.

Fever

Some people get fevers (temperatures above 38°C or 100.4°F). Fevers often come together with night sweats and weight loss, but they can happen separately. They can also be a sign of infection. Watch Dr Andrew Davies, Consultant in Medical Oncology, talk about the most common symptoms of lymphoma

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B symptoms

You might hear the term ‘B symptoms’. This means that you have:

Doctors often use these during staging (working out how many different parts of your body are affected by lymphoma). B symptoms are more common with some types of lymphoma than others. Doctors will take account of whether you have any B symptoms when they plan your treatment.

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‘Local’ and ‘systemic’ symptoms

Symptoms of lymphoma can be:

local, which means that they affect just one area of your body

systemic, which means that they affect the whole of your body.

Local symptoms

Local symptoms affect the area in and around the lymphoma itself.

The most common local symptom is a swollen lymph node or nodes. Other local symptoms are caused by swollen nodes pressing on nearby tissues. The symptoms you have depend on where the swollen lymph nodes are. You might have:

Less common symptoms include:

pain

symptoms that affect the brain and nerves, such as fits (seizures), dizziness or weakness in an arm or leg.

Systemic symptoms

Systemic symptoms affect your whole body. They can include:

Systemic symptoms are more common with Hodgkin lymphoma and high-grade non-Hodgkin lymphoma. They are less common in people with low-grade non-Hodgkin lymphoma.

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Swollen lymph nodes

Lymph nodes help to fight infection. They can become swollen for lots of reasons (for example, having an infection such as a cold), even when they’re working as they should. A swollen lymph node or nodes is the most common symptom of lymphoma. However, there are many other possible causes of swollen lymph nodes. Most people who have swollen lymph nodes do not have lymphoma. Also, a cyst or harmless fatty growth can sometimes look a bit like a swollen lymph node. If you notice a lump that doesn’t go away within 2 to 3 weeks, or you find that a lump is getting bigger, see your GP. It isn’t possible to tell if someone has lymphoma just by feeling a lymph node. However, your GP can examine you to check whether they should refer you for further tests and scans. Lymph nodes in the neck, armpit or groin are close to the surface of the skin and are easy to see and feel. Others that are deep inside the chest or tummy (abdomen), can’t be felt from the outside. They might only be found on a scan. They can cause pain if they swell and press on tissues inside your body.

Swollen lymph nodes caused by lymphoma:

are most commonly found in the neck, armpit or groin

are usually smooth and round

usually move out of the way when you press on them (are ‘mobile’)

have a ‘rubbery’ texture

are usually painless – although they can sometimes ache or cause pain in nearby areas (for example, if they’re pressing on a nerve)

can become very large.

Rarely, swollen lymph nodes can become painful soon after drinking alcohol. This affects up to 5 in 100 people with Hodgkin lymphoma.

Where might lymphoma cause swollen lymph nodes?

Swollen lymph nodes might be in just one area of your body. This can happen with any type of lymphoma. You might have swollen lymph nodes spread throughout your body (‘generalised lymphadenopathy’), which is more common in non-Hodgkin lymphoma than Hodgkin lymphoma.

Why does lymphoma cause swollen lymph nodes?

Swollen lymph nodes in lymphoma are caused by a build-up of cancerous cells in the lymph nodes. Sometimes the lymphoma is active, which means that it’s making lots of cancerous cells. At other times, it’s less active, and some of the lymphoma cells die. Lymph nodes sometimes grow (during times of high activity) and shrink (when activity is lower), especially in people with low-grade non-Hodgkin lymphoma.

What else can cause swollen lymph nodes?

There are many other possible causes of swollen lymph nodes, including:

infections, such as coughs, tonsillitis, colds, ear and throat infections

illness that affect the immune system, such as rheumatoid arthritis

skin conditions, such as eczema or psoriasis

some medicines, including penicillin, drugs used to treat epilepsy (phenytoin and carbamazepine), cephalosporins (a type of antibiotic) and the covid-19 vaccination.

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Fatigue

Fatigue is exhaustion that can be physical, emotional or mental. You might feel tired after doing very little. Sometimes, people describe it as ‘debilitating’ or feeling ‘drained of energy’. Fatigue can be a symptom of lymphoma and there are lots of possible reasons for this. However, there are many other possible causes of fatigue. For example: anaemia (a low number of red blood cells), an underactive thyroid gland, depression, anxiety, chronic fatigue syndrome (CFS or ‘ME’) and glandular fever.

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Unexplained weight loss

Unexplained weight loss means losing weight over a short amount of time without trying to. The NHS advises that you see your GP if you lose more than 5% of your normal body weight over 6 to 12 months. For an average person, this means losing around half a stone (7lbs or 3kg) or more. People with lymphoma can lose over 10% of their body weight within 6 months. For example, someone with lymphoma who usually weighs 11 stone (70kg) might lose 15lbs (7kg) or more. Speak to your GP if you lose a lot of weight over 6 to 12 months without trying to. Lymphoma can cause weight loss because cancerous cells use up your energy resources. At the same time, your body uses energy trying to get rid of the cancerous cells. Weight loss is more common with fast-growing (high-grade) lymphomas as these can put a sudden demand on your body.

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Lymphoma is just one of the possible causes of unexplained weight loss. As with many other symptoms, weight loss can happen for a lot of other reasons, such as stress, depression, digestive problems, or an overactive thyroid gland.

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Night sweats

Lymphoma can cause night sweats that make your nightclothes and bedsheets soaking wet. They are often described as ‘drenching’. Although they are usually called night sweats, they can also sometimes happen during the day. Any type of lymphoma can cause night sweats, though doctors don’t really know why. One possibility is that they happen as part of your body’s reaction to chemicals the lymphoma cells produce. Another is that they are a natural response to your body’s temperature rising above a normal level (fever) – as sweating is a way of cooling your body down. Night sweats can have other causes, such as infection, anxiety, menopause, overactive thyroid gland and some medicines. Speak to your doctor if you have night sweats that wake you up or if you also have other symptoms, such as fever or unexplained weight loss.

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Itching

Itching (‘pruritus’) is much more common with Hodgkin lymphoma than non-Hodgkin lymphoma.

Itching caused by lymphoma can affect:

areas of skin near lymph nodes that are affected by lymphoma

patches of skin lymphoma

your lower legs

your whole body.

It can be severe and might also cause a burning sensation. It’s uncommon to have a rash with it, unless you have skin lymphoma. Itching can be very uncomfortable, particularly in the heat. It is usually worse at night in bed. If you have a diagnosis of lymphoma and you are struggling with itching, there are things you could try that might help. Speak to your medical team for advice. Itching in lymphoma is thought to happen because of your body’s reaction to chemicals released by your immune system in reaction to the lymphoma. These chemicals irritate the nerves in your skin and make it itch. Although itching is common in people with lymphoma, having itchy skin does not necessarily mean you have lymphoma. Itching can have many different and far more common causes, including allergies, skin conditions such as eczema, skin infections or menopause.

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Fever

Fever is high body temperature of 38°C or 100.4°F or over. It is almost always caused by an infection, but there are a few other less common causes, including lymphoma. With lymphoma, fevers are usually mild (low-grade). This means that they are only a little over normal body temperature. Usually, these fevers come and go. Lymphoma causes fevers because the lymphoma cells produce chemicals that raise your body temperature.

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Difficulty recovering from infections

Having lymphoma can mean that your immune system is weakened.

Normally, white blood cells fight infections. If you have lymphoma, cancerous white blood cells (that make up the lymphoma) are produced instead of the healthy white blood cells. This can make you develop infections more easily. The infections could be more severe or last for longer than they would normally. Infections often cause a high temperature and make you feel hot and shivery. Other symptoms depend on where in your body you have the infection – for example, you might have an earache, a cough, a sore throat, pain when you wee, or sickness and diarrhoea. See your GP if you’re worried that you’re not getting better after a minor infection.

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Chest symptoms

Swollen lymph nodes in the chest are quite common in Hodgkin lymphoma and some types of high-grade non-Hodgkin lymphoma. However, any type of lymphoma can cause them. Swollen lymph nodes in the chest can press on your airways and lungs. They can also cause fluid to collect around your lungs.

Swollen lymph nodes in the chest can cause symptoms such as:

dry cough

shortness of breath

noisy breathing

pain behind the breastbone

a feeling of pressure in the chest.

These can be worse when you lie down.

If you have a cough or shortness of breath that lasts for more than 3 weeks, speak to your GP. Swollen lymph nodes that press against blood vessels can lower the blood flow through them. This can cause swelling and, in some cases, can increase the risk of a clot forming.

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Tummy (abdominal) symptoms

Lymphoma can develop in lymph nodes in the abdomen or lymphatic tissue in your liver or spleen. It can also develop outside your lymphatic system (‘extranodal’ lymphoma). The gut is the most common place for extranodal lymphoma to develop.

Symptoms depend on which parts of your body are affected. For example:

If your spleen is very swollen, you might have pain behind your ribs on the left side, or you might feel bloated or full after eating only a little. You or your doctor might be able to feel the swollen spleen as a lump in the top left side of your tummy. If you have lymphoma affecting your liver, your tummy might become swollen and the whites of your eyes and your skin might develop a yellow tinge (jaundice). Lymphoma affecting your liver might also cause you to feel bloated, which can happen from a build-up of fluid in your abdomen. Lymphoma in the stomach can cause swelling of the stomach lining (gastritis), which can cause pain or nausea (feeling or being sick).

Lymphoma in the bowel can cause abdominal pain, diarrhoea or constipation.

See your GP urgently if your skin or the whites of your eyes look yellow.

Speak to your GP if you have any of the following symptoms:

blood in your poo

a change in bowel habits (such as diarrhoea or constipation) that goes on for more than 7 days

green or yellow vomit

vomiting lasting more than 2 days

vomiting that causes you to become dehydrated by being unable to drink liquids without vomiting.

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Pain

Lymphoma isn’t usually painful but sometimes, swollen nodes press on other tissues and nerves which can cause pain. Lymphoma in the bone itself (rather than in the bone marrow) is rare but when it does happen, it can cause pain in the affected bone.

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Skin symptoms

Lymphoma can cause itchy skin.

If you have skin lymphoma, you might have symptoms that affect your skin. Common symptoms depend on the type of skin lymphoma, but could include:

lumps, which are often a purple colour

patches of skin that are dry, red, scaly or itchy

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patches of skin that are different to other areas – for example, are flatter, shiny, raised, scaly or red. Lymphoma in the skin can look a lot like other skin conditions, such as eczema or psoriasis. If you have been diagnosed with skin lymphoma, you might be interested in our information about living with skin lymphoma.

Speak to your GP urgently if you have a rash that:

starts suddenly and spreads quickly

is all over your body

comes with other symptoms such as pain, fever of breathlessness.

If you have a new rash that doesn’t go away within a few days, seek advice from your GP.

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Brain and nerve symptoms

Symptoms that affect your brain and nerves depend on where the lymphoma is.

Lymphoma that affects your central nervous system (CNS)

Central nervous system lymphoma is an uncommon type of lymphoma that is in your brain, spinal cord or eyes (your central nervous system, or CNS). Symptoms depend on where the lymphoma is, but can include:

fits (seizures)

problems with balance

dizziness

difficulties with memory and concentration

weakness or tingling in an arm or leg.

Lymphoma that affects your peripheral nervous system

Other types of lymphoma can cause damage to the nerves outside of the brain and spinal cord (the peripheral nervous system). This is called peripheral neuropathy. Symptoms of peripheral neuropathy depend on which group of nerves are affected. They can include: pins and needles, numbness or a burning sensation, often in the hands or feet

pain

increased sensitivity to touch or temperature

muscle twitches (small muscle contractions).

Tell your GP if you have any of these symptoms.

Peripheral neuropathy can happen if the lymphoma produces chemicals that stick to nerves and damage them. It is quite common in people with Waldenström's macroglobulinaemia (WM). Rarely, lymphoma spreads into the nerves. It can push up against them or grow around the tiny blood vessels that supply them. This can cause symptoms of peripheral neuropathy. Peripheral neuropathy can also affect the nerves of your autonomic nervous system, which carry messages between your brain and your internal organs. This can cause symptoms such as blood pressure changes and light-headedness.

Thinking processes (cognition)

Lymphoma can affect thinking processes (cognition) such as memory, attention and speed of response. This is known as cancer-related cognitive impairment (‘chemo brain’). However, anyone with lymphoma might be affected, not only people treated with chemotherapy. Fatigue or emotional factors, such as stress and anxiety, can also have an impact.

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Swelling in the arms or legs (lymphoedema)

Swollen lymph nodes can sometimes block the lymphatic vessels (tubes that run throughout your body and carry lymph fluid). This stops the lymph fluid draining properly from the tissues in your body. The lymph fluid can then build up, causing lymphoedema (swelling in the body’s tissues). Possible symptoms include swelling, feelings of tightness, heaviness, aching or soreness. It usually affects an arm or a leg, although it can affect other areas of your body, depending on where the lymphoma is. Other conditions can also cause lymphoedema. For example, infection, injury, genetic conditions and surgery.

If you have any symptoms of lymphoedema, speak to your GP.

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Anaemia

Many people with lymphoma are affected by anaemia at some point during their illness. Anaemia means that you have a shortage of red blood cells. This can make you feel tired and breathless because your body has to work harder than usual to get enough oxygen. You might experience anaemia if lymphoma affects your red blood cells, for example: Lymphoma in the bone marrow can affect the production of healthy blood cells, leading to anaemia.

Lymphoma in the gut can cause bleeding, which can lead to anaemia.

If red blood cells collect in the spleen or get destroyed in the spleen, this can cause anaemia.

Symptoms of anaemia can include:

weakness and tiredness

dizziness

headache

fluttering or pounding heart (palpitations)

a paler skin tone than is usual for you.

If you experience symptoms of anaemia, contact your GP.

There are lots of other causes of anaemia, including nutritional deficiencies (particularly iron), heavy periods, pregnancy and some infections.

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Frequently asked questions about symptoms of lymphoma

In this section, we answer some of the common questions about symptoms of lymphoma. If you have been diagnosed with lymphoma, seek guidance about symptoms from your medical team. If you have not been diagnosed with lymphoma, speak to your GP for advice.

What are the most common symptoms of lymphoma?

Lymphoma can cause many different symptoms, depending on its type and where it is in your body. The most common symptoms of lymphoma are:

Will I get all of the symptoms of lymphoma?

There are over 60 types of lymphoma, broadly divided into Hodgkin lymphoma and non-Hodgkin lymphoma. These lymphomas can start almost anywhere in the body and can have many different symptoms. The exact symptoms they cause depend on the type of lymphoma and where it is in the body. Even with the same type of lymphoma, different people are affected differently. For example: You might have lots of symptoms or only a few symptoms. Sometimes lymphoma is discovered during tests for something else and you might not have had any symptoms at all. You might have symptoms in one area (local symptoms) or symptoms that affect your whole body (systemic symptoms).

You might feel generally well or you might become very unwell quickly.

I haven’t been diagnosed with lymphoma but I’m concerned about symptoms – what should I do?

If you are concerned about any symptoms you’re experiencing, speak to your GP. You might find it helps to keep a note of your symptoms and how they’re affecting you. You could have this with you when you speak to your GP so that you remember everything you want to discuss. If your GP suspects lymphoma, you might be referred for tests and scans. If you would like to speak to a member of our helpline team about any aspect of lymphoma, contact us for support.

I have been diagnosed with lymphoma and I’m finding my symptoms difficult to cope with – what can I do?

Speak to a member of your medical team for advice about how to manage symptoms of lymphoma. Depending on the symptom and how it’s affecting you, they might be able to offer tips, treatment, or a referral to another health professional. You might also be interested in our information about coping with symptoms of lymphoma; however, check with a member of your medical team whether the approaches outlined are suitable for you.

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lymphoma-action.org.uk - Symptoms of lymphoma

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