Six Symptoms of Dying from Lymphoma

Recognizing the Signs and Symptoms of the End of Life for People with Lymphoma

1. Fatigue

Fatigue is one of the most common symptoms in the final stages of lymphoma. Cancer-related fatigue is often described as a deep exhaustion that doesn’t improve with rest. It is much more severe than normal tiredness and can make even small tasks like talking or sitting up feel impossible.

Research shows that up to 98% of people with cancer experience extreme fatigue in the last days of life. Unfortunately, most medications don’t help treat fatigue, but short-term use of steroids like dexamethasone may provide temporary relief.

2. Bone Marrow Failure Effects

The bone marrow is where infection-fighting white blood cells, oxygen-carrying red blood cells, and platelets that assist in blood clotting are made. When lymphoma progresses, it can cause changes in blood cell counts, leading to complications.

Anemia occurs when there aren’t enough red blood cells, reducing oxygen supply to cells and organs. This can cause people to feel tired and short of breath. Sometimes, a blood transfusion may help improve energy and quality of life, but the benefits don’t usually last long.

Low platelet counts (thrombocytopenia) can lead to easy bruising and bleeding. A platelet transfusion might help reduce bleeding. Since platelets have a short lifespan in the body, this benefit also doesn’t last long.

A lack of healthy white blood cells can lead to infection.

3. Breathing Changes

Breathlessness is a distressing symptom that becomes more common in the final stages of lymphoma. It can be caused by enlarged lymph nodes or fluid buildup in the chest, restricting air movement in the lungs. It can feel like a constant struggle for air, making simple activities difficult.

Managing breathlessness may involve medications, oxygen therapy, or interventions to improve anxiety and discomfort.

4. Pain

Pain in the final stages of lymphoma can occur if the cancer spreads into areas that put pressure on bones, nerves, or other organs. While not everyone will experience severe pain, it can be managed with medications and other treatments.

Care and Support During End Stages

Care during the final stages of lymphoma involves focusing on comfort and quality of life. It is important to have open and honest communication between the person with lymphoma, their caregivers, and the healthcare team to ensure the patient’s desires are known and can be met when the time comes.

Hospice care is a service that specializes in end-of-life care. The hospice team provides care at home or in a facility. Hospice care has been shown to improve quality of life at the end stage. In addition to giving palliative care (providing comfort and dignity) to the dying individual with lymphoma, hospice also offers emotional support to caregivers, which is also important during this difficult time.

Summary

Common signs and symptoms of dying from lymphoma include extreme fatigue, breathing changes, and digestive changes such as lack of appetite. Some people may have pain and confusion. Hospice care can provide support to the dying person and their caregivers at the end of life.

Sources

• Crawford et al. (2021). Care of the adult cancer patient at the end of life: ESMO clinical practice guidelines. Open. 6(4), 100225.
• Lymphoma Action. Lymphoma and the end of life.
• American Cancer Society. Signs and symptoms of non-Hodgkin lymphoma.
• Johnson et al. (2022). End-of-life care for older adults with aggressive non-Hodgkin lymphoma. Journal of Palliative Medicine. 25(5), 728.
• Gao et al. (2021). Causes of death and effect of non-cancer-specific death on rates of overall survival in adult classic Hodgkin lymphoma: a population-based competing risk analysis. BMC Cancer. 21(1), 955.
• Sarkozy et al. (2019). Cause of death in follicular lymphoma in the first decade of the rituximab era: a pooled analysis of French and US cohorts. JCO. 37(2), 144-152.