While it is possible to get cancer that originates in the spleen, known as primary spleen cancer, it is rare. When individuals refer to “spleen cancer,” they are more commonly discussing cancers that either start elsewhere in the body and spread to the spleen or systemic blood cancers that involve the spleen.
Understanding Cancers Involving the Spleen
The spleen is an organ that plays a role in the lymphatic system, filtering blood and helping the body fight infections. Primary spleen cancers, such as splenic marginal zone lymphoma (SMZL) and angiosarcoma, are uncommon. SMZL, a type of non-Hodgkin lymphoma, accounts for less than two percent of all lymphomas, while primary splenic angiosarcoma is an aggressive and rare vascular tumor.
The spleen is more frequently involved in systemic blood cancers like lymphomas and leukemias. Non-Hodgkin lymphomas, including diffuse large B-cell lymphoma and follicular lymphoma, commonly involve the spleen. Hodgkin lymphoma can also spread to the spleen, though it typically begins in the lymph nodes.
Leukemias, which are cancers of the blood and bone marrow, can also lead to spleen involvement. Various types of leukemia can cause an enlarged spleen. In these conditions, abnormal white blood cells can accumulate in the spleen, leading to its enlargement and affecting function.
Metastatic cancer from other organs can also spread to the spleen, although this is less common than involvement in blood cancers. Cancers originating in sites such as the breast, lung, stomach, pancreas, liver, and colon can metastasize to the spleen. This occurs when cancer cells break away from the primary tumor and travel through the bloodstream or lymphatic system to the spleen.
Recognizing Potential Symptoms
Symptoms indicating spleen involvement in cancer can vary and are often non-specific. A common sign is an enlarged spleen, medically known as splenomegaly, which can sometimes be detected during a physical examination. If the spleen becomes significantly enlarged, it might cause pain or discomfort in the upper left abdomen, sometimes described as a feeling of fullness or pressure behind the ribs.
An enlarged spleen can also press on the stomach, leading to early satiety. Other general symptoms include unexplained weight loss, persistent fatigue, fever, and night sweats. While these symptoms warrant medical evaluation, they are not exclusive to spleen cancer and can be present in many other illnesses.
Diagnosis and Evaluation
Diagnosing cancer involving the spleen begins with a thorough physical examination, where a doctor may gently palpate the abdomen to check for an enlarged spleen. Blood tests are then ordered. A complete blood count (CBC) can reveal abnormal levels of white blood cells, red blood cells, or platelets, which can indicate a blood cancer or other underlying issue.
Imaging tests are then used to visualize the spleen and surrounding areas. An ultrasound can provide initial images of the spleen’s size and any obvious abnormalities. More detailed imaging, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI), can offer a comprehensive view of the spleen, detect any masses, and assess for enlarged lymph nodes or other affected organs.
In cases where lymphoma or leukemia is suspected, a bone marrow biopsy may be performed. This involves taking a small sample of bone marrow to examine for cancer cells. A lymph node biopsy may also be conducted if enlarged lymph nodes are present. A direct spleen biopsy is less common due to the risk of bleeding, but it may be considered in specific situations, especially for diagnosing rare primary splenic tumors.
Treatment Approaches
Treatment for cancers involving the spleen is individualized, depending on the specific cancer type, its stage, and the patient’s overall health. Since spleen involvement is often secondary to blood cancers or metastatic disease, the primary treatment strategy targets the underlying cancer. Chemotherapy is a common approach.
Radiation therapy may also be employed, especially if the spleen is significantly enlarged and causing symptoms. Immunotherapy and targeted therapy are newer approaches that use the body’s own immune system or drugs that specifically target cancer cells to fight the disease. These therapies offer more precise ways to combat cancer with potentially fewer side effects.
In some instances, splenectomy, the surgical removal of the spleen, may be recommended. This procedure is considered if the spleen is severely enlarged, causing discomfort or other complications, or if it is the primary site of a rare tumor. Splenectomy can help alleviate symptoms and, in certain cases, contribute to the overall management of the cancer. Treatment plans are always tailored to the individual patient’s needs and the characteristics of their specific cancer.